逆行腋窝淋巴示踪术降低腋窝清扫术后乳腺癌相关上肢淋巴水肿风险:一项随机对照试验的系统评价和Meta分析  

Axillary reverse mapping reducing the risk of breast cancer-related upper extremity lymphedema after axillary dissection: A systematic review and Meta-analysis of a randomized controlled trial

作　　者：朱涛 徐洁[2] 田甜 牛飞 宣立学 Zhu Tao;Xu Jie;Tian Tian;Niu Fei;Xuan Lixue(Department of Breast and Thyroid Surgery, the People’s Hosptial of Jiaozuo, Jiaozuo 454000, China;Department of Internal Medicine-Oncology, the People’s Hosptial of Jiaozuo, Jiaozuo 454000, China;Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (National Cancer Center), Beijing 100021, China)

机构地区：[1]河南省焦作市人民医院乳腺甲状腺外科,454000 [2]河南省焦作市人民医院肿瘤内科,454000 [3]中国医学科学院北京协和医学院肿瘤医院(国家癌症中心),100021

出　　处：《中国实用医刊》2019年第5期76-79,共4页Chinese Journal of Practical Medicine

摘　　要：目的评估逆行腋窝淋巴示踪(ARM)术降低乳腺癌相关上肢淋巴水肿(BCRL)发生率的可行性。方法检索Pubmed、Cochrane library、WanFang Date、CNKI、VIP,筛选关于BCRL和ARM的随机对照研究的相关文献,提取相应的腋窝清扫术(ALND)后上肢淋巴水肿的数据,利用Revman 5.3软件行Meta分析。结果ARM组的上肢淋巴水肿发生率低于对照组,相对危险度为0.16(95% CI:0.10~0.25,P<0.01)。结论ARM可能有助于降低ALND后BCRL的发生率。但保留的上肢淋巴结或许存在转移,需要更多的研究评估其安全性。Objective To evaluate the feasibility of axillary reverse mapping (ARM) in reducing the incidence of breast cancer-related upper extremity lymphedema (BCRL). Methods Relevant literature on BCRL and ARM randomized controlled studies were searched from Pubmed, Cochrane library, WanFang Date, CNKI, VIP. And data about upper limb lymphedema after axillary dissection (ALND) of these theses were extracted and meta-analysis was performed using Revman 5.3 software. Results The incidence of upper limb lymphedema in ARM group was lower than that in control group, and the relative risk was 0.16 (95% CI: 0.10-0.25, P<0.01). Conclusions ARM may help to reduce the incidence of BCRL after ALND. However, retained upper extremity lymph nodes may have metastasis, and the safety should be evaluated by reviewing more studies.

关 键 词：逆行腋窝淋巴结示踪术 上肢淋巴水肿 乳腺癌 腋窝淋巴结清扫术 

分 类 号：R737.9[医药卫生—肿瘤]