术中联合淋巴结清扫对肝内胆管细胞癌预后影响的荟萃分析  

The impact of lymphadenectomy on the prognosis of intrahepatic cholangiocarcinoma:a Meta-analysis

作　　者：庞书杰 施洋 杨宁 叶庆旺 杨广顺 

机构地区：[1]东方肝胆外科医院肝外五科,上海200438

出　　处：《肝胆胰外科杂志》2016年第1期17-21,共5页Journal of Hepatopancreatobiliary Surgery

基　　金：十二五艾滋病和病毒性肝炎等重大传染病防治专项(2012ZX10002-017)

摘　　要：目的 评价术中联合淋巴结清扫术能否提高肝内胆管细胞癌预后。方法 计算机检索2005年1月1日至2015年3月31日期间PubMed、EmBase、Web of Science、中国知网、维普、万方数据库收录的比较肝内胆管细胞癌根治术中是否联合淋巴结清扫术对预后影响的文献,文献纳入由两名研究者独立筛选,经过质量评价与数据提取后,采用RevMan5.3进行Meta分析。结果 共纳入5篇队列研究,纳入病例总数522例,其中行淋巴结清扫术[LND（＋）]272例,未行淋巴结清扫术[LND（-）]250例。Meta分析显示术后3年总生存（RR=0.91,95%CI：0.74～1.13,P=0.41）,术后5年总生存率（RR=0.84,95%CI：0.63～1.11,P=0.22）,术后3年无瘤生存率（RR=0.89,95%CI：0.65～1.21,P=0.47）。结论 术中常规联合淋巴结清扫术对肝内胆管细胞癌预后无明显影响。Objective To evaluate whether lymphadeneetomy can improve the postoperative prognosis of patients with intrahepatic cholangiocarcinoma （ICC） or not. Methods PubMed, EmBase, Web of Science, CNKI, VIP, Wanfang Database were retrieved to collect researches published between 1 st Jan. 2005 to 31 st Mar. 2015. The inclusion and evaluation of those researches were conducted by two researchers independently, and then the data were extracted and analyzed by using RevMan 5.3 version. Results A total of 5 cohort studies which involved 522 patients with ICC were included in this study. There was no significant difference between LND（＋） and LND（-） group in terms of the 3-year overall survival rate （RR=0.84, 95%CI：0.74 - 1.13, P=-0.41）, the 5-year overall survival rate （RR=0.84, 95%CI： 0.63 - 1.11, P=-0.22） and the 3-year disease free survival rate （RR=0.89, 95%CI： 0.65 - 1.21, P=-0.47）. Conclusion Routine lymphadenectomy can not improve the prognosis of patiens with ICC after curative hepatectomy.

关 键 词：肝内胆管细胞癌 淋巴结清扫术 预后 META分析 

分 类 号：R735.8[医药卫生—肿瘤]