Association between vascular endothelial growth factor expression and lymph node metastasis in cervical cancer: A meta-analysis.

Abstract

The expression of vascular endothelial growth factor (VEGF) by cancer cells has been identified as a factor that is associated with lymph node metastasis (LNM) in some cancers, but an accurate description of the relation between VEGF and LNM in cervical cancer is lacking. We conducted a concurrent meta-analysis to investigate this issue. We searched PubMed and EMBASE for articles addressing the association between VEGF and cervical cancer. We used stata 12.0 and calculated the crude odds ratios (OR) and corresponding 95% confidence intervals (CI). Heterogeneity between the studies included was assessed by Cochran's Q-test. Overall, 16 relevant studies with 426 cases and 751 controls were included in our study. The results demonstrated that cervical cancer patients with VEGF-positive expression had a 2.87-fold higher risk of LNM than patients without VEGF-positive expression (95%CI=1.85-4.44, P<0.001). Furthermore, subgroup analysis by ethnicity revealed that VEGF-positive expression could increase the risk of LNM in cervical cancer among Asian populations (OR=2.55, 95%CI=1.61-4.03, P<0.001) and Caucasian populations (OR=8.81, 95%CI=2.78-27.88, P<0.001). Moreover, subgroup analysis by country revealed that VEGF-positive expression could increase the risk of LNM in cervical cancer among Chinese populations (OR=3.38, 95%CI=2.18-5.25, P<0.001) but not among Korean populations (P=0.84) or Japanese populations (P=0.06). Subgroup analysis based on sample size proved that VEGF-positive expression was statistically associated with LNM in a large sample group. Our study revealed that VEGF-positive expression is related with higher risk of LNM in cervical cancer.