CAJ | 학술논문

目的通过对胃肠胰腺神经内分泌瘤肝转移患者手术与非手术治疗对照研究的系统分析,探讨手术治疗胃肠胰腺神经内分泌瘤肝转移的价值.方法检索Cochrane图书馆、PubMed、Medline、Embase、中国生物医学文献数据库、万方数据库中的相关随机研究,按照Cochrane推荐的文献纳入标准筛选文献,并对纳入文献进行质量评估,共有10组研究中心的1 567例患者的数据纳入进行Meta分析.结果单纯手术切除治疗与药物(奥曲肽)治疗、全身放化疗、经动脉治疗、射频消融术等非手术治疗胃肠胰腺神经内分泌瘤肝转移相比较,3年生存率(OR:0.07,95％CI:0.02,0.22;Pheterogeneity=0.93,P＜0.00001)及5年生存率(OR:0.19,95％ CI:0.15,0.24;Pheterogeneity=0.11,P＜0.00001)差异具有统计学意义,手术治疗组的3、5年生存率明显优于非手术治疗组.结论手术切除是治疗胃肠胰腺神经内分泌瘤肝转移的首选治疗方法,其安全有效且较其他非手术治疗在生存期方面具有较好的优势.
목적 통과대위장이선신경내분비류간전이환자수술여비수술치료대조연구적계통분석,탐토수술치료위장이선신경내분비류간전이적개치.방법 검색Cochrane도서관、PubMed、Medline、Embase、중국생물의학문헌수거고、만방수거고중적상관수궤연구,안조Cochrane추천적문헌납입표준사선문헌,병대납입문헌진행질량평고,공유10조연구중심적1 567례환자적수거납입진행Meta분석.결과 단순수술절제치료여약물(오곡태)치료、전신방화료、경동맥치료、사빈소융술등비수술치료위장이선신경내분비류간전이상비교,3년생존솔(OR:0.07,95％CI:0.02,0.22;Pheterogeneity=0.93,P＜0.00001)급5년생존솔(OR:0.19,95％ CI:0.15,0.24;Pheterogeneity=0.11,P＜0.00001)차이구유통계학의의,수술치료조적3、5년생존솔명현우우비수술치료조.결론 수술절제시치료위장이선신경내분비류간전이적수선치료방법,기안전유효차교기타비수술치료재생존기방면구유교호적우세.
Objective To investigate the potential benefits of hepatic resection for patients with hepatic metastasis of gastroenteropancreatic neuroendocrine tumors.Methods A search in Cochrane Library,PubMed,Medline,Embase,CBM,Wanfang Databases for identifying randomized trails.Criteria for inclusion were established based on validity criteria by Cochrane Methods Group on screening and diagnostic tests,and correlated indexes of 10 articles including 1 567 patients were extracted for Meta-analysis.Results Compared with non-surgical treatment group,the 3-year survival rate (OR:0.07,95 ％ CI:0.02,0.22 ; Pheterogeneity =0.93,P ＜ 0.00001),the 5-year survival rate (OR:0.19,95 ％ CI:0.15,0.24 ; Pheterogeneity ＝ 0.11,＜ 0.00001) were significantly increased in the surgical group.Conclusions Surgical resection is the preferred treatment of gastroenteropancreatic neuroendocrine tumors in patients with liver metastasis.Surgery is safe and effective,furthermore it takes the advantages of significantly extend the surgical live time.