经肝动脉化疗栓塞术联合无水乙醇瘤内注射治疗原发性肝癌的Meta分析  

Transcatheter arterial chemoembolization combined with percutaneous ethanol injection in the treatment of primary hepatocellular carcinoma-a Meta-analysis

作　　者：苏飞[1] 王欣[2] 陈双倩[1] 王国洲[1] 杨帅龙 金二亮 李继强[1] 谢伟[1] 冯茂辉[1] 

机构地区：[1]武汉大学中南医院肿瘤外科肿瘤生物学行为湖北省重点实验室,430071 [2]湖北省通城县人民医院普外科

出　　处：《中华实验外科杂志》2014年第7期1553-1555,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（81072152）;湖北省自然科学基金资助项目（2009CD201）;湖北省卫生厅科研资助项目（2013.JX6820）;武汉市科技攻关重点资助项目（200860423230）

摘　　要：目的 系统评价经肝动脉化疗栓塞术联合无水乙醇瘤内注射（TACE-PEI）治疗原发性肝癌的疗效及安全性。方法 采用计算机检索和手工检索相结合的方法搜索Pubmed、Cochrane Central、Embase等外文数据库及中国知网（CNKI）、中国生物医学文献数据库（CBMdisc）、重庆维普（VIP）、万方等中文数据库,时间为从建库至2013年10月。收集TACE-PEI注射治疗原发性肝癌的随机对照试验（RCT）,对符合纳入标准的研究采用RevMan 5.1软件进行Meta分析。结果共纳入24篇文献,包括774例TACE-PEI介入治疗原发性肝癌病例和740例单用经肝动脉化疗栓塞术（TACE）介入治疗病例。Meta分析显示两组比较,TACE-PEI联合介入治疗原发性肝癌在1年生存率[比值比（OR）=3.44,95%可信区间（CI）（2.60-4.55）,P〈0.01]、2年生存率[OR=2.96,95%CI（2.29-3.83）,P〈0.01],3年生存率[OR=3.54,95%CI（2.53-4.97）,P〈0.01],治疗后血清甲胎蛋白（AFP）下降率[OR=3.14,95%CI（2.30-4.28）,P〈0.01],肿瘤缩小率[OR=3.05,95%CI（2.30-4.03）,P〈0.01]等方面明显优于单用TACE介入治疗,而在治疗原发性肝癌的不良反应发生率[OR=1.94,95%CI（1.17-3.21）,P〈0.05]方面TACE-PEI联合介入的发生率高于单用TACE介入治疗。结论 TACE-PEI治疗原发性肝癌的疗效优于单用经肝动脉化疗术,但不良反应有所增加,不良反应一般较轻,大多数患者可耐受。Objective To assess the efficacy and adverse events of transcatheter arterial chemoem- bolization combined with percutaneous ethanol injection （TACE-PEI） in the treatment of primary hepato cellular carcinoma. Methods Databases such as Pubmed, Cochrane Central, Embase, CNKI, CBMdisc, VIP and WanFang were searched till October 2010, and randomized controlled trials of TACE-PEI in the treatment of primary hepatocellular carcinoma were collected. For all the included studies, we performed Meta-analysis using RevMan 5.1. Results Twenty-one literatures were reviewed, including 774 cases receiving TACE-PEI and 740 cases receiving TACE. Meta-analysis revealed the 1-year survival rate [ OR = 3.44, 95 % confidence interval （CI） （2. 60-4. 55 ）, P 〈 0. 01 ], 2-year survival rate [ OR = 2. 96, 95 % CI （2. 29-3.83 ）, P 〈 0. 01 ], 3-year survival rate [ OR = 3.54, 95 % CI （ 2. 53-4. 97 ）, P 〈 0. 01 ], the decrease of AFP [ OR = 3.14, 95 % CI（2. 30-4. 28） ,P 〈 0. 01 ], and shrinkage of tumor mass [ OR = 3.05, 95% CI（2. 30-4. 03 ）,P 〈 0. O1 ] in TACE-PEI group were significantly higher than in TACE group. The adverse events [ OR = 1.94, 95% CI （1.17-3.21） ,P 〈 O. 05 J were also more frequently seen in TACE- PEI group than in TACE group. Conclusion The efficacy of TACE-PEI in the treatment of primary hepato cellular carcinoma was superior to that of TACE alone. However, the combination of TACE-PEI increased the adverse events.

关 键 词：癌 肝细胞 经肝动脉化疗栓塞术 无水乙醇瘤内注射 META分析 

分 类 号：R735.7[医药卫生—肿瘤]