光动力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Meta分析

Photodynamic diagnosis and white light imaging in treatment of non-muscle-invasive bladder cancer:A meta-analysis

目的:系统评价光动力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1994年1月—2016年11月光动力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、维普数据库和中国生物医学文献数据库。研究光动力和白光成像内镜治疗非浸润性膀胱癌后3个月、9个月、1年、2年和5年的复发率。在评价文献质量后,应用Review Manager 5.3软件进行Meta分析,结果以风险比及其95%可信区间予以表示。结果:共纳入10项临床随机对照试验,共2 430例患者。与白光成像辅助内镜治疗相比,光动力辅助内镜治疗非浸润性膀胱癌的9个月(风险比:0.80,95%可信区间:0.69~0.93;P=0.005)、1年(风险比:0.65,95%可信区间:0.46~0.91;P=0.010)、2年(风险比:0.54,95%可信区间:0.40~0.72;P<0.001)和5年(风险比:0.76,95%可信区间:0.61~0.94;P=0.010)复发率显著较低。结论:与白光成像辅助内镜治疗非浸润性膀胱癌相比,光动力辅助内镜治疗术后5年内的复发率较低。

Objective： To compare the efficacy of photodynamic diagnosis- assisted transurethral resection of bladder tumor （TURB） with conventional white light imaging-assisted TURB in primary non- muscle-invasive bladder cancer. Methods： Cochrance VIP Data and Chinese Libarary, PubMed, Embase, Wanfang Data, BioMedical Literature Database （CBM）. The endpoints were 3-month, 9-month, 1-year, 2-year and 5-year biochemical failure rates. After evaluating the quality of the included literatures and extracting the data, the Meta- analysis was performed using Review Manager 5.3 software. The results were expressed as risk ratio （RR） with the corresponding 95% confidence interval （CI）.Results： The final analysis included ten studies including 2 430 patients. The 9-month （RR： 0.80, 95% CI： 0.69-0.93; P = 0.005）, 1-year （RR： 0.65, 95% CI： 0.46-0.91 ; P = 0.010）, 2-year （RR： 0.54, 95%： CI： 0.40-0.72; P 〈 0.001） and 5-year （RR： 0.76, 95% CI： 0.61-0.94; P = 0.010） biochemical failure rates were lower in patients who received photodynamic diagnosis- assisted TURB.Conclusion： The efficacy of photodynamic d white light imaging-assisted in efficacy of years. agnosis-assisted TURB is superior to conventional primary non-muscle-invasive bladder cancer in 5 years.