【摘要】：目的：比較羥基喜樹堿與吡柔比星膀胱灌注預(yù)防膀胱腫瘤復(fù)發(fā)的有效性和安全性。 方法：計算機(jī)檢索1988-01~2013-04期間PubMed,EMBASE,Cochrane圖書館，CNKI，萬方數(shù)據(jù)庫。納入羥基喜樹堿與吡柔比星膀胱灌注預(yù)防膀胱腫瘤復(fù)發(fā)有效性和安全性的研究。對納入研究根據(jù)Cochrane手冊進(jìn)行質(zhì)量評價后采用Stata12軟件進(jìn)行Meta分析。 結(jié)果：共納入13個研究，包括1122例患者，其中羥基喜樹堿組共530例，吡柔比星組共592例。對13篇研究進(jìn)行Meta分析。結(jié)果顯示，羥基喜樹堿膀胱灌注預(yù)防膀胱腫瘤復(fù)發(fā)的療效低于吡柔比星,RR=1.446，95%CI(1.152，1.815)(P0.01)。但是羥基喜樹堿膀胱灌注時血尿的發(fā)生率低于吡柔比星, RR=0.453，95%CI(0.252，0.816)(P0.01)。 結(jié)論：患者能耐受不良反應(yīng)的情況下，與羥基喜樹堿相比吡柔比星膀胱灌注預(yù)防膀胱腫瘤復(fù)發(fā)效果更好。但由于所納入研究的質(zhì)量不高，上述結(jié)論尚需高質(zhì)量、大樣本的隨機(jī)盲法對照實驗加以證實。 目的:評價熒光原位雜交技術(shù)在上尿路尿路上皮癌診斷中的應(yīng)用價值。 方法:計算機(jī)檢索PubMed,Cochrane圖書館、中國知網(wǎng)和萬方數(shù)據(jù)庫，收集熒光原位雜交技術(shù)診斷上尿路尿路上皮癌的研究文獻(xiàn)，按QUADAS標(biāo)準(zhǔn)評價文獻(xiàn)的質(zhì)量，采用MetaDisc1.4軟件進(jìn)行Meta分析，計算合并效應(yīng)量，并繪制受試者工作特征曲線（SROC曲線）和計算曲線下面積，以評價熒光原位雜交技術(shù)診斷上尿路尿路上皮癌的價值。 結(jié)果:共納入11篇文獻(xiàn)，涉及了902個病例。異質(zhì)性檢驗顯示無閾值效應(yīng)，但存在其他原因?qū)е碌漠愘|(zhì)性。Meta分析結(jié)果合并敏感度、合并特異度、合并陽性似然比、合并陰性似然比、合并診斷性試驗比值比分別為82%[95%CI(0.78，，0.86）)、95%[95%CI（0.93，0.96）]、10.37[95%CI（5.06，21.26）]、0.21[95%C（I0.14，0.30）]、59.26[95%C（I22.97，152.87）]。合并ROC曲線下面積（AUC）為0.9368。 結(jié)論: FISH為上尿路尿路上皮癌的術(shù)前定性診斷提供了無創(chuàng)、特異性高且敏感性高的檢查手段。
[Abstract]:Objective: to compare the efficacy and safety of hydroxycamptothecin and pirarubicin in preventing bladder tumor recurrence. Methods: a computer-based search was carried out on the PubMedus EMBASE Cochrane Library, CNKI, Wanfang database, from 1988-01 to 2013-04. To study the efficacy and safety of intravesical instillation of hydroxycamptothecin and pirarubicin in the prevention of bladder cancer recurrence. According to the Cochrane manual to evaluate the quality of the inclusion study, Stata12 software was used for Meta analysis. Results: a total of 13 studies were conducted, including 1122 patients, including 530 cases in hydroxy camptothecin group and 592 cases in pirarubicin group. 13 studies were analyzed by Meta. The results showed that the efficacy of hydroxy camptothecin instillation in preventing bladder tumor recurrence was lower than that of pirarubicin 1.446c95 CI (1.152 鹵1.815) (P0.01). However, the incidence of hematuria during bladder instillation of hydroxycamptothecin was lower than that of pirarubicin, and RRX 0.45395 CI (0.252 鹵0.816) (P0.01). Conclusion: compared with hydroxycamptothecin, the effect of intravesical instillation of pirarubicin on preventing bladder tumor recurrence is better than that of hydroxycamptothecin. However, because the quality of the study is not high, these conclusions need to be confirmed by a large sample of randomized blind controlled trials. Objective: to evaluate the value of fluorescence in situ hybridization in the diagnosis of upper urinary epithelial carcinoma. Methods: the online database of PubMedus Cochrane, China Zhiwang and Wanfang were searched, and the literature on the diagnosis of upper urinary tract epithelial carcinoma by fluorescence in situ hybridization was collected. The quality of the literature was evaluated according to QUADAS standard, and the Meta analysis was carried out by MetaDisc1.4 software. To evaluate the value of fluorescence in situ hybridization (fish) in the diagnosis of upper urinary tract epithelial carcinoma, the combined effect was calculated, and the operating characteristic curve (SROC curve) and the area under the curve were drawn. Results: totally 11 articles were included, involving 902 cases. Heterogeneity test showed no threshold effect, but there were other reasons for heterogeneity. Meta-analysis showed that the sensitivity, specificity, positive likelihood ratio and combined negative likelihood ratio were 82% [95%CI (0.780.86) 95% [95%CI (0.930.96)] 10.37 [95%CI (5.0621.26)] 0.21 [95C (I0.140.30)] 59.26 [95C (I22.97152.87)]. The area (AUC) under the combined ROC curve was 0.9368. Conclusion: FISH is a noninvasive, highly specific and sensitive method for the preoperative qualitative diagnosis of upper urinary epithelial carcinoma.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.14

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