CO_2激光治疗喉癌前病变临床疗效的Meta分析  

Efficacy of Carbon Dioxide Laser for Treatment of laryngeal Precancerous Lesion:A Meta-analysis

作　　者：雷磊[1] 王敏[1] 赵鑫[1] 张军[1] LEI Lei WANG Min ZHAO Xin et al.(Affiliated Hospital of Yan＇ an University, Yan＇ an 716000, China)

机构地区：[1]延安大学附属医院,陕西延安716000

出　　处：《中国肿瘤》2017年第6期482-489,共8页China Cancer

摘　　要：[目的]评价CO_2激光切除喉癌前病变的近远期疗效,为优化治疗策略提供参考。[方法 ]检索Pub Med、Cochrane Library、Web of Science和万方、中国知网、中国生物医学、维普数据库,检索时限均从建库截至2016年5月,依据纳入和排除标准筛选文献,采用JADAD评分对纳入的随机对照研究文献进行质量评价,采用NOS评分对回顾性研究进行质量评价,用Rev Man 5.2软件进行Meta分析,结局指标包括手术时间、复发率和治愈率。[结果 ]共纳入12项研究,实验组506例,对照组384例,其中包括接受传统手术199例、微切割钻切除肿瘤74例,低温离子等其他离子切除术式103例。Meta分析结果显示,CO_2激光治疗术式在手术时间上无统计学差异;CO_2激光治疗组与其他术式相比,治愈率具有明显统计学差异,合并效应量OR为2.18,95%CI为1.28~3.71(P=0.004)。CO_2激光治疗组与对照组的术后复发率也具有统计学差异性,合并效应量OR为0.52,95%CI为0.35~0.78(P=0.002)。[结论]CO_2激光切除喉癌前病变相比于其他术式,能够显著降低复发率,提高治愈率。CO_2激光切除术是目前手术治疗喉癌前病变的最佳手术方式。Abstract：[Purpose ] To systemically review the efficacy of carbon dioxide laser in treatment of la- ryngeal precancerous lesions. [Methods ] PubMed,the Cochrane Library,Web of Science and CN- KI,WanFang Data and VIP were searched from inception to May 2016 for all studies on the treatment of laryngeal precancerou lesions using carbon dioxide laser,including retrospective cohort study and ease controlled study. The JADAD scoring system was used to evaluate the case controlled studies,the NOS scoring system was used to evaluate the retrospective cohort studies. Then Meta-analysis was performed using RevMan5.2 software. The operative time,cure rate and recurrence rate were regarded as the primary counter to observe. [Results] A total of 12 studies involving 890 patients were included,including 506 cases treated with carbon dioxide laser and 384 cases treated with other surgical methods as control group. The results of recta-analysis showed that compared to control group,carbon dioxide laser improved cure rate（effect size ：OR=2.18,95%CI： 1.28- 3.71, P=0.004 ）, and decreased recurrence rate（effect size ： OR =0.52,95% CI ： 0.35 -0.78, P=0.002 ）. However,there were no significant differences in operative time between the laser group and control group. [Conclusionl Compared to the other surgical methods,carbon dioxide laser can improve cure rate and decrease recun＇ence rate for treatment of laryngeal precancerous lesions.

关 键 词：CO2激光治疗 喉乳头状瘤 喉癌前病变 META分析 

分 类 号：R739.65[医药卫生—肿瘤]