射频消融术与肝切除术治疗小肝癌（米兰标准）有效性和安全性的Meta分析

发布时间：2018-07-02 19:22

本文选题：肝癌 + 射频消融　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]比较射频消融术(Radiofrequencyablation, RFA)与手术切除术治(Surgical resection,SR)米兰标准下小肝癌的临床有效性和安全性。[方法]利用计算机和人工检索的方式检索PubMed、The Cochrane Library、Embase、CNKI、维普期刊、万方数据、中国生物医学文献数据库(CBM),全面搜集射频消融术与手术切除治疗米兰标准下小肝癌的临床对照研究。按照Cochrane协作网提供的方法用RevMan5.3软件进行Meta分析[结果]一共检索出11篇文献,2274名患者纳入此次研究,其中RFA组1160名,SR 组 1114。RFA 组与 SR 组 1、3 年总体生存率(OR,0.79 (95%CI,0.46to 1. 36) , Z 检验:P=0. 39, OR,0.72 (95%CI,0.50to1. 02),Z 检验:P=0. 06)无统计学差异(P0. 05),5年总体生存率RFA组低于SR组(OR, 0. 55 (95% CI,0.41 to 0.73),Z检验:P0.0001),差异有统计学意义(P0.05)。1年和5年无瘤生存率相比分别为(OR, 0. 78 (95% CI,0. 61 to 1. 00),Z检验:P=0. 05)。和(OR,0.47 (95% CI,0. 37 to 0. 61),Z 检验:P00001)。SR 组在 1、5 年无瘤生存率中比RFA组更高,差异有统计学意义。3年无瘤生存率(OR, 0. 74 (95%CI, 0.53 to 1.02),Z检验:P=0. 06)差异无统计学意义。RFA组比SR组的并发症发生率低(OR,0.23 (95% CI, 0.11 to 0.52) , Z 检验:P=0.0003),安全性更高。[结论]RFA相较于SR有更少的并发症,安全性(并发症的发生率)更高。就短期疗效(1、3年总体生存率及1、3年无瘤生存率)来说RFA与SR的治疗效果相当,长期生存率(5年以后及更远的总体生存率及无瘤生存率)而言SR疗效是优于RFA的。,SR术仍然是肝癌患者的首选治疗方式
[Abstract]:[objective] to compare the clinical efficacy and safety of radiofrequency ablation (RFA) and Surgical resection (SR) in the treatment of small hepatocellular carcinoma (HCC). [methods] computer and manual search were used to retrieve the Cochrane Library Embase CNKI, Weip Journal, Wanfang data, Chinese Biomedical Literature Database (CBM), and to collect the clinical comparative study of radiofrequency ablation and surgical excision for small hepatocellular carcinoma (HCC) in Milan standard. According to the method provided by Cochrane Cooperative Network, Meta-analysis was performed with RevMan5.3 software. [results] A total of 11 articles were retrieved from 2274 patients who were included in the study. Among them, 1160 patients in SR group and 1114 in SR group and SR group had a 3-year overall survival rate (OR0.79 (95CI0.46to 1). 36), Z test: P0. 95 CI 0.50 to 1. 02) Z test. There was no statistical difference (P0. The 5-year overall survival rate in RFA group was lower than that in SR group (OR, 0. 55 (95% CI 0.41 to 0.73) Z test: P0.0001, the difference was statistically significant (P0.05). The 1-year and 5-year tumor-free survival rates were respectively (ORO, 0. 0001). 78 (95% CI). 61 to 1. 00) Z test. ) And (ORX) 0.47 (95% CI). 37 to 0. 61) the 5-year tumor-free survival rate in SR group was higher than that in RFA group, and the 3-year tumor-free survival rate was significantly higher in SR group than that in RFA group. 74 (95CI, 0.53 to 1.02). The incidence of complications in RFA group was lower than that in SR group (OR 0.23 (95% CI, 0.11 to 0.52), Z test was 0.0003), and the safety of RFA group was higher than that of SR group. [conclusion] RFA has fewer complications and higher safety than SR. In terms of short-term efficacy (1-, 3-year overall survival rate and 1-, 3-year tumor-free survival rate), RFA is comparable to SR. Long-term survival rate (overall survival and tumor-free survival after 5 years and beyond) SR is superior to RFA. SR is still the first choice for HCC patients.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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