乳腺癌改良根治术后Ⅰ期乳房再造临床预后的Meta分析

Meta-analysis of clinical prognosis of stage Ⅰ breast reconstruction after modified radical mastectomy

目的:使用Meta分析评价乳腺癌改良根治术后Ⅰ期乳房再造的临床预后。方法:计算机检索万方资源数据库、维普信息资源系统、中国期刊全文数据库、中国知网(CNKI)、中文科技期刊数据库(VIP)、Cochrane Library、EMbase、PubMed,检索时间从各数据库建库至2021年8月25日。收集与乳腺癌根治术后Ⅰ期乳房再造有关的临床对照试验组和随机对照试验组,提取相关资料,并采用RevMan 5.3软件进行Meta分析。结果:最终纳入12篇文献。Meta分析结果显示,采用改良根治术后Ⅰ期乳房再造和采用单纯改良根治术对局部复发率、远处转移率、3年无瘤生存率和并发症无影响(OR=0.91,95%CI 0.50~1.68,P=0.77;OR=0.66,95%CI 0.42~1.06,P=0.09;OR=1.22,95%CI 0.77~1.93,P=0.40;OR=0.91,95%CI 0.58~1.41,P=0.66)。采用改良根治术后Ⅰ期乳房再造对生命质量评分的影响优于采用单纯改良根治术(MD=9.79,95%CI 8.82~10.76,P<0.001)。结论:乳腺癌改良根治术后Ⅰ期乳房再造可减轻患者因身体缺陷带来的压力,帮助患者树立信心,提高患者生命质量。

Objective To evaluate the clinical prognosis of stageⅠbreast reconstruction after modified radical mastectomy by using Meta-analysis.Methods Wanfang Resource Database,Chinese Journal Full-Text Database,VIP Information Resource System,Chinese Scientific and Technological Journal Database,Cochrane Library,EMbase,PubMed were searched by computer.The retrieval time was from the establishment of each database to August 25,2021.To collect clinical control test group(CCT)and randomized controlled trial(RCT)on breast reconstruction after radical mastectomy.The researchers independently searched the inclusion and exclusion criteria,screened and sorted them,evaluated them,extracted relevant data,and performed Meta-analysis with Rev man 5.3 software.Results Twelve research were enrolled in this study.the Meta-analysis results showed that there were no significant differences in the local recurrence rate,distant metastasis rate,3-year tumor free survival rate and complications between the patients performed stageⅠbreast reconstruction after modified radical mastectomy and the patients only performed modified radical mastectomy(OR=0.91,95%CI 0.50-1.68,P=0.77;OR=0.66,95%CI 0.42-1.06,P=0.09;OR=1.22,95%CI 0.77-1.93,P=0.40;OR=0.91,95%CI 0.58-1.41,P=0.66).The quality of life score in the patients performed stageⅠbreast reconstruction after modified radical mastectomy was higher than that in the patients only performed modified radical mastectomy(MD=9.79,95%CI 8.82-10.76,P<0.001).Conclusions StageⅠbreast reconstruction after modified radical mastectomy can reduce the pressure of patients due to physical defects,help patients build up confidence and improve their quality of life.