术前血小板计数升高对卵巢上皮恶性肿瘤分期的预测价值的meta分析

发布时间：2018-12-14 04:07

【摘要】：背景： 卵巢上皮恶性肿瘤是卵巢恶性肿瘤中最常见的肿瘤，可发生于任何年龄段，发病率及死亡率高，诊断的特异性差，目前诊治面临诸多难点。目前关于卵巢上皮恶性肿瘤常用的预测指标有CA125及HE4等。CA125和HE4是目前应用比较广泛的预测指标，能在一定程度上对病情进行预测，但该指标仍然存在着干扰因素多，普遍适用性差，，价格昂贵等负面因素，因此在临床应用中其预测效果仍然有一定的局限性。 目前很多学者已经深入的研究了术前血小板计数水平对卵巢上皮恶性肿瘤的预测价值，证实术前血小板计数水平在卵巢上皮恶性肿瘤的分期分级、腹水、满意减瘤术、化疗效果、无瘤生存期及总生存期上均有一定的预测价值。 卵巢癌的国际妇产科联盟（FIGO）分期是手术病理分期，其准确性对于卵巢癌的治疗十分重要，如果能在术前对卵巢癌FIGO分期进行预测，不仅有助于手术病理分期准确性的提高，还可以指导治疗方案的选择，如预测分期高的患者可以直接行新辅助化疗等。 本文通过对相关主题的文献的筛选，运用统计学的方法，合并相类似的研究结果，来探讨术前血小板计数水平对卵巢上皮恶性肿瘤早期（StageI/II）及晚期（Stage III/IV）的确切预测价值。 目的：利用可以获得的数据来探讨术前血小板计数升高对卵巢上皮恶性肿瘤早期（StageI/II）及晚期（Stage III/IV）的预测价值。 方法：计算机检索PubMed数据库、Med-Line数据库、万方数据库、中国学术文献总库（CNKI），中国生物医学文献数据库（CBM），语言类型为英文或中文，检索时间为1993年至2013年。两位研究者独立对纳入文献进行质量评价。内容要求是关于术前血小板计数升高和卵巢上皮恶性肿瘤的相关研究、所有患者都进行了减瘤术和（或）术后化疗、有明确的病理诊断结果及肿瘤分期、以血小板计数升高作为分组依据的病例对照研究类型文献。 结果：总共纳入5篇文献811例患者，提取数据后，stata12.0软件进行meta分析，分析结果显示：1.术前血小板计数升高对卵巢上皮恶性肿瘤早期（StageI/II）的预测价值，合并后的RR值为0.53[0.42,0.67]，森林图中的棱形不与垂直线相交，棱形偏左（I2=0.0%，P=0.538），提示术前血小板计数升高组患者诊断为卵巢上皮恶性肿瘤早期（StageI/II）的风险小；2.术前血小板计数升高组对卵巢上皮恶性肿瘤晚期（Stage III/IV）的预测价值，合并后的RR值为1.37[1.24,1.51]，森林图中的棱形不与垂直线相交，棱形偏右（I2=0.0%，P=0.590），提示术前血小板计数升高组患者诊断为卵巢上皮恶性肿瘤晚期（Stage III/IV）的风险大；3.“PLT400×109/L”做为定义术前血小板计数升高标准的指标，可以用来预测卵巢上皮恶性肿瘤的早期（StageI/II）及晚期（Stage III/IV）。 结论： 1.术前血小板计数升高作为卵巢上皮恶性肿瘤在体内的病情进展情况的一个重要标志，可以预测卵巢上皮恶性肿瘤的分期； 2.“PLT400×109/L”做为定义术前血小板计数升高的标准在预测卵巢上皮恶性肿瘤分期上有一定的临床应用价值。
[Abstract]:Background: Ovarian epithelial tumor is the most common tumor in the ovarian malignant tumor. It can be found in any age group. The morbidity and mortality are high. The specificity of diagnosis is poor. Point. Current predictive indicators for ovarian epithelial malignancies are CA125 and HE4 CA125 and HE4 are widely used to predict the condition of the disease. However, there are many negative factors, such as many interference factors, poor general applicability and high price. Therefore, the prediction effect of CA125 and HE4 is still limited in clinical application. At present, many scholars have studied the prediction value of pre-operative platelet count on the malignant tumor of the ovary, and confirm that the level of the pre-operative platelet count is in the stage of stage, ascites and satisfactory detumorization of the malignant tumor of the ovary. has a certain pre-treatment effect on the effect of the fruit, the tumor-free survival time and the overall survival time The staging of the International Obstetrics and Gynecology Union (FIIGO) of ovarian cancer is the pathological stage of the operation, and its accuracy is very important for the treatment of ovarian cancer. If the staging of the FIGO of the ovarian cancer can be predicted before the operation, it is not only helpful for the pathological staging of the operation. the improvement of the accuracy can also guide the selection of the treatment scheme, In this paper, the early stage of ovarian epithelial malignant tumor (StageI/ II) and advanced stage (Stage III/ IV) were discussed by the screening of the literature of the related subjects, the statistical methods and the similar results. Purpose: To explore the early stage of ovarian epithelial malignancies (StageI/ II) and advanced stage (Stage III) using data that can be obtained Methods: The computer searches the PubMed database, the Med-Line database, the Wanfang database, the Chinese Academic Library (CNKI), the Chinese Biomedical Literature Database (CBM), the language type is English or Chinese, and the retrieval time is 1993-2013. The two investigators were independent Quality evaluation was conducted on the inclusion of the literature. The content requirements are related to the increase of pre-operative platelet count and ovarian epithelial malignancies, all of which have been treated with a reduction of tumor and/ or post-operative chemotherapy, with a clear The results of the pathological diagnosis and the staging of the tumor are based on the increase of the platelet count as the grouping basis. Case-control study type literature. Results: A total of 5 literatures were included in 811 patients. After the data was extracted, the stata12.0 software was used for me. The results of the analysis showed that: 1. The pre-operative platelet count increased the predictive value of the early stage of the malignant ovarian tumor (StageI/ II), the combined RR value was 0.53[0.42, 0.67], and the prism in the forest plot did not intersect the vertical line, and the prismatic deviation was left (I2 = 0. 0%, P = 0. 538), suggesting that the pre-operative platelet count increased group was diagnosed as an early stage of ovarian epithelial malignancy (Sta The risk of geI/ II was small; 2. The pre-operative platelet count increased the predictive value of advanced stage (Stage III/ IV) of the ovarian epithelial malignancy, and the combined RR value was 1.37[1.24, 1.51], and the prism in the forest plot does not intersect the vertical line, and the prism is right (I2 = 0. 0%, P = 0. 590), suggesting that the pre-operative platelet count increased group was diagnosed with a high risk of advanced stage of ovarian epithelial malignancy (Stage III/ IV); and 3. The 鈥淧LT400脳109/L鈥

本文编号：2377894