Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Sep 20, 2022; 12(5): 448-458
Published online Sep 20, 2022. doi: 10.5662/wjm.v12.i5.448
Microvessel density in differentiated thyroid carcinoma: A systematic review and meta-analysis
Konstantinos Perivoliotis, Athina A Samara, Prodromos Koutoukoglou, Panagiotis Ntellas, Katerina Dadouli, Sotirios Sotiriou, Maria Ioannou, Konstantinos Tepetes
Konstantinos Perivoliotis, Athina A Samara, Konstantinos Tepetes, Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
Prodromos Koutoukoglou, Katerina Dadouli, Postgraduate Programme Research Methodology in Biomedicine, Biostatistics and Clinical Bioinformatics, University of Thessaly, Larissa 41110, Greece
Panagiotis Ntellas, Maria Ioannou, Department of Pathology, University of Thessaly, Larissa 41100, Greece
Sotirios Sotiriou, Department of Embryology, University of Thessaly, Larissa 41100, Greece
Author contributions: Perivoliotis K, Ntellas P, and Samara AA performed study conception and design; Dadouli K and Koutoukoglou P acquired the data; Perivoliotis K and Ntellas P analyzed and interpreted the data; Perivoliotis K, Ntellas P, and Samara AA drafted the manuscript; Ioannou M, Tepetes K, and Sotiriou S critically revised the manuscript; all authors have approved the final version of the present manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Athina A Samara, MD, MSc, Surgeon, Department of Surgery, University Hospital of Larissa, Mezourlo Hill, Larissa 41110, Greece. at.samara93@gmail.com
Received: October 28, 2021
Peer-review started: October 28, 2021
First decision: December 27, 2021
Revised: December 30, 2021
Accepted: July 18, 2022
Article in press: July 18, 2022
Published online: September 20, 2022
Processing time: 323 Days and 1.4 Hours
Abstract
BACKGROUND

Microvessel density (MVD) has been proposed as a direct quantification method of tumor neovascularization. However, the current literature regarding the role of MVD in differentiated thyroid carcinoma (DTC) remains inconclusive.

AIM

To appraise the effect of tumoral MVD on the survival of patients with DTC.

METHODS

This meta-analysis was based on the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The electronic databases Medline, Web of Science, and Scopus were systematically screened. A fixed-effects or random-effects model was used, according to the Cochran Q test. The data were then extracted and assessed on the basis of the Reference Citation Analysis (https://www.referencecitationanalysis.com/).

RESULTS

A total of nine studies were included in the present study. Superiority of low MVD tumors in terms of 10-year disease free survival (OR: 0.21, 95%CI: 0.08–0.53) was recorded. Lowly vascularized thyroid cancers had a lower recurrence rate (OR: 13.66, 95%CI: 3.03–61.48). Moreover, relapsing tumors [weighed mean difference (WMD): 11.92, 95%CI: 6.32–17.52] or malignancies with regional lymph node involvement (WMD: 8.53, 95%CI: 0.04–17.02) presented with higher tumoral MVD values.

CONCLUSION

MVD significantly correlates with the survival outcomes of thyroid cancer patients. However, considering several study limitations, further prospective studies of higher methodological and quality level are required.

Keywords: Cancer; Density; Microvessel; Thyroid; Vascularization

Core Tip: This systematic review is the first meta-analysis investigating the effect of tumoral vascularity, through microvessel density (MVD) assessment, on the survival of patients with differentiated thyroid carcinoma. Higher intratumoral MVD values were associated with inferior disease-free survival outcomes.