同时性多原发结直肠癌的临床病理和预后研究:Meta分析  

Clinicopathological and prognosis of synchronous colorectal cancer:a Meta-analysis

作　　者：张翔宇 任万博 邓凯 霍新凯 王新[1] 赵亮[1] ZHANG Xiangyu;REN Wanbo;DENG Kai;HUO Xinkai;WANG Xin;ZHAO Liang(Department of Gastrointestinal Surgery,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000,China)

机构地区：[1]山东大学齐鲁医院德州医院胃肠外科,山东德州253000

出　　处：《胃肠病学和肝病学杂志》2024年第4期407-412,共6页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探究同时性多原发结直肠癌(synchronous colorectal cancer,SCRC)的临床病理特征,并系统评价其预后、术后并发症发生率及术后30 d内死亡率。方法对PubMed、EmBase、中国知网和维普数据库进行了系统的检索,筛选以英文或中文发表于2001年1月至2022年10月的研究,提取数据并进行文献质量评价和统计分析。结果共纳入17项研究,共10657例SCRC患者。SCRC患者的OS、CSS短于孤立性结直肠癌患者(OS:HR=1.17,95%CI:1.06~1.29,P=0.001;CSS:HR=1.54,95%CI:1.16~2.03,P=0.003),但SCRC与RFS之间无相关性(HR=1.06,95%CI:0.96~1.17,P=0.282);SCRC患者术后30 d内死亡率升高(OR=1.42,95%CI:1.19~1.70,P=0.00);但术后并发症的发生率升高不显著(OR=1.63,95%CI:0.99~2.69,P=0.054)。SCRC患者TNM分期偏晚,淋巴结转移风险高,易表现为黏液腺癌或印戒细胞癌病理类型和微卫星缺陷型。结论SCRC患者预后不良,术后30 d内死亡率高,应加强围术期管理和术后监测。Objective To investigate the clinicopathological features of synchronous colorectal cancer(SCRC)and explore its prognosis,incidence of postoperative complications rate and mortality within 30 days after surgery.Methods Relevant literature was searched on PubMed,EmBase,CNKI and VIP databases.The studies published in English or Chinese from Jan.2001 to Oct.2022 were screened,and the data were extracted for literature quality evaluation and statistic analysis.Results A total of 17 studies and 10657 cases of SCRC patients were included.Compared with patients with solitary colorectal cancer,patients with SCRC had shorter OS and CSS(OS:HR=1.17,95%CI:1.06-1.29,P=0.001,CSS:HR=1.54,95%CI:1.16-2.03,P=0.003),but there was no significant correlation between SCRC and RFS(HR=1.06,95%CI:0.96-1.17,P=0.282).The mortality of SCRC patients increased within 30 days after surgery(OR=1.42,95%CI:1.19-1.70,P=0.00).However,the incidence of postoperative complications was not significantly increased(OR=1.63,95%CI:0.99-2.69,P=0.054).SCRC patients were more likely to have advanced TNM stage and lymph node metastasis,and they were proned to mucinous adenocarcinoma or sig-ring cell carcinoma pathological type and microsatellite defect type.Conclusion SCRC patients have poor prognosis and high mortality within 30 days after surgery.Perioperative management and postoperative monitoring are recommended for SCRC patients.

关 键 词：同时性多原发结直肠癌 预后 META分析 

分 类 号：R735.3[医药卫生—肿瘤]