骨肉瘤进展性肺微结节的meta分析  

A meta-analysis of progressive pulmonary micro nodules in osteosarcoma

作　　者：蔡震宇[1] 汤小东[1] 谢璐[1] 孙馨[1] 许婕[1] 郭卫[1] Cai Zhenyu;Tang Xiaodong;Xie Lu;Sun Xin;Xu Jie;Guo Wei(Musculoskeletal Tumor Center,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院骨肿瘤科,北京100044

出　　处：《中华骨科杂志》2023年第4期257-262,共6页Chinese Journal of Orthopaedics

摘　　要：目的探讨肺微结节在骨肉瘤患者中的发生率、进展率以及进展为肺转移的肺微结节特征。方法使用PubMed、Embase、Web of Science和Cochrane Library数据库对2000年1月1日至2022年9月1日发表的文献进行检索,采用改良Newcastle-Ottawa量表评估文献质量,回顾骨肉瘤肺微结节的发生率、进展率及发生进展的危险因素的文献,7篇文献纳入Meta分析,证据等级均为Ⅲ级、高质量研究。分析文献中肺部微结节在骨肉瘤患者中的发生率、进展率以及进展性肺微结节特征等。结果骨肉瘤肺微结节的发生率为36.0%[95%CI(14.6%,57.3%)]。骨肉瘤肺微结节进展为肺转移的比例为52.5%[95%CI(37.7%,67.2%)]。相对大的肺微结节(直径≥5 mm)发生进展的风险显著增加,HR=2.40[95%CI(1.06,5.42,P=0.035)]。肺微结节的进展在其数量、成分和边界方面的差异无统计学意义(P>0.05)。结论肺微结节在骨肉瘤患者中十分常见,其进展为肺转移的比例高。肺微结节进展与多种因素相关,除考虑其影像学特点外,还需结合患者的临床特点对肺微结节作出早期诊断。Objective To identify the prevalence of pulmonary micro nodule(PMN)in osteosarcoma,investigate radiologic features of progressive PMN,and provide evidence for early diagnosis of pulmonary metastasis of osteosarcoma.Methods Electronic articles published in PubMed,EMBASE,Web of Science and the Cochrane Library databases between January 1,2000,and September 1,2022,were searched and critically evaluated.The authors independently reviewed the abstracts and extracted data on the prevalence of PMN in osteosarcoma and radiologic features of progressive PMN.Seven high quality studies were finally included in the meta-analysis with evidence level Ⅲ.Results The pooled prevalence of PMN in osteosarcoma was 36.0%,95%CI(14.6%,57.3%).The pooled progressive rate of PMN was 52.5%,95%CI(37.7%,67.2%).As for a specific PMN,it was more likely to progress which had a larger Dmax,HR=2.40,95%CI(1.06,5.42),P=0.035.No significant difference was found in number,component,and border.Conclusion PMN is quite common in patients with osteosarcoma.About half of the patients suffered the progression of PMN,and it is related to several risk factors.

关 键 词：骨肉瘤 肺疾病 肿瘤转移 疾病恶化 

分 类 号：R738.1[医药卫生—肿瘤]