Increased risk of poor survival in ovarian cancer patients with high expression of SNAI2 and lymphovascular space invasion
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Jun Li1,2, Shufen Li3, Ruifang Chen1,2, Xin Lu1,2
1Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
2Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
3State Key Laboratory of Medical Genomics and Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Xin Lu, email: [email protected]
Keywords: ovarian cancer, lymphovascular space invasion, SNAI2, prognosis, survival
Received: October 22, 2016 Accepted: November 24, 2016 Published: December 25, 2016
This study is aimed to conduct a meta-analysis to evaluate the prognostic value of lymphovascular space invasion(LVSI) and to explore the potential association of SNAI1 and SNAI2 with LVSI in ovarian cancer. A systematic literature search in PubMed, ISI Web of Science, and Medline was conducted to identify relevant studies assessing the prognostic value of LVSI in ovarian cancer. The main outcomes analyzed were progression free survival/disease free survival and overall survival. TCGA database was used to explore the potential link of SNAI1 and SNAI2 with LVSI status. A total of 11 eligible studies enrolling 1817 patients were included for the meta-analysis. The overall analysis indicated that LVSI presence was associated with shorter duration of survival in ovarian cancer patients. Multivariate analysis indicated that both advanced stage and SNAI2 expression were associated with increased risk of LVSI presence. Survival analysis indicated that tumors with LVSI presence and high SNAI2 expression were significantly correlated with poorer survival when compared to tumors with both LVSI absence and low SNAI2 expression. In conclusion, LVSI presence was associated with worse clinical outcomes in ovarian cancer. Increased expression of SNAI2 and advanced stage were independent risk factors for LVSI presence. Our findings also emphasizes the potential of SNAI2 in promoting lymphovascular spread of ovarian cancer.
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