Wang Xiang-Yu, Zhang Bo, Gu Yin-Chen, Yang Mei, Tao Bao-Rui, Sun Rong-Quan, Li Yi-Tong, Chen Zhen-Mei, Ying Sen-Feng, Yi Chen-He, Geng Yan, Zhang Rui, Fan Jie, Chen Jin-Hong
Hepatobiliary Surgery, Department of General Surgery, Huashan Hospital and Cancer Metastasis Institute, Fudan University, 12 Middle Urumqi Road, Shanghai, 200040, China.
Department of Pathology, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, 200040, China.
Clin Exp Metastasis. 2025 Jul 15;42(5):41. doi: 10.1007/s10585-025-10361-2.
Histopathological growth pattern (HGP) is emerging as a promising pathological biomarker in liver metastases, with potential associations to prognosis and response to antiangiogenic therapy. Nonetheless, its prognostic role requires further elucidation for substantial heterogeneity of previous studies. We searched PubMed, Web of Science, Embase and Cochrane Library for studies comparing the overall survival (OS) or disease-free survival (DFS) between different HGPs in liver metastases from various cancer types. Data were pooled using hazard ratios (HRs) along with 95% confidence intervals (CIs) according to fixed or random-effects models. Subgroup analysis was also performed to adjust critical confounders. In total, 36 studies were included in the final analysis. It was demonstrated that desmoplastic HGP (dHGP) was associated with favorable OS compared with non-dHGP (HR, 0.59; 95% CI 0.54-0.64), replacement HGP (rHGP, HR, 0.60; 95% CI 0.49-0.74) and pushing HGP (pHGP, HR, 0.63; 95% CI 0.43-0.92), respectively. Similarly, dHGP also demonstrated improved DFS compared with non-dHGP (HR, 0.58; 95% CI 0.52-0.65), rHGP (HR, 0.61; 95% CI 0.49-0.77) and pHGP (HR, 0.51; 95% CI 0.31-0.83), respectively. In subgroup analysis, dHGPs remains an independent prognostic factor regardless of critical confounders, such as the preoperative systemic therapy, cancer types and HGP categorization criteria. This study confirmed the prognostic role of HGPs in liver metastases receiving surgical resection. Clinically, adding HGPs in prognostic models may provide further optimization.
组织病理学生长模式（HGP）正成为肝转移中有前景的病理生物标志物，与预后及抗血管生成治疗反应可能相关。尽管如此，由于既往研究存在显著异质性，其预后作用仍需进一步阐明。我们检索了PubMed、科学网、Embase和Cochrane图书馆，以查找比较不同HGP在各种癌症类型肝转移中的总生存期（OS）或无病生存期（DFS）的研究。根据固定效应或随机效应模型，使用风险比（HRs）及95%置信区间（CIs）汇总数据。还进行了亚组分析以调整关键混杂因素。最终分析共纳入36项研究。结果表明，促结缔组织增生性HGP（dHGP）与非dHGP相比，OS更佳（HR，0.59；95%CI 0.54 - 0.64），与替代型HGP（rHGP，HR，0.60；95%CI 0.49 - 0.74）及浸润型HGP（pHGP，HR，0.63；95%CI 0.43 - 0.92）相比亦如此。同样，dHGP与非dHGP相比，DFS也有所改善（HR，0.58；95%CI 0.52 - 0.65），与rHGP（HR，0.61；95%CI 0.49 - 0.77）及pHGP（HR，0.51；95%CI 0.31 - 0.83）相比亦是如此。在亚组分析中，无论术前全身治疗、癌症类型和HGP分类标准等关键混杂因素如何，dHGPs仍是独立的预后因素。本研究证实了HGP在接受手术切除的肝转移中的预后作用。临床上，在预后模型中加入HGP可能会进一步优化。
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