中国人群VEGFR-3与胃癌预后关系的Meta分析

Prognostic Value of VEGFR-3 in Gastric Cancer among Chinese People: A Meta-analysis

目的评价血管内皮生长因子受体(VEGFR)的高表达在中国胃癌患者预后中的预测价值。方法在Pub Med、Cochrane Library、EMbase、CNKI、CBM、VIP和Wan Fang Data数据库检索并收集关于中国人群中VEGFR表达情况与胃癌预后关系的相关临床研究原始文献并进行筛选,检索时限均为建库起至2017年,末次检索时间为2017年11月12日。应用Stata 12.0软件对研究结果进行统计学分析,采用Egger's检验评价发表偏倚。结果共纳入10篇文献,合计患者1 023例,均采用免疫组织化学法判定VEGFR表达情况。Meta分析结果显示,中国胃癌患者胃癌组织中VEGFR高表达者较VEGFR低表达者肿瘤更易发生T_3、T_4浸润(OR=1.95,95%CI 1.45~2.63,P<0.001)及淋巴结转移(OR=2.70,95%CI 2.08~3.51,P<0.001)。VEGFR高表达是影响胃癌患者总生存期的危险因素(HR=1.86,95%CI 1.55~2.23,P<0.001)。亚组分析显示,VEGFR-3高表达患者较VEGFR低表达患者组织浸润更深(OR=1.89,95%CI 1.36~2.63,P<0.001),更容易发生淋巴结转移(OR=2.55,95%CI 1.93~3.38,P<0.001),VEGFR-3高表达提示更高的死亡风险(HR=1.90,95%CI 1.57~2.31,P<0.001)。对VEGFR与胃癌总生存期及胃癌浸润深度关系的Meta分析行Egger's检验提示未发现存在明显发表偏倚(P>0.05),对VEGFR与胃癌淋巴结转移关系的Meta分析行Egger's检验提示可能存在一定发表偏倚(P<0.05)。结论在中国胃癌患者胃癌组织中VEGFR-3高表达对胃癌的不良预后具有一定预测价值,有望在中国人群中将VEGFR-3与其他胃癌预后标志物指标结合协助判断胃癌预后。

Objective To evaluate the prognostic significance of vascular endothelial growth factor receptor(VEGFR)overexpression in gastric cancer among Chinese patients.Methods The databases PubMed,Cochrane Library,EMbase,CNKI,CBM,VIP and WanFang Data were systematically searched for articles reporting the prognostic significance of VEGFR in gastric cancer among Chinese population.The statistical analyses were carried out using Stata version 12.0.Egger′s tests were performed to evaluate the publication bias of the eligible studies.Results A total of 10 studies,1 023 individuals were eligible for meta-analysis.VEGFR overexpression was correlated with deeper invasion(T 3,T 4)(OR=1.95,95%CI 1.45-2.63,P<0.001)and positive lymph node metastasis(OR=2.70,95%CI 2.08-3.51,P<0.001).The death risk of VEGFR+group was significantly higher than that of VEGFR-group(HR=1.86,95%CI 1.55-2.23,P<0.001).Subgroup analysis showed that VEGFR-3 overexpression was associated with deeper invasion(OR=1.89,95%CI 1.36-2.63,P<0.001)and positive lymph node metastasis(OR=2.55,95%CI 1.93-3.38,P<0.001),and it was correlated with an increased risk in overall survival(HR=1.90,95%CI 1.57-2.31,P<0.001).By Egger′s test,no obvious evidence of publication bias was revealed in the meta-analysis of overall survival and deeper invasion(P>0.05),while there was publication bias in the studies of positive lymph node metastasis(P<0.05).Conclusion VEGFR-3 overexpression has a certain predictive value for poor prognosis of gastric cancer,and is expected to become a prognostic predictor together with other markers for patients with gastric cancer among Chinese population.