Prognostic Value of Perineural Invasion in Esophageal and Esophagogastric Junction Carcinoma: A Meta-Analysis

作者：Aiqin Gao, Linlin Wang, Juan Li, Hongyu Li, Yali Han, Xiaoxia Ma, Yuping Sun · 发表于：Disease Markers · 年份：2016 · DOI：10.1155/2016/7340180 · 被引用次数：41 · 研究领域：Esophageal Cancer Research and Treatment、Head and Neck Cancer Studies、Pancreatic and Hepatic Oncology Research

OBJECTIVE: Here we aimed to clarify the prognostic significance of perineural invasion (PNI) in esophageal and esophagogastric junction (EGJ) carcinoma. METHODS: A comprehensive literature search for relevant reports published up to July 2015 was performed using Pubmed and Embase databases. The pooled HR and 95% CI for overall survival (OS) and disease-free survival (DFS) were used to assess the prognostic value. The association of PNI with pathological characteristics was evaluated by OR and 95% CI. RESULTS: A total of 13 cohorts were retrieved, covering 2770 patients treated by surgery. The cumulative analysis revealed a statistical correlation between PNI and poor OS (HR = 1.76, 95% CI: 1.54-2.20, and P < 0.00001), as well as poor DFS (HR = 1.96, 95% CI: 1.42-2.71, and P < 0.001). Moreover, analysis of 1475 patients showed improved PNI in T3 + T4 (OR = 0.39, 95% CI: 0.21-0.70, and P = 0.002), N+ (OR = 0.52, 95% CI: 0.40-0.69, and P < 0.00001), and G3 + G4 (OR = 0.66, 95% CI: 0.48-0.90, and P = 0.008) patients compared with T1 + T2, N-, and G1 + G2 ones, respectively. No significant heterogeneity was found between the studies. CONCLUSIONS: PNI is an adverse prognostic biomarker in esophageal and EGJ carcinoma. Moreover, PNI implies advanced T, N stage and poor cell differentiation.