CAJ | 학술논문

目的采用系统评价方法分析乳腺癌治疗后,引起上肢淋巴水肿的危险因素及关联强度.方法检索PubMed、Ovid、EMbase、Cochrane图书馆等英文数据库中从建库至2012年12月发表的临床研究.按照NOS标准对纳入文献进行质量评价,采用Stata 10.0以及RevMan 5.2软件进行数据分析,对各种危险因素的关联强度采用比值比(OR)及其95％ CI描述.结果最终纳入文献22篇,共包含10106例患者.与乳腺癌治疗后上肢淋巴水肿相关因素主要为腋窝淋巴结清扫(OR=2.72,95％ CI=1.06～6.99,P=0.038)、高血压(OR=1.84,95％ CI=1.38～2.44,P=0.000)、体重指数(OR=1.68,95％ CI=1.22～2.32,P=0.001)、放疗(OR=1.65,95％ CI=1.20～2.25,P=0.002),而化疗、年龄、阳性淋巴结数目、淋巴结清扫数目等因素未见明显相关性.结论乳腺癌治疗后上肢淋巴水肿具有较高的发生率,腋窝淋巴结清扫、高血压、体重指数、放疗是乳腺癌治疗后淋巴水肿的主要危险因素.
목적 채용계통평개방법분석유선암치료후,인기상지림파수종적위험인소급관련강도.방법 검색PubMed、Ovid、EMbase、Cochrane도서관등영문수거고중종건고지2012년12월발표적림상연구.안조NOS표준대납입문헌진행질량평개,채용Stata 10.0이급RevMan 5.2연건진행수거분석,대각충위험인소적관련강도채용비치비(OR)급기95％ CI묘술.결과 최종납입문헌22편,공포함10106례환자.여유선암치료후상지림파수종상관인소주요위액와림파결청소(OR=2.72,95％ CI=1.06～6.99,P=0.038)、고혈압(OR=1.84,95％ CI=1.38～2.44,P=0.000)、체중지수(OR=1.68,95％ CI=1.22～2.32,P=0.001)、방료(OR=1.65,95％ CI=1.20～2.25,P=0.002),이화료、년령、양성림파결수목、림파결청소수목등인소미견명현상관성.결론 유선암치료후상지림파수종구유교고적발생솔,액와림파결청소、고혈압、체중지수、방료시유선암치료후림파수종적주요위험인소.
Objective To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations.Methods PubMed,Ovid,EMbase,and the Cochrane Library were searched to identify clinical trials published up to December 2012.The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2;the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95％ confidence intervals (CI).Results Twenty-two studies involving 10106 patients were included in the meta-analysis.The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR =2.72,95％ CI=1.06-6.99,P=0.038),hypertension (OR=1.84,95％ CI=1.38-2.44,P=0.000),body mass index (OR =1.68,95％ CI=1.22-2.32,P =0.001),and radiotherapy (OR =1.65,95％ CI =1.20-2.25,P =0.002),while no significant associations were found for such factors as chemotherapy,age,number of positive lymph nodes,and number of dissected lymph nodes.Conclusions The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment,and axillary lymph node dissection,hypertension,body mass index,and radiotherapy are the main risk factors for lymphedema after breast cancer treatment.