前哨淋巴结微转移与乳腺癌复发风险的系统评价及Meta分析  

Sentinel lymph node micrometastasis and risks of breast cancer recurrence: a systematic review and meta analysis

作　　者：未灯辉 许志宏 谢莉莉 韩晖[1] 林舜国[1] 许春森[1] Wei Denghui;Xu Zhihong;Xie Lili;Han Hui;Lin Shunguo;Xu Chunsen(Department of Breast Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院乳腺外科,福州350001

出　　处：《中华普通外科学文献（电子版）》2019年第1期80-84,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：福建省医学创新课题(2018-CX-40);福建省卫生厅项目(2011-cxb-8)

摘　　要：目的系统评价在未行腋窝淋巴结清扫时,前哨淋巴结(SLN)微转移对乳腺癌患者复发相关事件发生率(RRER)的影响。方法检索PubMed、EMBASE、WanFang数据、CNKI、CBM建库至2018年5月1日的文献资料,严格按照纳入和排除标准筛选相关研究,对纳入的研究进行资料提取,采用NOS量表进行质量评价,使用RevMan 5.2软件进行Meta分析。结果最终筛选出6篇相关文献共1 730例患者,其中3项前瞻性观察研究,3项回顾性研究。中位随访33～77个月,SLN微转移组(370例)与SLN阴性组(1 360例)的RRER差异无统计学意义(OR=1.37,95%CI:0.72～2.59,I^2=47%,P=0.34);同时,在局部复发率方面,SLN微转移组354例,复发12例,SLN阴性组1 337例,复发35例,两者比较差异亦无统计学意义(OR=1.49,95%CI:0.75～2.97,I2=40%,P=0.26)。结论 SLN微转移并不增加乳腺癌患者的复发风险。Objective To systemically evaluate the recurrence related event rate(RRER)of breast cancer with sentinel lymph node micrometastasis(SLN MIC)without axillary lymph node dissection(ALND).Methods Databases such as PubMed,EMBASE,WanFang Data,CNKI and CBM were searched comprehensively for studies about SLN for breast cancer from foundation to May 1st,2018.On the basis of the inclusion and exclusion criteria,extracting data,assessing methodological quality and analyzing results was achieved.RevMan 5.2 was used to carry out statistical analyses.Results A total of six studies,including 3 prospective observational studies and 3 retrospective studies involving 1 730 patients of whom 370 had SLN MIC and 1 360 had negative SLN(-),were qualified for final analysis.The odds ratio(OR)of RRER between group SLN MIC and group SLN(-)of breast cancer patients who didn’t performed ALND was 1.37(95%CI:0.72-2.59,I2=47%,P=0.34),without statistical differences.In addition,there was also no statistical difference in regional recurrence rate between group SLN MIC and group SLN(-)of breast cancer patients without ALND(OR=1.49,95%CI:0.75~2.97,I2=40%,P=0.26).Conclusion Compared with patients with negative SLN,SLN MIC does not increase the risk of recurrence in breast cancer patients without ALND.

关 键 词：乳腺肿瘤 META分析 前哨淋巴结活组织检查 复发 前哨淋巴结微转移 

分 类 号：R737.9[医药卫生—肿瘤]