Zannoni Gian Franco, Travaglino Antonio, Raffone Antonio, Arciuolo Damiano, D'Alessandris Nicoletta, Scaglione Giulia, Tralongo Pietro, Inzani Frediano, Angelico Giuseppe, Santoro Angela
Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy.
Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy.
Diagnostics (Basel). 2021 Sep 26;11(10):1772. doi: 10.3390/diagnostics11101772.
several different criteria have been proposed to categorize the pathological response in cervical cancer after neoadjuvant therapy; although it is unclear what the most prognostically valuable one is. to assess the prognostic value of pathological criteria for categorizing the response in cervical cancer after neoadjuvant therapy, through a systematic review and meta-analysis. four electronic databases were searched from January to December 2020 for all studies, assessing the prognostic value of pathological response in cervical cancer after neoadjuvant therapy. Hazard ratio (HR) for overall survival (OS) was calculated with a significant -value < 0.05. A meta-analysis was performed for each criteria assessed in at least three studies. sixteen studies were included. Criteria for pathological response included (i) residual stromal invasion < vs. >3 mm; (ii) complete response vs. any residual; (iii) proportion of viable cells; (iv) residual tumor diameter; and (v) intracervical vs. extracervical residual. Criteria (i) and (ii) were suitable for meta-analysis. The presence of a residual tumor with stromal invasion > 3 mm showed a HR of 4.604 (95% CI; 3.229-6.565; < 0.001), while the presence of any residual showed a HR of 1.610 (95% CI; 1.245-2.081; < 0.001); statistical heterogeneity was absent in both analyses. dichotomizing the pathological response in cervical cancer after neoadjuvant therapy as < vs. >3 mm stromal invasion is more prognostically valuable than dichotomizing as complete response vs. any residual. Further studies are necessary to evaluate other systems.
已经提出了几种不同的标准来对新辅助治疗后宫颈癌的病理反应进行分类；尽管尚不清楚哪种标准在预后方面最具价值。为了通过系统评价和荟萃分析评估新辅助治疗后宫颈癌反应分类的病理标准的预后价值，在2020年1月至12月期间检索了四个电子数据库，以查找所有评估新辅助治疗后宫颈癌病理反应预后价值的研究。计算总生存期（OS）的风险比（HR），显著性值<0.05。对至少三项研究中评估的每个标准进行荟萃分析。纳入了16项研究。病理反应标准包括：（i）残余间质浸润<与>3mm；（ii）完全缓解与任何残留；（iii）存活细胞比例；（iv）残余肿瘤直径；以及（v）宫颈内与宫颈外残留。标准（i）和（ii）适用于荟萃分析。间质浸润>3mm的残留肿瘤的存在显示HR为4.604（95%CI：3.229-6.565；<0.001），而任何残留的存在显示HR为1.610（95%CI：1.245-2.081；<0.001）；两项分析均无统计学异质性。将新辅助治疗后宫颈癌的病理反应分为间质浸润<与>3mm比分为完全缓解与任何残留更具有预后价值。需要进一步研究来评估其他系统。
