子宫内膜癌术后患者下肢淋巴水肿危险因素的Meta分析

A Meta-analysis of risk factors for lower limb lymphedema in postoperative patients with endometrial carcinoma

目的通过Meta分析明确子宫内膜癌术后患者下肢淋巴水肿危险因素。方法检索中英文数据库及纳入文献的参考文献,检索时间为建库至2021年4月30日,由2名研究人员按照纳入和排除标准独立筛选文献、提取资料并评价文献的质量。采用RevMan 5.3软件进行Meta分析。结果共纳17篇文献,样本量为5375例,包括14项危险因素。Meta分析结果显示:开腹手术(OR=2.21)、旋髂淋巴结(CIN)切除(OR=5.19)、淋巴结切除数目(OR=2.06)、辅助放疗(OR=2.92)、FIGO分期≥Ⅲ期(OR=1.84)、肿瘤组织学分级≥G3(OR=1.28)是子宫内膜癌术后患者并发下肢淋巴水肿的危险因素,前哨淋巴结(,SLN)活检术(OR=0.46)是保护因素。结论手术方式、CIN切除、淋巴结切除数目、放疗、SLN活检术、FIGO分期、肿瘤组织学分级对子宫内膜癌患者下肢淋巴水肿的影响较大,尚不能确定年龄、肌层浸润深度、化疗等的影响水平;子宫内膜癌患者术后并发下肢淋巴水肿危险因素相关研究存在差异,仍需进行更多高质量研究明确子宫内膜癌术后患者发生下肢淋巴水肿的危险因素。

Objective To determine the risk factors of lower limb lymphedema in postoperative patients with endometrial carcinoma by Meta analysis.Methods Chinese and English databases and references were searched,the retrieval time is from the establishment of the database to April 30,2021.Two researchers independently was screened,extracted and evaluated the literature quality according to the criteria.RevMan 5.3 software was used for Meta analysis.Results A total of 17 articles were included,with a sample size of 5375 cases,including 13 risk factors.Meta analysis showed that laparotomy(OR=2.21),CIN(circumflex iliac node)resection(OR=5.19),number of resected LNs(OR=2.06),adjuvant radiotherapy(OR=2.92),FIGO stage≥Ⅲ(OR=1.84)and tumor grade≥G3(OR=1.28)were risk factors for lower limb lymphedema in postoperative patients with endometrial carcinoma;SLN(Sentinel Lymph node)biopsy(OR=0.46)was a protective factor.Conclusion Surgical approach,CIN(circumflex iliac node)resection,number of resected LNs,adjuvant radiotherapy,SLN biopsy,FIGO stage and tumor grade have great influence on lower limb lymphedema in postoperative patients with endometrial cancer.Age,myometrial invasion,adjuvant chemotherapy and other factors can not determine the level of lower limb lymphedema in patients with endometrial cancer.At present,there are differences in the risk factors of postoperative lower limb lymphedema in patients with endometrial cancer,and more high-quality studies are needed to further clarify the risk factors of lower limb lymphedema in postoperative patients with endometrial cancer.