摘要
目的采用Meta分析方法评价血管内皮生长因子(vascular endothelial growth factor,VEGF)在食管癌预后中的价值。方法计算机检索PubMed、EMbase中VEGF与食管癌预后相关性的回顾性队列研究,并辅以文献追溯方法查找相关文献。检索时限均从建库至2012年6月。由2名评价者按纳入与排除标准独立选择文献、提取资料和评价质量后,采用RevMan 5.0软件进行Meta分析,并用Begg’s漏斗图和Egger’s法评估文献的发表偏倚。结果最终纳入10个队列研究,共811例食管癌患者。Meta分析结果显示,VEGF高表达的食管癌患者死亡风险更高[HR=1.55,95%C(I1.25,1.91)]。进一步按VEGF亚型、VEGF表达临界值及患者来源进行的亚组分析结果显示,VEGF-C在组织的高表达与预后并无显著联系。临界值为10%的VEGF亚组在肿瘤组织的高表达提示死亡风险更高,而临界值为30%的亚组VEGF表达水平与预后并无显著联系。中国患者VEGF在肿瘤组织的高表达较非中国患者对预测食管癌预后更具价值。结论 VEGF在肿瘤组织的表达水平对食管癌的预后具有预测价值。
Objective To assess the value of vascular endothelial growth factor （VEGF） expression in the prognosis of esophageal cancer. Methods PubMed and EMbase were searched for collecting retrospective cohort studies on the correlation between VEGF expression and prognosis of esophageal cancer, and relevant articles were also retrieved from inception to June, 2012. Two reviewers independently screened the literature, extracted the data, and evaluated the qual- ity. Then the meta-analysis was performed by using RevMan5.0 software, and the publication bias of literature was evalu- ated by means of Begg＇s funnel plot and Egger＇s method. Results Finally 10 cohort studies involving 811 patients were included. The meta-analysis showed that, patients with high level of VEGF had poor overall survival （HR=l.55, 95%CI 1.25 to 1.91）. The results of subgroup analyses including VEGF subtype, critical value of VEGF and source of patient showed that： a） there was no correlation between patient＇s prognosis and high level of VEGF-C; b） The high level of VEGF subtype in cancer tissue indicated a higher risk of death when the critical value was 10%, while it was not related to the prognosis when the critical value was 30%; and c） The high level of VEGF in cancer tissue was more valuable to predict the prognosis of esophageal cancer for Chinese patients rather than non-Chinese patients. Conclusion The level of VEGF＇s expression in cancer tissue is valuable to predict the prognosis of esophageal cancer.
出处
《中国循证医学杂志》
CSCD
2013年第5期553-559,共7页
Chinese Journal of Evidence-based Medicine
关键词
食管癌
血管内皮生长因子
预后
生存率
META分析
队列研究
Esophageal cancer
Vascular endothelial growth factor
Prognosis
Survival rate
Meta-analysis
Cohort study
