Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
Pathol Res Pract. 2021 Nov;227:153644. doi: 10.1016/j.prp.2021.153644. Epub 2021 Oct 5.
Angiogenesis produced by tumor microenvironment is play an important role in development of esophageal squamous cell carcinoma (ESCC). As a quantitative index of angiogenesis, literature has emerged contradictory results about the prognostic role of microvessel density (MVD) in ESCC. The aim of the study was to explore the impact of the correlation between MVD and the prognosis of ESCC based the published evidence.
Pubmed and Web of science database were screened for the relationship of MVD with prognostic feature in ESCC up to March, 2021. 11 relevant articles were used for meta-analysis. The following data were extracted from the literature: author, year, country, the patients number of high/low MVD, tumor-node-metastasis (TNM) classification, clinical stage, lymphoid infiltrates, vessel invasion, invasive depth, differential degree and survival rate. The hazard ratio (HR) and odds ratios (OR) with 95% CI were used to assess the associations between MVD and overall survival (OS). Chi-squared test and I statistics were completed to evaluate the heterogeneity in our study. A random-effects model was used when significant heterogeneity existed (I>50% and p < 0.05). Egger test was used to calculate the publication bias. Subgroup analysis was stratified by antibody, region, sample capacity to explore the source of heterogeneity.
11 studies with 1055 patients were analyzed. Our results suggested that high MVD is an important factor to advanced TNM classification and clinical stage, and the high MVD is positive correlation with the lymph node invasion and vascular invasion(p < 0.05) in ESCC, but irrelevant to poor differential and invasive depth(p > 0.05). The result also indicated that low MVD is a benefit factor to prolong the survival rate (p < 0.05). And the source of the heterogeneity maybe is that the antibody used to detect the MVD was not consistent, patient number was not large enough and the count method on MVD.
Across multiple studies, high MVD is correlated with clinicopathological criteria of poor prognosis and survival in ESCC. MVD could be the quantitative index to reactive angiogenesis and may play a pivotal role in ESCC development and progression. MVD may represent a valuable addition to current pathologic analysis and help to guide prognosis and treatment.
肿瘤微环境产生的血管生成在食管鳞状细胞癌（ESCC）的发展中起着重要作用。微血管密度（MVD）作为血管生成的定量指标，文献中关于其在 ESCC 中的预后作用存在相互矛盾的结果。本研究旨在根据已发表的证据探讨 MVD 与 ESCC 预后之间的相关性。
检索 Pubmed 和 Web of science 数据库，以确定 MVD 与 ESCC 预后特征之间的关系，检索时间截至 2021 年 3 月。共纳入 11 篇相关文献进行荟萃分析。从文献中提取以下数据：作者、年份、国家、MVD 高/低的患者数量、肿瘤-淋巴结-转移（TNM）分期、临床分期、淋巴细胞浸润、血管浸润、浸润深度、分化程度和生存率。使用风险比（HR）和比值比（OR）及其 95%置信区间（CI）评估 MVD 与总生存率（OS）之间的相关性。采用卡方检验和 I ² 统计量评估研究中的异质性。当存在显著异质性（I>50%且 p<0.05）时，采用随机效应模型。采用 Egger 检验计算发表偏倚。采用亚组分析按抗体、地区、样本量分层，以探讨异质性的来源。
对 11 项包含 1055 例患者的研究进行了分析。结果表明，MVD 升高是 TNM 分期和临床分期进展的重要因素，MVD 与 ESCC 中的淋巴结侵犯和血管侵犯呈正相关（p<0.05），但与分化不良和浸润深度无关（p>0.05）。结果还表明，MVD 降低是延长生存率的有益因素（p<0.05）。异质性的来源可能是用于检测 MVD 的抗体不一致、患者数量不足以及 MVD 的计数方法。
多项研究表明，MVD 与 ESCC 的临床病理标准及预后不良相关。MVD 可能是反映反应性血管生成的定量指标，在 ESCC 的发生和发展中可能起着关键作用。MVD 可能是目前病理分析的一个有价值的补充，有助于指导预后和治疗。
