窄带成像辅助内镜与白光成像辅助内镜治疗非浸润性膀胱癌疗效的荟萃分析

The treatment of non-musle-invasive cancer by narrow band imaging or white light imaging： a review and meta-analysis

目的 系统评价窄带成像辅助内镜与白光成像辅助内镜治疗非浸润性膀胱癌的疗效.方法 检索2000年1月至2016年9月窄带成像辅助内镜和白光成像辅助内镜治疗非浸润性膀胱癌的相关文献.检索的数据库包括Cochrance Libarary、PubMed、Embase、万方数据库、维普数据库、中国知网和中国生物医学文献数据库.研究窄带成像和白光成像两种内镜治疗非浸润性膀胱癌后3个月、1年和2年的复发率,并对检索的数据进行Meta分析.结果以风险比和其相对应的95％置信区间（CI）表达.结果 共纳入7篇临床对照试验,共1 889例患者.窄带成像辅助内镜与白光成像辅助内镜治疗非浸润性膀胱癌比较,在3个月（RR0.73,95％ CI0.55 ～0.96;P=0.02）、1年（RR 0.69,95％ CI0.58～0.80;P＜0.01）及2年（RR0.58,95％ CI0.41～0.82;P=0.002）的复发率中具有明显的优势.白光成像辅助内镜治疗NMIBC 3个月、1年、2年的复发率平均为14.44％、29.35％和30.00％.窄带成像辅助内镜与白光成像辅助内镜治疗非浸润性膀胱癌相比,3个月、1年及2年的复发率平均减少3.61％、9.35％和12.59％.结论 窄带成像辅助内镜与白光成像辅助内镜治疗非浸润性膀胱癌相比,术后2年内复发率低,具有明显的优势.

Objective The purpose of this work was to compare the efficacy of narrow band imaging-assisted transurethral resection of bladder tumour （TURB） with conventional white light imagingassisted TURB in primary non-muscle-invasive bladder cancer.Methods Several databases were searched,including Cochrance Libarary,PubMed,Embase,Wanfang,VIP,CNKI and CBM.The endpoints were biochemical failure in 3 months,1 year and 2 years.We performed a meta-analysis of the published data.The results are expressed as risk ratio （RR）,with the corresponding 95% confidence interval （CI）.Results The final analysis included seven trials comprising 1889 patients.Biochemical failure in 3months （RR0.73,95% CI 0.55-0.96;P =0.02）,1 year（RR 0.69,95% CI 0.58-0.80;P 〈 0.01） and 2 years （RR 0.58,95% CI 0.41-0.82;P =0.002） were fewer in patients who received narrow band imagingassisted TURB.The recurrence rates of 3 months,1 year and 2 years were 14.44%,29.35% and 30% in white light imaging group.The recurrence rates of 3 months,1 year and 2 years were 3.61%,9.35% and 12.59% lower in narrow band imaging group compared with white light imaging group.Conclusions Narrow band imaging-assisted TURB was superior to conventional white light imaging-assisted TURB in primary non-muscle-invasive bladder cancer in 2 years.