本文選題：胰腺癌 + 體重丟失�。� 參考：《皖南醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:采用系統(tǒng)評價(jià)的方法探索體重丟失對胰腺癌患者預(yù)后、住院時(shí)間、生活質(zhì)量及腫瘤特征等一系列臨床特征的影響。方法:檢索Pubmed、Embase、SCI-Ex-panded、Cochrane圖書館、相關(guān)期刊論文(China National Knowledge Infrastructure/Chinese Academic Journals Full-Text Database,CNKI)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(Chinese Biomedical Database,CBM)、維普中文科技期刊數(shù)據(jù)庫(Science and Technology Period Ical Database,VIP)及萬方數(shù)據(jù)知識(shí)服務(wù)平臺(tái),同時(shí)檢索正在進(jìn)行的相關(guān)研究及會(huì)議文獻(xiàn),并對納入文獻(xiàn)的參考文獻(xiàn)進(jìn)行追蹤分析。納入研究為有關(guān)體重丟失與胰腺癌患者生存及一系列臨床特征關(guān)系的相關(guān)文獻(xiàn)。根據(jù)預(yù)先設(shè)定的納入及排除標(biāo)準(zhǔn),兩名研究者單獨(dú)對納入的文獻(xiàn)進(jìn)行納入排除及數(shù)據(jù)提取,并根據(jù)渥太華文獻(xiàn)質(zhì)量評估標(biāo)準(zhǔn)(Newcastle-Ottawa Quality Assessment Scale,NOS)評估納入文獻(xiàn)質(zhì)量。采用Rev Man5.3軟件進(jìn)行數(shù)據(jù)綜合及發(fā)表偏倚評估,根據(jù)數(shù)據(jù)綜合結(jié)果的異質(zhì)性大小決定采用固定(Fixed effects model,FE)或隨機(jī)(Random effects model,RE)效應(yīng)模型;同時(shí)對未能整合行meta分析的部分?jǐn)?shù)據(jù)進(jìn)行定性的分析評價(jià)。結(jié)果:共24篇文獻(xiàn)符合納入標(biāo)準(zhǔn),其中10篇(1976例)可行meta分析,其余文獻(xiàn)均分別進(jìn)行描述性分析。結(jié)果顯示:納入meta分析的總?cè)巳褐械目偵嫫?Overall Survival,OS)的合并危險(xiǎn)比(Hazard Ratio,HR)為2.32(95%CI:1.21~4.47,P=0.01);體重丟失以百分比為劃分標(biāo)準(zhǔn)的人群中,其OS的綜合HR值為1.79(95%CI:1.07~3.01,P=0.03);以公斤數(shù)為劃分標(biāo)準(zhǔn)的人群中,其綜合的HR值為16.32(95%CI:10.4~25.6,P0.00001);以BMI指數(shù)減低為劃分標(biāo)準(zhǔn)的人群中,其綜合HR值為1.30(95%CI:1.06~1.60,P=0.01);納入人群中1年生存率的綜合風(fēng)險(xiǎn)比(Risk Ratio,RR)為0.66(95%CI:0.50~0.87,P=0.003)。亞組分析結(jié)果顯示,體重丟失≥或10%的患者組與體重丟失≥5%或5%的患者組中,兩組人群OS的綜合HR值分別為1.93(95%CI:1.45~2.55,P0.00001)及3.03(95%CI:2.08~4.41,P0.00001);經(jīng)手術(shù)治療組及經(jīng)放化療治療組中,兩組人群OS的綜合HR值分別為1.83(95%CI:1.39~2.41,P0.0001)及2.43(95%CI:1.07~5.50,P=0.03)。并且體重丟失與患者的PFS、MST、住院時(shí)間、KPS評分、生活質(zhì)量、腫瘤的臨床特征及放化療反應(yīng)的發(fā)生均有一定的相關(guān)性。結(jié)論:(1)Meta分析結(jié)果顯示,胰腺癌患者中,體重丟失將縮短患者的OS;降低患者的1年生存率。(2)亞組分析顯示,采用不同方式治療的過程中,體重丟失均會(huì)導(dǎo)致患者的OS縮短。(3)體重丟失可延長患者的住院時(shí)間,降低患者的KPS評分、生活質(zhì)量,并增加患者化療副反應(yīng)的發(fā)生率。
[Abstract]:Objective: to investigate the effects of weight loss on the prognosis, hospital stay, quality of life and tumor characteristics of patients with pancreatic cancer. Methods: the Pubmeda Embase SCI-Expanded Cochrane Library, the China National knowledge Infrastructure / Chinese Academic Journals Full-Text Database, the Chinese Biomedical Database CBMN, the Chinese Science and Technology period Ical Database VIPs, and the Wanfang data knowledge Service platform were searched in Pubmedus Embase, the Chinese Academic Journals Full-Text Database (CNKI), the Chinese Biomedical Database (CBM), the WIP Chinese Science and Technology periodical Database (Science and Technology period) and the Wanfang data knowledge Service platform. At the same time, the related research and conference documents are searched, and the references included in the literature are followed up. The study was included in the literature on the relationship between weight loss and survival and a range of clinical features in patients with pancreatic cancer. According to the pre-set inclusion and exclusion criteria, the two researchers separately excluded the included literature and extracted the data, and evaluated the literature quality according to the Ottawa document quality assessment standard, Newcastle-Ottawa quality Assessment scale notes. Rev Man5.3 software was used to evaluate data synthesis and publication bias. According to the heterogeneity of data synthesis results, fixed effects model (FEE) or random effects model (REE) effect model were adopted. At the same time, the qualitative analysis and evaluation of some data which can not be integrated with meta analysis are carried out. Results: a total of 24 articles met the inclusion criteria, of which 10 were eligible for meta analysis. The results showed that the overall survival rate of the total population included in the meta analysis was higher than that of Hazard Ratiohor (2.32 / 95 CI: 1.21: 4.47 P0.01a); the overall HR value of the population with weight loss as percentage was 1.7995 CI: 1.073.01P0.03; in the population with kilograms as the criterion, the overall HR value was 1.7995 CIW 1.073.01P0.03; and in the group with weight loss as a percentage, the overall HR value was 1.7995 CI: 1.073.01p 0.03; in the population whose weight was measured by the number of kg, the overall HR value of the population was 1.7995 CI: 1.073.01. Its comprehensive HR value was 16.32 / 95 CI: 10.4 25.6% P0.00001; in the population whose BMI index was reduced, the comprehensive HR value was 1.3095% (CI: 1.061.60), and the comprehensive risk ratio of 1-year survival rate was 0.66 95% 0.50% 0.50% 0.87P0. 0030.The total HR value was 0.66 95% 0.50% 0. 50% 0. 7% P = 0. 003, and the total HR value of 1 year survival rate was 0. 66% 95 CI: 0. 50% 0. 50% 0. 7% P = 0. 003. The results of subgroup analysis showed that in the patients with weight loss 鈮，

本文編號(hào)：2049627