乳腺癌患者发生腋网综合征危险因素的Meta分析

Meta-analysis of risk factors for axillary web syndrome in breast cancer patients

目的 采用Meta分析系统评价乳腺癌患者发生腋网综合征(AWS)的危险因素。方法 以“腋网综合征”“axillary web syndrome”为题名或关键词,通过计算机检索中英文数据库PubMed、EBSCO、GeenMedical、中国知网、万方数据库、维普数据库,搜索从建库至2021年9月30日发表的有关乳腺癌AWS危险因素或影响因素的文献,按照纳入和排除标准筛选文献,并进行Meta分析。结果 共检索到275篇文献,最终纳入11篇。Meta分析结果显示,乳腺癌患者是否化疗、是否放疗、肿瘤部位、肿瘤分期、乳房切除术类型(部分切除、全切除)、血肿均与AWS发病风险无相关性,而乳腺癌患者的年龄、体重指数(BMI)、手术方式(保乳、改良)、淋巴结是否转移、是否行腋窝淋巴结清扫(ALND)、淋巴结清扫数目以及是否行乳房重建术均与AWS发病风险具有相关性。结论乳腺癌患者是否化疗、是否放疗、肿瘤部位、肿瘤分期、乳房切除术类型(部分切除、全切除)、血肿与AWS的发病风险无关,而乳腺癌患者的年龄、BMI、手术方式(保乳、改良)、淋巴结是否转移、是否行ALND、淋巴结清扫数目以及是否行乳房重建术与AWS的发病风险有关。由于纳入研究文献数量和质量的限制,以上结论尚需开展更多更高质量研究予以验证。

Objective To systematically evaluate the risk factors of axillary web syndrome(AWS) in breast cancer patients by Meta-analysis. Method By using“axillary web syndrome”as the title or keyword, the Chinese and English databases PubMed, EBSCO, GeenMedical, CNKI, Wanfang database, and VIP database from the establishment to September 30, 2021 were searched to identify literature on the risk factors or influencing factors of breast cancer AWS, and the literature was screened according to the inclusion and exclusion criteria to perform Meta-analysis. Result A total of275 articles were retrieved, and 11 articles were finally included. Meta-analysis showed that the risk of AWS was not correlated with chemotherapy, radiotherapy, tumor location, tumor staging, type of mastectomy(partial resection, total resection), and hematoma. The age, body mass index(BMI), surgical methods(breast-conserving, modified surgery), metastasis of lymph nodes, axillary lymph node dissection(ALND), number of lymph node dissection, and breast reconstruction surgery were correlated with the risk of AWS. Conclusion Chemotherapy, radiotherapy, tumor location, tumor staging,type of mastectomy(partial resection, total resection), and hematoma are not correlated with the risk of AWS, while the age, BMI, surgical methods(breast-conserving, modified surgery), metastasis of lymph nodes, ALND, number of lymph node dissection, and breast reconstruction surgery are correlated with the risk of AWS. Due to the limitation of the number and quality of the included research literature, the conclusion still need to be verified by more and higher-quality studies.