上尿路尿路上皮肿瘤根治术前输尿管镜检查对远期预后影响的Meta分析

发布时间：2018-05-27 14:48

本文选题：上尿路尿路上皮肿瘤 + 输尿管镜检查　；参考：《第三军医大学学报》2017年01期

【摘要】：目的 Meta分析上尿路尿路上皮肿瘤(upper tract urothelial carcinoma,UTUC)根治手术前行输尿管镜检查(ureteroscopy,URS)对UTUC远期预后的影响。方法计算机检索Pub Med、EMbase、Cochrane Library、中国生物医学文献数据库、万方、维普和中国知网数据库,收集URS对UTUC预后影响的前瞻性或回顾性研究,检索时限为建库至2016年2月29日。由两名研究者按照纳入与排除标准进行文献纳入,对纳入的研究行质量评价,提取相关肿瘤预后资料风险比(hazard ratios,HR)及其95%可信区间(confidence interval,CI),采用Stata 12软件进行Meta分析。结果共纳入13个回顾性研究,包括4 105例患者。Meta分析结果显示:术前行URS未增加疾病无复发生存风险,单因素合并结果[HR=0.93,95%CI(0.73,1.13)],多因素合并结果[HR=1.13,95%CI(0.90,1.36)];行URS未增加膀胱内无复发生存风险,单因素合并结果[HR=1.13,95%CI(0.82,1.43)],多因素合并结果[HR=1.54,95%CI(0.97,2.12)];对于肿瘤特异生存期,单因素合并结果显示行URS组优于未行URS组[HR=0.68,95%CI(0.48,0.88)],而多因素合并结果两者差异无统计学意义[HR=0.83,95%CI(0.54,1.12)];行URS未增加总体生存风险,单因素合并结果差异无统计学意义[HR=0.87,95%CI(0.46,1.27)]。结论术前行URS并未影响UTUC患者术后远期肿瘤复发及生存情况。
[Abstract]:Objective to analyze the effect of ureteroscopy on the long term prognosis of upper urinary tract epithelial tumor (UTUC) by ureteroscope before radical operation with upper tract urothelial carcinoma (UTUC) by Meta. Methods Pub Medsite EMbase Cochrane Library, Chinese Biomedical Literature Database, Wanfang, Weip and China KnowledgeNet databases were searched by computer. Prospective or retrospective studies on the influence of URS on the prognosis of UTUC were collected. The search time was established until February 29, 2016. According to the criteria of inclusion and exclusion, two researchers carried out literature review, evaluated the quality of the included studies, extracted the risk ratio of tumor prognostic data to Hazard ratios-HRs and 95% confidence interval-CIG, and analyzed Meta by Stata 12 software. Results A total of 13 retrospective studies were included, including 4,105 patients. Meta-analysis results showed that preoperative URS did not increase the risk of disease recurrence, univariate association [HRN 0.9395 CI0.73C1.13], multivariate results [HR1.13995 CI0.901.36], and URS did not increase the risk of intravesical recurrence. Results of univariate combination [HRN 1.1395 CI 0.821.43], multivariate combination results [HRN 1.5495 CI 0.97 / 2.12]; for tumor-specific survival period, univariate combination results showed that URS group was superior to non-URS group [HR0.6895 CI 0.480.88], but multifactorial combination had no statistical significance [HRN 0.8395CI 0.541.12]; URS did not increase the overall survival risk. There was no significant difference in univariate combined results. Conclusion preoperative URS does not affect the recurrence and survival of long-term tumor in patients with UTUC.
【作者单位】：兰州大学泌尿外科研究所兰州大学第二医院泌尿外科甘肃省泌尿系统疾病临床医学中心甘肃省泌尿系统疾病研究重点实验室;
【基金】：国家自然科学基金面上项目(81402122)~~
【分类号】：R737.1

【相似文献】