保留卵巢对年轻早期子宫内膜癌患者预后影响的荟萃分析  

Meta-analysis of prognosis of ovarian preserving in young patients with early endometrial cancer

作　　者：王佳[1] 李小毛[1] 

机构地区：[1]中山大学附属第三医院妇科,广州510630

出　　处：《中华妇产科杂志》2016年第8期602-607,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金（30772332）;广东省自然科学基金（S2012010008640）

摘　　要：目的探讨保留卵巢对年轻早期子宫内膜癌患者预后的影响。方法（1）计算机检索的中、英文数据库包括Cochrane图书馆数据库、Embase数据库、PubMed数据库、WebofScience数据库、中国知网（CNKI）数据库、万方医学网数据库、中文科技期刊（csTJ）数据库等，手工检索《国际肿瘤杂志》、《中华妇产科杂志》、《实用妇产科杂志》等杂志以及百度、谷歌等网络资源，收集从1966年1月至2016年3月间发表的相关文献。由2名研究者独立按照纳入及排除标准筛选文献并提取相关数据，采用Newcastle—Ottawa scale（NOS）量表对纳入的文献进行质量评价，评分t〉7分者具有较高质量等级。（2）使用Cochrane图书馆数据库提供的RevMan5_3软件进行荟萃分析，先对人选研究进行异质性检验，根据异质性大小选用效应模型（包括固定效应模型、随机效应模型）进行合并分析，探讨保留卵巢对年轻早期子宫内膜癌患者预后（包括5年肿瘤复发率、5年总生存率）的影响。结果（1）本研究共纳入10篇中、英文文献，均为队列研究，共5299例患者，其中保留卵巢的年轻早期子宫内膜癌患者916例。文献质量评价采用NOS量表进行评分，人选研究均≥7分，均具有较高质量等级。（2）荟萃分析结果显示，年轻早期子宫内膜癌保留卵巢与切除卵巢患者的5年肿瘤复发率[分别为2．58％（7／271）、4．43％（51／1150）]比较，差异无统计学意义（RR=1．01，95％CI为0．46～2．22，P=O．986）；两者的5年总生存率[分别为96．00％（863／899）、96．51％（3736／3871）]比较，差异也无统计学意义（RR=1．00，95％C1为0．99～1．02，P=0．792）。结论年轻早期子宫内膜癌患者行保留卵巢的手术，对其预后无明显影响。Objective To discuss the effect of preserving ovaries on the prognosis of young early endometrial cancer patients. Methods Searched English and Chinese databases by computors, including Cochranc library, Embase, PubMed, Web of Science, China National Knowledge Internet （CNKI）, data base of Wanfang, China Science and Technology Journal （CSTJ）, and also relevant journals and magazines by hand. Retrieval time from January 1996 to March 2016. In accordance with the inclusion criteria, two independent investigators screened the studies and extracted the relevant data respectively. Then evaluated the quality of included studies. Finally, conducted the meta-analysis with RevMan 5.3 software from cochrane collaboration network, in which heterogeneity test of enrolled studies firstly was completed and combined analysis with effect models according to the heterogeneity secondary. In the light of the result, effect of remaining ovaries on the prognosis （5-year recurrence rate and 5-year overall survival rate） of young early endometrial cancer patients was determined. Results Ten trials were included. All of them were cohort studies, a total of 5 299 patients, in which 916 patients＇ ovaries were remained. Quality assessment of all l0 studies were based on Newcastle-Ottawa Scale （NOS） scale. All of the studies enrolled were of high quality with a score of ≥7. After quality assessment,all studies illustrated the higher the quality. Meta- analysis showed that there was no statistically significant difference between who had ovarian preservation and without preservation in terms of 5-year overall survival rate [96.00% （863/899） vs 96.51% （3 736/3 871）; RR=1.00, 95%CI： 0.99-1.02, P=0.792] and the 5-year reeurrenee rate [2.58% （7/271） vs 4.43% （51/1 150）; RR=1.01, 95%CI： 0.46-2.22, P=0.986]. Conclusion Ovarian preservation in young early stage patients of endometrial cancer eould not effect the 5-year overall survival rateand the 5-year reeurrenee rate.

关 键 词：子宫内膜肿瘤 卵巢 Meta分析 器官保留治疗 

分 类 号：R737.33[医药卫生—肿瘤]