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中华普通外科学文献(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 80 -84. doi: 10.3877/cma.j.issn.1674-0793.2019.01.018

所属专题: 专题评论 文献

循证医学

前哨淋巴结微转移与乳腺癌复发风险的系统评价及Meta分析
未灯辉1, 许志宏1, 谢莉莉1, 韩晖1, 林舜国1, 许春森1,()   
  1. 1. 350001 福州,福建医科大学附属协和医院乳腺外科
  • 收稿日期:2018-08-22 出版日期:2019-02-01
  • 通信作者: 许春森
  • 基金资助:
    福建省医学创新课题(2018-CX-40); 福建省卫生厅项目(2011-cxb-8)

Sentinel lymph node micrometastasis and risks of breast cancer recurrence: a systematic review and meta analysis

Denghui Wei1, Zhihong Xu1, Lili Xie1, Hui Han1, Shunguo Lin1, Chunsen Xu1,()   

  1. 1. Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
  • Received:2018-08-22 Published:2019-02-01
  • Corresponding author: Chunsen Xu
  • About author:
    Corresponding author: Xu Chunsen, Email:
引用本文:

未灯辉, 许志宏, 谢莉莉, 韩晖, 林舜国, 许春森. 前哨淋巴结微转移与乳腺癌复发风险的系统评价及Meta分析[J]. 中华普通外科学文献(电子版), 2019, 13(01): 80-84.

Denghui Wei, Zhihong Xu, Lili Xie, Hui Han, Shunguo Lin, Chunsen Xu. Sentinel lymph node micrometastasis and risks of breast cancer recurrence: a systematic review and meta analysis[J]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(01): 80-84.

目的

系统评价在未行腋窝淋巴结清扫时,前哨淋巴结(SLN)微转移对乳腺癌患者复发相关事件发生率(RRER)的影响。

方法

检索PubMed、EMBASE、WanFang数据、CNKI、CBM建库至2018年5月1日的文献资料,严格按照纳入和排除标准筛选相关研究,对纳入的研究进行资料提取,采用NOS量表进行质量评价,使用RevMan 5.2软件进行Meta分析。

结果

最终筛选出6篇相关文献共1 730例患者,其中3项前瞻性观察研究,3项回顾性研究。中位随访33~77个月,SLN微转移组(370例)与SLN阴性组(1 360例)的RRER差异无统计学意义(OR=1.37,95%CI:0.72~2.59,I2=47%,P=0.34);同时,在局部复发率方面,SLN微转移组354例,复发12例,SLN阴性组1 337例,复发35例,两者比较差异亦无统计学意义(OR=1.49,95%CI:0.75~2.97,I2=40%,P=0.26)。

结论

SLN微转移并不增加乳腺癌患者的复发风险。

Objective

To systemically evaluate the recurrence related event rate (RRER) of breast cancer with sentinel lymph node micrometastasis (SLN MIC) without axillary lymph node dissection (ALND).

Methods

Databases such as PubMed, EMBASE, WanFang Data, CNKI and CBM were searched comprehensively for studies about SLN for breast cancer from foundation to May 1st, 2018. On the basis of the inclusion and exclusion criteria, extracting data, assessing methodological quality and analyzing results was achieved. RevMan 5.2 was used to carry out statistical analyses.

Results

A total of six studies, including 3 prospective observational studies and 3 retrospective studies involving 1 730 patients of whom 370 had SLN MIC and 1 360 had negative SLN (-), were qualified for final analysis. The odds ratio (OR) of RRER between group SLN MIC and group SLN (-) of breast cancer patients who didn’t performed ALND was 1.37 (95%CI: 0.72-2.59, I2=47%, P=0.34), without statistical differences. In addition, there was also no statistical difference in regional recurrence rate between group SLN MIC and group SLN(-) of breast cancer patients without ALND (OR=1.49, 95%CI: 0.75~2.97, I2=40%, P=0.26).

Conclusion

Compared with patients with negative SLN, SLN MIC does not increase the risk of recurrence in breast cancer patients without ALND.

图1 文献筛选流程
表1 纳入研究的基本特征
表2 纳入观察性研究的质量评价
图2 乳腺癌复发相关事件发生率情况 SLN MIC:前哨淋巴结微转移;SLN(-):前哨淋巴结阴性
图3 乳腺癌局部复发率情况 SLN MIC:前哨淋巴结微转移;SLN(-):前哨淋巴结阴性
图4 复发相关事件发生率的发表偏倚分析
图5 局部复发率的发表偏倚分析
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