微小肝细胞癌合并微血管侵犯临床研究的荟萃分析  

Clinical study on microhepatocellular carcinoma complicated with microvascular invasion:a meta-analysis

作　　者：刘世奇 徐建波[1] 严雨楼 王丹丹 洪晟乾 祁付珍[1] 张建淮[1] Liu Shiqi;Xu Jianbo;Yan Yulou;Wang Dandan;Hong Shengqian;Qi Fuzhen;Zhang Jianhuai(Department of Hepatobiliary-Pancreatic Surgery,the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院肝胆胰外科,淮安223300

出　　处：《中华肝胆外科杂志》2022年第8期613-617,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：南京医科大学附属淮安第一医院"临床医学研究创新团队"项目(YLCT202003)。

摘　　要：目的通过荟萃分析系统评价微血管侵犯(MVI)对于微小肝细胞癌术后预后的影响。方法系统性检索PubMed、Cochrane Library、Embase、中国知网、维普、万方数据库中相关文献。检索时间为2012年1月至2022年1月。中文检索词为"肝癌"、"肝细胞癌"、"2 cm"、"微血管侵犯"、"预后"。英文检索词为"small"、"solitary small"、"up to 2 cm"、"<2 cm"、"liver"、"hepatocellular carcinoma"、"microvascular invasion"。比较MVI(+)组和MVI(-)组微小肝细胞癌患者的预后差异。采用Review Manager 5.4软件进行荟萃分析。结果最终7篇文献纳入系统评价,总计1319例患者。所有纳入文献改良后纽卡斯尔-渥太华量表评分均≥7分。荟萃分析结果显示,MVI(+)组与MVI(-)组1年总生存期(OS)差异无统计学意义(OR=3.14,95%CI:0.92~10.72,P=0.068)。MVI(+)组患者5年OS短于MVI(-)组,差异有统计学意义(OR=2.34,95%CI:1.62~3.36,P<0.001)。MVI(-)组1年和5年的无病生存期均优于MVI(+)组,差异有统计学意义(1年:OR=3.09,95%CI:1.75~5.44,P<0.001;5年:OR=1.76,95%CI:1.24~2.51,P=0.002)。结论MVI(+)的微小肝细胞癌患者的预后较差,与MVI(-)患者相比,其术后复发率高,远期生存率低。Objective To evaluate the effect of microvascular invasion(MVI)on postoperative prognosis of microhepatocellular carcinoma by a meta-analysis system.Methods Relevant literatures in PubMed,Cochrane Library,Embase,CNKI,VIP and Wanfang databases were systematically searched.The search period was from January 2012 to January 2022.The Chinese search terms were"liver cancer","hepatocellular carcinoma","2 cm","microvascular invasion",and"prognosis".The English search terms were"small","solitary small","up to 2 cm","<2 cm","liver","hepatocellular carcinoma","microvascular invasion".The differences in prognosis of patients with microhepatocellular carcinoma in MVI(+)group and MVI(-)group were compared.Meta-analysis was performed using Review Manager 5.4 software.Results Finally,7 articles were included in the systematic review,with a total of 1319 patients.All included literatures were scored≥7 on the modified Newcastle-Ottawa scale.The results of meta-analysis showed that there were no significant differences in 1-year overall survival(OS)between MVI(+)group and MVI(-)group(OR=3.14,95%CI:0.92-10.72,P=0.068).The 5-year OS time of patients in the MVI(+)group was shorter than that in the MVI(-)group,and the differences were statistically significant(OR=2.34,95%CI:1.62-3.36,P<0.001).The 1-year and 5-year disease-free survival of the MVI(-)group were better than those of the MVI(+)group,and the difference was statistically significant(1-year:OR=3.09,95%CI:1.75-5.44,P<0.001;5 years:OR=1.76,95%CI:1.24-2.51,P=0.002).Conclusion The 5-year and long-term survival of MVI(+)patients with microhepatocellular carcinoma was poor,and the postoperative recurrence rate was high.

关 键 词：癌 肝细胞 肝切除术 预后 微血管侵犯 

分 类 号：R735.7[医药卫生—肿瘤]