中国女性乳腺癌患者术后复发影响因素meta分析  

Influencing factors of recurrence after surgery among Chinese female breast cancer patients:a meta-analysis

作　　者：刘玲玲[1,2] 林芳[1,2] 韩耀风[1,2] 方亚[1,2] 

机构地区：[1]厦门大学公共卫生学院,福建厦门361102 [2]卫生技术评估福建省高校重点实验室

出　　处：《中国公共卫生》2017年第1期165-169,共5页Chinese Journal of Public Health

基　　金：厦门市科技计划项目(3502Z20143006)

摘　　要：目的探讨中国女性乳腺癌患者术后复发的影响因素,为改善乳腺癌患者预后提供参考依据。方法检索中国学术文献总库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、Web Of Science数据库、Pubmed数据库、Science Direct数据库和BIOSIS数据库,并辅以手工检索和文献追溯法收集2000年1月1日—2013年12月31日公开发表的关于中国女性乳腺癌患者术后复发影响因素的相关文献;应用Rev Man 5.2和SAS 9.2软件对纳入的文献进行meta分析。结果最终纳入25篇中文文献,共累计女性乳腺癌患者16 471例,其中术后复发患者1 048例,复发率为6.36%;meta分析结果显示,肿瘤直径>2 cm(OR=2.89,95%CI=1.76~4.74)、肿瘤分期>Ⅱ期(OR=3.79,95%CI=3.08~4.66)、原发灶T分期>T2期(OR=3.78,95%CI=2.47~5.78)、有淋巴结转移(OR=2.68,95%CI=1.67~4.31)、淋巴结转移数目>3个(OR=3.17,95%CI=2.49~4.03)和人表皮生长因子2阳性(OR=2.85,95%CI=2.21~3.67)为中国女性乳腺癌患者术后复发的危险因素,雌激素受体/孕激素受体阳性(OR=0.47,95%CI=0.38~0.59)和术后放疗(OR=0.21,95%CI=0.12~0.36)为中国女性乳腺癌患者术后复发的保护因素;敏感性分析和发表偏倚评估结果显示,纳入的文献不存在发表偏倚,结果较为可靠。结论肿瘤直径、肿瘤分期、淋巴结转移状态、淋巴结转移数目、原发灶T分期、人表皮生长因子2状态、雌激素受体/孕激素受体状态和术后放疗情况是中国女性乳腺癌患者术后复发的主要影响因素。Objective To explore influencing factors of recurrence of breast cancer after surgery among Chinese female patients and to provide evidences for decision-making for improving prognosis of the patients. Methods Literatures published between January 1 st, 2000 and December 31 st,2013 relevant to influencing factors of recurrence of breast cancer after surgery among Chinese female patients were searched online through China National Knowledge Infrastructure （CNKI）, Wanfang Database, Chinese Biological and Medical Database （CBM）, Web of Science, Pubmed, Science Direct,and BIOSIS and supplemented with manual searching. Meta-analysis on the data collected was performed with RevMan 5.2 and SAS 9. 2. Results Totally 25 studies conducted among 16 471 Chinese female breast cancer patients were included;of all the patients, 1 048 had recurrence after surgery of breast cancer, with a recurrence rate of 6. 36%. The results of meta-analysis showed that tumor size 〉 2 cm in diameter （odds ratio [ OR] = 2. 89,95% confidence interval [95% CI] = 1.76 -4. 74） ,neoplasm staging of greater than stage 11 （ OR = 3.79,95% CI = 3.08 -4. 66） ,primary tumor T-stage of higher than T2 （ OR = 3. 78,95% CI = 2. 47 - 5.78 ）, lymph node metastasis （ OR = 2. 68,95% CI =1.67 - 4. 31 ）, total number of lymph node metastasis of more than 3 （ OR = 3.17,95 % CI = 2.49 - 4. 03 ）, and human epidermal receptor-2 （Her-2） positive （ OR = 2. 85,95% CI = 2. 21 - 3.67 ） were risk factors of recurrence; whereas estrogen receptors to progesterone receptors （ER/PR） positive （ OR = 0.47,95% CI = 0. 38 - 0. 59 ） and postoperative radiotherapy （ OR = 0. 21,95% CI = 0. 12 - 0. 36 ） were protective factors. Sensitivity analysis and publication bias assessment indicated that the results were stable and there was no publication bias. Conclusion The recurrence of breast cancer after surgery is related to tumor size, tumor staging, T-stage of primary tumor, lymph node metastasis, lymph node metastasis number, Her-2 status

关 键 词：乳腺癌患者 术后复发 影响因素 中国女性 META分析 

分 类 号：R173[医药卫生—妇幼卫生保健]