Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Cancer Prevention and Treatment Institute of Chengdu, Department of Pathology, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China.
Front Immunol. 2024 Jul 8;15:1401118. doi: 10.3389/fimmu.2024.1401118. eCollection 2024.
We performed this pooled analysis for the first time to comprehensively explore the prognostic value of tumor-associated high endothelial venules (TA-HEVs) and determine their relationships with clinicopathological features in solid tumors.
Four online databases, including PubMed, Web of Science, Embase, and Cochrane Library, were comprehensively searched to identify studies assessing the effect of TA-HEVs on prognosis or clinicopathological features. Hazard ratios (HRs) with 95% confidence intervals (CIs) were applied to evaluate survival outcomes, including overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS). The association between TA-HEV status and clinicopathological characteristics was assessed by odds ratios (ORs) combined with 95% CIs. Subgroup analysis was conducted to explore sources of heterogeneity. The sensitivity analysis was performed to evaluate the stability of our findings. Meanwhile, Funnel plots were employed to visually evaluate potential publication bias, and both Begg's and Egger's tests were adopted to quantitatively determine publication bias.
A total of 13 retrospective cohort studies, involving 1,933 patients were finally included in this meta-analysis. Effect-size pooling analysis showed that the positivity of TA-HEVs was related to improved OS (pooled HR: 0.75, 95% CI: 0.62-0.93, <0.01), and DFS (pooled HR = 0.54, 95% CI = 0.41-0.72, < 0.01). However, TA-HEV positivity in solid tumors was not linked to PFS (pooled HR = 0.75, 95% CI 0.34-1.64, = 0.47) or CSS (pooled HR: 0.58, 95% CI: 0.04-7.58, P= 0.68). Further subgroup analysis demonstrated that ethnicity and source of HR were the main factors contributing to heterogeneity. Moreover, TA-HEVs were inversely associated with lymph node metastasis and distant metastasis, but were positively related to worse tumor differentiation. However, TA-HEVs were not significantly correlated with sex, LVI, clinical stage, and depth of invasion. Sensitivity analysis suggested that the pooled results were stable and reliable, with no significant publication bias in all included articles.
This is the first comprehensive analysis of the prognostic value of TA-HEVs in solid tumors using existing literature. Overall, our study demonstrated a significant correlation between TA-HEVs and prognosis as well as clinicopathological features. TA-HEVs may serve as novel immune-related biomarkers for clinical assessments and prognosis prediction in solid tumors.
https://www.crd.york.ac.uk/prospero/display_record.php, identifier CRD42023394998.
我们首次进行了这项荟萃分析，旨在全面探讨肿瘤相关高内皮小静脉（TA-HEVs）的预后价值，并确定其与实体瘤临床病理特征的关系。
我们全面检索了 PubMed、Web of Science、Embase 和 Cochrane Library 这四个在线数据库，以确定评估 TA-HEVs 对预后或临床病理特征影响的研究。应用风险比（HRs）及其 95%置信区间（CIs）来评估生存结局，包括总生存期（OS）、无病生存期（DFS）、无进展生存期（PFS）和癌症特异性生存期（CSS）。应用优势比（ORs）及其 95%CI 评估 TA-HEV 状态与临床病理特征之间的关联。通过亚组分析来探讨异质性的来源。进行敏感性分析以评估我们研究结果的稳定性。同时，采用漏斗图来直观评估潜在的发表偏倚，并采用 Begg 和 Egger 检验进行定量评估。
最终共有 13 项回顾性队列研究，涉及 1933 例患者被纳入本荟萃分析。效应大小合并分析表明，TA-HEVs 的阳性表达与改善 OS（合并 HR：0.75，95%CI：0.62-0.93，<0.01）和 DFS（合并 HR=0.54，95%CI=0.41-0.72，<0.01）相关。然而，TA-HEVs 在实体瘤中与 PFS（合并 HR=0.75，95%CI 0.34-1.64，=0.47）或 CSS（合并 HR：0.58，95%CI：0.04-7.58，P=0.68）无显著相关性。进一步的亚组分析表明，种族和 HR 来源是导致异质性的主要因素。此外，TA-HEVs 与淋巴结转移和远处转移呈负相关，但与肿瘤分化程度较差呈正相关。然而，TA-HEVs 与性别、LVI、临床分期和浸润深度无显著相关性。敏感性分析表明，合并结果稳定可靠，且所有纳入文献均无显著发表偏倚。
这是首次利用现有文献对实体瘤中 TA-HEVs 的预后价值进行全面分析。总的来说，我们的研究表明 TA-HEVs 与预后以及临床病理特征之间存在显著相关性。TA-HEVs 可能成为实体瘤临床评估和预后预测的新型免疫相关生物标志物。
https://www.crd.york.ac.uk/prospero/display_record.php，标识符 CRD42023394998。
