临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
1期
101-105
,共5页
肝肿瘤%肝动脉%栓塞,治疗性%导管消融术%meta分析
肝腫瘤%肝動脈%栓塞,治療性%導管消融術%meta分析
간종류%간동맥%전새,치료성%도관소융술%meta분석
Liver neoplasma%Hepatic artery%Embolization,therapeutic%Catheter ablation%Meta-analysis
目的：对原发性肝癌肝动脉化疗栓塞( transarterial chemoembolization, TACE)联合经皮射频消融( percu-taneous radiofrequency ablation, PRFA)治疗的有效性和安全性进行评价。方法通过计算机检索中国知网、中国生物医学文献数据库、维普期刊数据库、PubMed、Cochrane图书馆、EMbase数据库中关于TACE联合PRFA治疗原发性肝癌的效果及安全性的研究,对文献质量进行严格评价和资料提取,对符合质量标准的研究文献进行meta分析。结果本研究共纳入10篇文献累计病例798例。结果显示,TACE联合PRFA组治疗后3年总体生存率、肿瘤灭活率及肿瘤复发率均优于TACE组[OR=2.72,95% CI(1.81,4.10), P<0.01；OR=3.74,95% CI(2.25,6.23), P<0.01；OR=0.38,95% CI(0.24,0.61), P<0.01],而在肝脏甲胎蛋白转阴率方面两组相比差异无统计学意义[OR=1.40,95% CI(0.65,3.01), P=0.39]。纳入文献相关并发症发生较少。结论 TACE联合PRFA治疗原发性肝癌的有效性和安全性显著优于TACE单独疗法,然而还需加大研究文献量及样本量,以增加论证强度。
目的：對原髮性肝癌肝動脈化療栓塞( transarterial chemoembolization, TACE)聯閤經皮射頻消融( percu-taneous radiofrequency ablation, PRFA)治療的有效性和安全性進行評價。方法通過計算機檢索中國知網、中國生物醫學文獻數據庫、維普期刊數據庫、PubMed、Cochrane圖書館、EMbase數據庫中關于TACE聯閤PRFA治療原髮性肝癌的效果及安全性的研究,對文獻質量進行嚴格評價和資料提取,對符閤質量標準的研究文獻進行meta分析。結果本研究共納入10篇文獻纍計病例798例。結果顯示,TACE聯閤PRFA組治療後3年總體生存率、腫瘤滅活率及腫瘤複髮率均優于TACE組[OR=2.72,95% CI(1.81,4.10), P<0.01；OR=3.74,95% CI(2.25,6.23), P<0.01；OR=0.38,95% CI(0.24,0.61), P<0.01],而在肝髒甲胎蛋白轉陰率方麵兩組相比差異無統計學意義[OR=1.40,95% CI(0.65,3.01), P=0.39]。納入文獻相關併髮癥髮生較少。結論 TACE聯閤PRFA治療原髮性肝癌的有效性和安全性顯著優于TACE單獨療法,然而還需加大研究文獻量及樣本量,以增加論證彊度。
목적：대원발성간암간동맥화료전새( transarterial chemoembolization, TACE)연합경피사빈소융( percu-taneous radiofrequency ablation, PRFA)치료적유효성화안전성진행평개。방법통과계산궤검색중국지망、중국생물의학문헌수거고、유보기간수거고、PubMed、Cochrane도서관、EMbase수거고중관우TACE연합PRFA치료원발성간암적효과급안전성적연구,대문헌질량진행엄격평개화자료제취,대부합질량표준적연구문헌진행meta분석。결과본연구공납입10편문헌루계병례798례。결과현시,TACE연합PRFA조치료후3년총체생존솔、종류멸활솔급종류복발솔균우우TACE조[OR=2.72,95% CI(1.81,4.10), P<0.01；OR=3.74,95% CI(2.25,6.23), P<0.01；OR=0.38,95% CI(0.24,0.61), P<0.01],이재간장갑태단백전음솔방면량조상비차이무통계학의의[OR=1.40,95% CI(0.65,3.01), P=0.39]。납입문헌상관병발증발생교소。결론 TACE연합PRFA치료원발성간암적유효성화안전성현저우우TACE단독요법,연이환수가대연구문헌량급양본량,이증가론증강도。
Objective To review the effectiveness of the combination of transarterial chemoembolization ( TACE) and percutaneous radiofrequency ablation (PRFA) for treatment of hepatocellular carcinoma. Methods The documents of ran-domized controlled trials ( RCT) related to the combination of TACE and PRFA for treatment of primary liver cancer from the establishment time of the data-bases to March 2014 were retrieved from the databases of CNKI, CBM, VIP, PubMed, Co-chrane, EMbase and there ferrous in RCT were retrieved by hand at the same time. The documents were screened, extracted and evaluated according to in-collusion and exclusion criteria, and then went through a meta-analysis. Results There were totally 10 RCT (798 patients included). The results of meta-analysis showed as follows:the 3-year overall survival rate, inac-tivation rate of tumors, recurrence of the combination of TACE and PRFA were much better than that of TACE [ OR=2. 72, 95% CI (1. 81, 4. 10), P<0. 01;OR=3. 74, 95% CI (2. 25, 6. 23), P<0. 01; OR=0. 38, 95% CI (0. 24, 0. 61), P<0. 01]. There were significant statistical differences in the complete necrosis rates of tumors, but there were no significant statistical differences in the attenuation rates of positive AFP [OR=1. 40, 95% CI (0. 65, 3. 01), P=0. 39]. Conclusion The combination of TACE and PRFA has more advantages in terms of safety and efficacy in the treatment of HCC than that of TACE monotherapy, but further research is needed.
