Lymphatic microvessel density and vascular endothelial growth factor-C and -D as prognostic factors in breast cancer: a systematic review and meta-analysis of the literature

The use of lymphatic microvessel density (LVD) and pro-lymphangiogenic mediators as prognostic factors for survival in breast cancer remains controversial. We searched the electronic databases PubMed and EMBASE without language restrictions for relevant literature to aggregate the survival results. To be eligible, every study had to include the assessment of the LVD or the expression of vascular endothelial growth factor (VEGF)-C or -D in patients with breast cancer and provide a survival comparison, including disease-free survival (DFS) or overall survival (OS), according to the LVD, VEGF-C or VEGF-D status. Across all studies, 56.64?% of patients were considered to have a VEGF-C-positive tumor, and 65.54?% of patients had VEGF-D-positive tumors. High LVD had an unfavorable impact on DFS, with a pooled hazard ratio (HR) of 2.222 (95?% CI 1.579–3.126) and an OS with a HR of 2.493 (95?% CI 1.183–5.25). According to the different lymphatic makers, the subgroup HR in the D2-40 studies was 2.431 (95?%?CI 1.622–3.644) for DFS and 4.085 (95?% CI 1.896–8.799) for OS. VEGF-C overexpression, as assessed by immunochemistry, was a prognostic factor for decreased DFS (HR 2.164; 95?% CI 1.256–3.729) and for decreased OS (HR 2.613; 95?% CI 1.637–4.170). VEGF-D overexpression was a significant although weak prognostic factor for DFS only when assessed by immunochemistry, with a HR of 2.108 (95?% CI 1.014–4.384). Our meta-analysis demonstrated that LVD, VEGF-C and VEGF-D could predict poor prognosis in patients with breast cancer. However, standardization of the assessment of LVD and for the expression of lymphangiogenesis factors is needed.     

Blood vessel invasion as a strong independent prognostic indicator in non-small cell lung cancer: a systematic review and meta-analysis

Background and Objective

Blood 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.

Methods

A 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.

Results

A 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; P<0.0001) and 3.98 (95% CI: 2.24–7.06; P<0.0001), respectively. For the analyses of blood vessel invasion and OS, the pooled HR estimate was 2.22 (95% CI: 1.93–2.56; P<0.0001) by univariate analysis and 1.90 (95% CI: 1.65–2.19; P<0.0001) by multivariate analysis. Furthermore, in stage I NSCLC patients, the meta-risk for recurrence (HR = 6.93, 95% CI: 4.23–11.37, P<0.0001) and death (HR = 2.15, 95% CI: 1.68–2.75; P<0.0001) remained highly significant by multivariate analysis.

Conclusions

This 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.     

微针技术用于非经皮途径的药物递送研究进展

近年来,微针作为一种新兴的经皮给药技术,具有微创、无痛、使用方便和高效的特点,逐渐成为一种极具研究价值和应用潜力的给药策略。微针技术在过去20年中得到迅速发展并呈现出多样化的趋势,已可根据不同需求来定制微针的形状、组成、机械性能和其他特殊功能等。由于微针能以微创方式穿越各种生物屏障,因此许多研究人员探索了微针在除皮肤外各类组织和器官中的药物递送应用。本文综述了微针技术及其近年来在眼睛、血管、心脏等组织和器官的药物递送中的应用研究,以期推动微针技术的应用发展。     

The Role of Teachers' Stories in the Staffroom of a Religious School

Women teachers in the staffroom of a religious high school in a small Israeli town are caught in a conflict between a modern consumer society that requires them to be educated career women, and the religious community of the town that requires them to be mothers and housewives. They solve the dilemma by turning the staffroom into an extension of their homes, by means of stories. The stories not only present the conflict to the teachers in the staffroom, but present the solution to the conflict.     

Lymphatic microvessel density as a prognostic factor in non-small cell lung carcinoma: a meta-analysis of the literature

The role of lymphatic microvessel density (LVD) as a prognostic factor for survival of patients with non-small cell lung carcinoma (NSCLC) remains controversial. To evaluate this potential role, we performed a systematic review of the electronic databases PubMed and EMBASE for relevant literature to review and compile available survival results. To be eligible, a study had to assess LVD in patients with NSCLC and to compare survival based on LVD stratification. Among 12 eligible trials, all dealt with NSCLC, and 10 trials provided results for the meta-analysis of survival data (evaluable trials). In terms of survival, high LVD was reported to be an unfavorable prognostic factor for overall survival in 8 studies, whereas it was not in 4 studies. The overall survival hazard ratio for the 10 evaluable studies (1,426 patients) was calculated to be 1.41 (95% CI: 1.14–1.75) using a random effects model, indicating a poorer survival for NSCLC patients with high LVD. The hazard ratio was 1.52 (95% CI: 1.10–2.11) in 5 NSCLC studies where LVD was assessed based on D2-40 and 1.31 (95% CI: 1.08–1.60) in 4 studies where LVD was measured based on vascular endothelial growth factor receptor-3. This study supports the hypothesis that the lymphatic microvessel count or LVD, which reflects levels of lymphangiogenesis, is a poor prognostic factor for patient survival in surgically treated NSCLC. However, the present findings may overestimate the prognostic capacity of LVD because of publication and report bias. In addition, the standardization of lymphangiogenesis assessment by the lymphatic microvessel count is necessary.     

Has-miR-146a polymorphism (rs2910164) and cancer risk: a meta-analysis of 19 case–control studies

Epidemiological studies have evaluated the association between has-miR-146a polymorphism (rs2910164) and cancer risk. However, published data are still inconclusive. Here, we performed a meta-analysis to assess the relationship between has-miR-146a polymorphism (rs2910164) and cancer susceptibility until May 8, 2010. Nineteen published case–control studies including a total of 10,496 cases and 12,885 controls were acquired. Overall, Increased cancer risk was found in domain model (OR = 1.18, 95% CI: 1.03–1.35) rather than in other genetic models when all studies were pooled into the meta-analysis. Stratified analysis shown that significant association between rs2910164 polymorphism and cancer susceptibility was present in Asians (OR = 1.14, 95% CI: 1.01–1.29 for CG vs. CC; OR = 1.19, 95% CI: 1.03–1.39 for GG + CG vs. CC), but not in Caucasian populations. In the subgroup analysis by cancer types, no significantly increased risk of breast, gastric, prostate or bladder cancer were found in any of the genetic models. In summary, this meta-analysis suggests that has-miR-146a polymorphism (rs2910164) is associated with increased cancer susceptibility in Asians. However, further well-designed studies with large sample size will be necessary to validate the risk identified in the current meta-analysis.     

Nrf2 expression participates in growth and differentiation of endometrial carcinoma cells in vitro and in vivo

The expression level of Nrf2 is increased in series of tumors and it plays a vital role in proliferation of cancer cells. However, little is known about the clinical implications and biological functions of Nrf2 in endometrial carcinoma. The aim of this study is to study whether up-regulation of Nrf2 expression can promote growth of endometrial carcinoma cells. Using immunohistochemistry, Nrf2 protein expression was analyzed in endometrial carcinoma patients. A series of assays was performed to elucidate the role of Nrf2 in growth of endometrial carcinoma. Positive rate of Nrf2 was 64.3 % (45/70) in endometrial carcinoma patients, and it was associated with FIGO stage and histological grade (P < 0.05). In addition, ectopic overexpression of Nrf2 promoted the growth of endometrial carcinoma cells in vitro and in vivo. Interestingly, Nrf2 protein translocation from cytoplasm to nucleus may influence differentiation of endometrial carcinoma cells. These results suggest that Nrf2 participates in progression of endometrial carcinoma by influencing the growth and differentiation of endometrial carcinoma cells, and it could be used as a novel and potential therapeutic target for endometrial carcinoma.