Blood Vessel Invasion as a Strong Independent Prognostic Indicator in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Background and ObjectiveBlood vessel invasion plays a very important role in the progression and metastasis of cancer. However, blood vessel invasion as a prognostic factor for survival in non-small cell lung cancer (NSCLC) remains controversial. The aim of this study is to explore the relationship between blood vessel invasion and outcome in patients with NSCLC using meta-analysis. MethodsA meta-analysis of published studies was conducted to investigate the effects of blood vessel invasion on both relapse-free survival (RFS) and overall survival (OS) for patients with NSCLC. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to assess the strength of this association. ResultsA total of 16,535 patients from 52 eligible studies were included in the systematic review and meta-analysis. In total, blood vessel invasion was detected in 29.8% (median; range from 6.2% to 77.0%) of patients with NSCLC. The univariate and multivariate estimates for RFS were 3.28 (95% CI: 2.14–5.05; PPPPPP ConclusionsThis study shows that blood vessel invasion appears to be an independent negative prognosticator in surgically managed NSCLC. However, adequately designed large prospective studies and investigations are warranted to confirm the present findings.背景与目的 血管侵犯（blood vessel invasion）在癌症的进展与转移过程中发挥着至关重要的作用。然而，血管侵犯作为非小细胞肺癌（non-small cell lung cancer, NSCLC）患者生存预后的影响因素，目前仍存在争议。本研究旨在通过Meta分析（meta-analysis）探讨非小细胞肺癌患者血管侵犯与预后结局的关联。 方法 本研究对已发表的相关研究开展Meta分析，以探究血管侵犯对非小细胞肺癌患者无复发生存期（relapse-free survival, RFS）与总生存期（overall survival, OS）的影响。本研究采用风险比（hazard ratios, HRs）联合95%置信区间（95% confidence intervals, 95% CIs）评估该关联的强度。 结果 本系统评价（systematic review）与Meta分析共纳入52项符合纳入标准的研究，涉及16535例患者。整体而言，29.8%的非小细胞肺癌患者检出血管侵犯（中位占比，范围6.2%~77.0%）。无复发生存期的单因素与多因素分析估计值为3.28（95% CI: 2.14–5.05; PPPPPP）。 结论 本研究表明，在接受手术治疗的非小细胞肺癌患者中，血管侵犯可作为一项独立的不良预后因素。但仍需开展设计完善的大规模前瞻性研究以验证本研究结论。