title: Association between vascular endothelial growth factor expression and lymph node metastasis in cervical cancer: A meta-analysis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Our study revealed that VEGF-positive expression is related with higher risk of LNM in cervical cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Haiying
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Fangxu
authors.initials: F
authors.lastname: Tang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Shasha
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xiong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Shaoshuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Kecheng
authors.initials: K
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Jia
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Department of Gynecology & Obstetrics, Central Hospital of Wuhan, Wuhan, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Tian
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. dma@tjh.tjmu.edu.cn.
authors.forename: Ding
authors.initials: D
authors.lastname: Ma
authors.affiliation: Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. lee5190008@126.com.
authors.forename: Shuang
authors.initials: S
authors.lastname: Li
mesh_terms: D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D042461:Vascular Endothelial Growth Factor A
keywords: cervical cancer; expression; lymph node metastasis; meta-analysis; vascular endothelial growth factor