Department of Anatomical Pathology, Singapore General Hospital, Singapore.
Health Service Research Unit, Singapore General Hospital, Singapore.
Lab Invest. 2023 Jun;103(6):100136. doi: 10.1016/j.labinv.2023.100136. Epub 2023 Mar 27.
Recently, tumor budding (TB) has been suggested as a strong prognostic marker in urinary tract urothelial carcinoma (UC). The aim of this systematic review is to test the prognostic value of TB in UC by a meta-analysis of previously published studies. We systematically reviewed the literature related to TB by using the databases of Scopus, PubMed, and Web of Science. The search was limited to publications in the English language up to July 2022. There were 790 patients from 7 retrospective studies in which TB has been evaluated in UC. Two authors independently extracted the results from eligible studies. The meta-analysis of eligible studies revealed that TB is a significant prognosticator for progression-free survival in UC, with a hazard ratio (HR) of 3.51 (95% CI, 1.86-6.62; P < .001) in univariate analysis and a HR of 2.78 (95% CI, 1.57-4.93; P < .001) in multivariate analysis; a significant prognosticator for overall survival and cancer-specific survival in UC, with a HR of 3.07 (95% CI, 2.04-4.64; P < .001) and a HR of 2.18 (95% CI, 1.11-4.29; P = .02) respectively in univariate analysis. Our findings confirm that UC with a high TB count is at a high risk of progress. TB could be considered as an element in pathology reports and future oncologic staging systems.
最近，肿瘤芽（TB）被认为是尿路上皮癌（UC）的一个强有力的预后标志物。本系统评价的目的是通过对先前发表的研究进行荟萃分析来检验 TB 在 UC 中的预后价值。我们系统地检索了 Scopus、PubMed 和 Web of Science 数据库中与 TB 相关的文献。检索范围限于 2022 年 7 月之前以英文发表的出版物。共有 790 例来自 7 项回顾性研究的患者，其中评估了 UC 中的 TB。两位作者独立提取了合格研究的结果。合格研究的荟萃分析显示，TB 是 UC 无进展生存期的显著预后标志物，单因素分析的风险比（HR）为 3.51（95%可信区间，1.86-6.62；P<0.001），多因素分析的 HR 为 2.78（95%可信区间，1.57-4.93；P<0.001）；也是 UC 总生存期和癌症特异性生存期的显著预后标志物，单因素分析的 HR 分别为 3.07（95%可信区间，2.04-4.64；P<0.001）和 2.18（95%可信区间，1.11-4.29；P=0.02）。我们的研究结果证实，TB 计数高的 UC 进展风险较高。TB 可以被认为是病理报告和未来肿瘤分期系统中的一个要素。
