Microvessel density in patients with gastrointestinal stromal tumors: A systematic review and meta-analysis

Table 1 Study characteristics, n (%)

Ref.	Type of study	Country	Centre	Sample (patients)	Analysis sample	Specimens	Age	Gender (male/female)	Follow-up
Chen et al[22], 2005	Retrospective	Taiwan	Single centre	62	59 (3 cases lost to follow-up)	62	24 (38.7) ≤ 61 yr; 38 (61.3) > 61 yr	34 (54.8)/28 (45.2)	50.5 (31) mo for 59 cases
Imamura et al[8], 2007	Retrospective	Japan	Single centre	95	95 (80 from the K-M curves)	95	64 (11.667) yr	48 (50.5)/47 (49.5)	48.4 (26.1833) mo for 80 cases
Takahashi et al[23], 2003	Retrospective	Japan	Single centre	53	53	53	59.5 (13.3) yr	32 (60.3)/21 (39.6)	81.7 (63.2) mo
Waengertner et al[24], 2011	Retrospective	Brazil	Single centre	79	79	79	58.9 (13) yr	42 (53.2)/37 (46.8)	2.5 (2.8) yr
Wang et al[9], 2009	Retrospective	China	Multicentre	68	68	68	56.8 (14.75) yr	38 (55.9)/30 (44.1)	42.9 (14) mo for 64 patients
Zhao et al[25], 2012	Retrospective	China	Single centre	124	124	124	54.6 (11.667) yr	64 (51.6)/60 (48.4)	52 (32.333) mo

Table 2 Microvessel density assessment

Ref.	MVD assessment method	Antibody	Magnification used	Spots examined	Blinded reading	Observers	Separate count for intra/peritumoral vessels	MVD cut off
Chen et al[22]	Light microscopy, immunohistochemistry	CD31	10X; 20X; 100X	3	N/A	N/A	N/A	15/HPF
Imamura et al[8]	Light microscopy, immunohistochemistry, slight modification of Horak et al technique	CD31	40X; 200X	10	Yes	2	N/A	7/0.95 mm²
Takahashi et al[23]	Light microscopy, immunohistochemistry	CD31	40X; 100X; 400X	3	N/A	N/A	N/A	19/HPF
Waengertner et al[24]	Light microscopy, immunohistochemistry, modified Chalkley method	CD31	200X	3 to 5	N/A	N/A	N/A	6 vessels
Wang et al[9]	Light microscopy, immunohistochemistry	CD31	200X	4	Yes	2	N/A	10.54/200HPF
Zhao et al[25]	Light microscopy, immunohistochemistry, Weidner technique	CD34	100X; 200X	5	N/A	N/A	N/A	N/A

MVD: Microvessel density; N/A: Not applicable.

Table 3 Tumor classification, n (%)

Ref.	Risk				Location
	Very low risk	Low risk	Intermediate risk	High risk	Stomach	Small intestine	Colon	Rectum	Esophagus
Chen et al[22]	0 (0)	31 (50)	0 (0)	31 (50)	41 (66)	18 (29)	3 (4.8)	0 (0)	0 (0)
Imamura et al[8]	7 (7.3)	22 (23.2)	38 (40)	28 (29.5)	64 (67.4)	31 (32.6)	0 (0)	0 (0)	0 (0)
Takahashi et al[23]	16 (30.1)		10 (18.8)	27(50.9)	53 (100)	0 (0)	0 (0)	0 (0)	0 (0)
Waengertner et al[24]	12 (15.4)	11 (13.8)	18 (23.1)	38 (47.7)	36 (45.6)	30 (38)	0 (0)	0 (0)	0 (0)
Wang et al[9]	0 (0)	20 (29.4)	0 (0)	48 (70.6)	28 (41.2)	20 (29.4)	11 (16.2)	0 (0)	0 (0)
Zhao et al[25]	6 (4.8)	20 (16.1)	37 (29.8)	61 (49.3)	62 (50)	28 (22.6)	14 (11.3)		9 (7.3)

Table 4 Tumor and treatment characteristics, n (%)

	Necrosis		Hemorrhage		Mitotic count		Tumor size		Pcna index		Cell type			Treatment
Ref.	Yes	No	Yes	No					≤ 10%	> 10%	Epithelioid	Spindle	Mixed	Surgery	Surgery type	Chemotherapy	Chemotherapy type
Chen et al[22]	23 (37)	39 (63)	45 (72.6)	17 (27.4)	36 (58) < 2/10 HPF	26 (42) ≥ 2/10 HPF	32 (51.6) < 5 cm	30 (48.4) ≥ 5 cm	32 (51.6)	30 (48.4)	N/A	N/A	N/A	Yes	Subtotal gastrectomy, complete tumor resection or segmental enterectomy	Yes (some of them)	See comments
Imamura et al[8]	N/A	N/A	N/A	N/A	55 (57.9) < 5/50 HPF	40 (42.1) ≥ 5/50 HPF	39 (41.05) < 5 cm	56 (58.95) ≥ 5 cm	N/A	N/A	1 (1.05)	92 (96.85)	2 (2.1)	Yes	Resection with negative margins	N/A	N/A
Takahashi et al[23]	N/A	N/A	N/A	N/A	33 (62.2) < 3/50 HPF	20 (37.7) ≥ 3/50 HPF	21 (39.6) ≤ 3 cm	32 (60.3) > 3 cm	N/A	N/A	N/A	N/A	N/A	Yes	Surgical resection	N/A	N/A
Waengertner et al[24]	N/A	N/A	N/A	N/A	N/A	N/A	N/A, varies from 0.5 to 25 cm (median 4.8 cm)		N/A	N/A	N/A	57 (72.2%)	N/A	N/A	N/A	Yes	Adjuvant therapy with tyrosine kinase inhibitors (400mg/daily) for no longer than 3 months
Wang et al[9]	N/A	N/A	N/A	N/A	45 (66.2) < 2/10 HPF	23 (33.8) ≥ 2/10 HPF	24 (35.3) ≤ 5 cm	44 (64.7) > 5 cm	N/A	N/A	N/A	N/A	N/A	Yes	N/A	No	No
Zhao et al[25]	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	28 (22.58)	73 (58.87)	23 (18.55)	Yes	Only biopsy, palliative resection, radical resection	Yes	Postoperative

N/A: Not applicable.