摘要
目的 系统评价肝癌经动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)后影响复发的危险因素,为预防TACE术后复发提供科学依据.方法 检索 PubMed、EmBase、Cochrane Library、Web of Science、中国知网、万方数据库、维普、中国生物医学文献数据库自建库至 2023 年 2 月 1 日发表的有关肝癌 TACE术后复发危险因素的文献报道.由 2 名研究者根据纳入和排除标准进行文献筛选、数据提取和质量评价.使用软件 Rev Man 5.3 对纳入文献进行 Meta分析和发表偏倚评估.结果 通过筛选最终共纳入 9 篇高质量队列研究进行 Meta分析.分析结果显示差异有统计学意义的危险因素包括甲胎蛋白(OR=3.05,95%CI:1.11～8.38,P=0.03)、白蛋白(OR=5.79,95%CI:2.46～13.62,P<0.0001)、肿瘤分化程度(OR=2.64,95%CI:1.00～6.92,P=0.05)、肿瘤数量(OR=3.76,95%CI:1.71～8.27,P=0.001)、肿瘤 ADC值(OR=0.01,95%CI:0.00～0.09,P<0.0001).结论 肿瘤直径、甲胎蛋白、白蛋白、肿瘤分化程度、肿瘤数量和肿瘤 ADC值是 TACE术后复发的危险因素.
Abstract
Objective To systematically evaluate the risk factors that affect recurrence after TACE for liver cancer,and provide scientific basis for preventing recurrence after TACE.Methods Retrieve literature reports on risk factors for postoperative recurrence of liver cancer after TACE,including PubMed,EmBase,Cochrane Library,Web of Sci-ence,CNKI,WanFang data,VIP,and CBM,published on Feb.1st,2023.Two researchers conducted literature screening,data extraction,and quality evaluation based on inclusion and exclusion criteria.A Meta-analysis was con-ducted on the included literature using software Rev Man 5.3.Results A total of 9 high-quality cohort study were in-cluded for meta analysis through screening.The analysis results showed that statistically significant risk factors included alpha fetoprotein(OR=3.05,95%CI:1.11-8.38,P=0.03),albumin(OR=5.79,95%CI:2.46-13.62,P<0.0001),tumor differentiation degree(OR=2.64,95%CI:1.00-6.92,P=0.05),tumor number(OR=3.76,95%CI:1.71-8.27,P=0.001),and tumor ADC value(OR=0.01,95%CI:0.00-0.09,P<0.0001).Conclusion Tumor diameter,alpha fetoprotein,albumin,tumor differentiation degree,tumor number,and tumor ADC value are risk factors for recurrence after TACE surgery.
基金项目
国家科技重大专项—艾滋病和病毒性肝炎等重大传染病防治项目(2018ZX10303502)
河南省特色骨干学科中医学第二批学科建设项目(STG-ZYX01-202101)
NETL
NSTL
万方数据