發(fā)布時間：2018-05-27 14:48

  本文選題：上尿路尿路上皮腫瘤 + 輸尿管鏡檢查　； 參考：《第三軍醫(yī)大學學報》2017年01期

【摘要】：目的 Meta分析上尿路尿路上皮腫瘤(upper tract urothelial carcinoma,UTUC)根治手術前行輸尿管鏡檢查(ureteroscopy,URS)對UTUC遠期預后的影響。方法計算機檢索Pub Med、EMbase、Cochrane Library、中國生物醫(yī)學文獻數據庫、萬方、維普和中國知網數據庫,收集URS對UTUC預后影響的前瞻性或回顧性研究,檢索時限為建庫至2016年2月29日。由兩名研究者按照納入與排除標準進行文獻納入,對納入的研究行質量評價,提取相關腫瘤預后資料風險比(hazard ratios,HR)及其95%可信區(qū)間(confidence interval,CI),采用Stata 12軟件進行Meta分析。結果共納入13個回顧性研究,包括4 105例患者。Meta分析結果顯示:術前行URS未增加疾病無復發(fā)生存風險,單因素合并結果[HR=0.93,95%CI(0.73,1.13)],多因素合并結果[HR=1.13,95%CI(0.90,1.36)];行URS未增加膀胱內無復發(fā)生存風險,單因素合并結果[HR=1.13,95%CI(0.82,1.43)],多因素合并結果[HR=1.54,95%CI(0.97,2.12)];對于腫瘤特異生存期,單因素合并結果顯示行URS組優(yōu)于未行URS組[HR=0.68,95%CI(0.48,0.88)],而多因素合并結果兩者差異無統(tǒng)計學意義[HR=0.83,95%CI(0.54,1.12)];行URS未增加總體生存風險,單因素合并結果差異無統(tǒng)計學意義[HR=0.87,95%CI(0.46,1.27)]。結論術前行URS并未影響UTUC患者術后遠期腫瘤復發(fā)及生存情況。
[Abstract]:Objective to analyze the effect of ureteroscopy on the long term prognosis of upper urinary tract epithelial tumor (UTUC) by ureteroscope before radical operation with upper tract urothelial carcinoma (UTUC) by Meta. Methods Pub Medsite EMbase Cochrane Library, Chinese Biomedical Literature Database, Wanfang, Weip and China KnowledgeNet databases were searched by computer. Prospective or retrospective studies on the influence of URS on the prognosis of UTUC were collected. The search time was established until February 29, 2016. According to the criteria of inclusion and exclusion, two researchers carried out literature review, evaluated the quality of the included studies, extracted the risk ratio of tumor prognostic data to Hazard ratios-HRs and 95% confidence interval-CIG, and analyzed Meta by Stata 12 software. Results A total of 13 retrospective studies were included, including 4,105 patients. Meta-analysis results showed that preoperative URS did not increase the risk of disease recurrence, univariate association [HRN 0.9395 CI0.73C1.13], multivariate results [HR1.13995 CI0.901.36], and URS did not increase the risk of intravesical recurrence. Results of univariate combination [HRN 1.1395 CI 0.821.43], multivariate combination results [HRN 1.5495 CI 0.97 / 2.12]; for tumor-specific survival period, univariate combination results showed that URS group was superior to non-URS group [HR0.6895 CI 0.480.88], but multifactorial combination had no statistical significance [HRN 0.8395CI 0.541.12]; URS did not increase the overall survival risk. There was no significant difference in univariate combined results. Conclusion preoperative URS does not affect the recurrence and survival of long-term tumor in patients with UTUC.
【作者單位】： 蘭州大學泌尿外科研究所蘭州大學第二醫(yī)院泌尿外科甘肅省泌尿系統(tǒng)疾病臨床醫(yī)學中心甘肅省泌尿系統(tǒng)疾病研究重點實驗室;
【基金】：國家自然科學基金面上項目(81402122)~~
【分類號】：R737.1

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