海藻酸钠微球联合肝动脉化疗栓塞治疗原发性肝癌的Meta分析

Meta analysis: The clinical value of sodium alginate microspheres combined with transcatheter arterial chemoembolization in treating primary hepatocellular cancer

目的评价国产海藻酸钠微球栓塞剂（KMG）联合肝动脉化疗栓塞（TACE）治疗原发性肝癌的临床效果。方法：检索Cochrane数据库、PubMed数据库、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）及万方数据库。检索时间为建库至2016年10月。中文检索词为海藻酸钠、肝动脉化疗栓塞、肝癌。英文检索词为sodiumalginatemicrospheres、hepatocellularcarcinoma、transcatheterarterialchemoembolization。搜集公开发表的关于KMG联合TACE治疗原发性肝癌的中英文文献，由3名研究者盲法按纳入与排除标准进行文献筛选和纳入文献的质量评估。使用RevManManger5.3软件对数据进行Meta分析。结果按要求共纳入6篇中文文献，共计497例，其中病例组（KMG联合TACE）225例，对照组（单纯TACE）272例。Meta分析结果显示较于TACE，KMG联合TACE能更好地缩小肿瘤体积（OR=4.15,95%CI:2.38～7.24,P<0.05）；提高患者1年生存率（OR=2.53,95%CI:1.71～3.75,P<0.05）。但并不能更好地减少术后发热（OR=1.23,95%CI:0.57～2.69,P=0.60）、术后消化道反应（OR=1.49,95%CI:0.54～4.15,P=0.44）和术后腹痛（OR=1.39,95%CI:0.77～2.52,P=0.27）。结论KMG联合TACE能够缩小病灶和提高患者1年生存率，但对术后栓塞反应无明显改善，具有一定的临床价值。

Objective: To evaluate the clinical value of sodium alginate microspheres (KMG) combined with transcatheter arterial chemoembolization (TACE) in treating patients with primary hepatocellular carcinoma.Methods: A comprehensive search into the Cochrane library, PubMed, CNKI, CMB and WanFang databases was conducted with the key words of sodium alginate microspheres、hepatocellular carcinoma、transcatheter arterial chemoembolization. Relative studies published in these sources were first screened by three researchers based on double-blind acceptance and rejection criteria. The accepted studies were then analyzed by RevManManger 5.3.Results: In the selected 6 studies, a total of 497 patients, 225 received KMG+TACE, and 272 underwent TACE only.The Meta analysis showed that KMG combined with TACE could shrink the tumor size better compared with TACE (OR=4.15, 95%CI:2.38-7.24, P<0.05), and improve the 1 year survival rate (OR=2.53, 95%CI:1.71-3.75, P<0.05).No publication bias was found (P>0.05). Conclusions: KMG combined with TACE could shrink tumor size and improve the 1 year survival rate better than TACE, however, it could not alleviate the postoperative complications better. So comparatively, KMG combined with TACE has some superior clinical value in treating primary hepatocellular carcinoma.