吲哚菁绿识别黑色素瘤前哨淋巴结有效性的Meta分析

Meta-analysis of efficacy of indocyanine green in identifying sentinel lymph nodes in melanoma

目的通过Meta分析系统评估吲哚菁绿(indocyaninegreen,ICG)和^(99)Tc^(m)在黑色素瘤前哨淋巴结(sentinel lymph node,SLN)识别率的差异,为临床选择淋巴示踪方法提供循证参考。方法系统检索中英文数据库,筛选出所有符合纳入标准的文献。绘制森林图并以I^(2)和Q检验为指标分析异质性,采用相应的模型分析合并效应量。使用Egger检验评估发表偏移,并用敏感性分析评估结果是否稳定可靠。结果共纳入15项研究,最终结果显示ICG和^(99)Tc^(m)在黑色素瘤SLN识别率方面差异无统计学意义(P>0.05),敏感性分析表明结果稳定可靠,Egger检验表明不存在发表偏倚。结论ICG和^(99)Tc^(m)在黑色素瘤SLN识别率方面差异无统计学意义,但ICG无放射性,操作更安全简便,有望替代^(99)Tc^(m)成为识别黑色素瘤SLN的重要手段。

Objective To systematically assess the differences between indocyanine green(ICG)and ^(99)Tc^(m) in identification rates of sentinel lymph node(SLN)in melanoma by meta-analysis,and to provide an evidence-based reference for the clinical selection of lymphatic tracing methods.Methods A systematic search of Chinese and English databases was performed to screen out all articles that met the inclusion criteria.Forest plots were drawn and heterogeneity was analyzed using I^(2)and Q test as indicators,and the corresponding model was used to analyze pooled effect sizes.Publication bias was assessed using Egger′s test,and sensitivity analysis was used to assess whether the results were stable and reliable.Results A total of 15 studies were included.The final results showed that there was no significant difference in SLN identification rate between ICG and ^(99)Tc^(m) in melanoma(P>0.05).Sensitivity analysis showed that the results were stable and reliable.Egger′s test showed that there was no publication bias.Conclusion There is no significant difference between ICG and ^(99)Tc^(m) in identifying SLN in melanoma,but ICG is non-radioactive,which is safer and easier to perform.Therefore,it is expected to replace ^(99)Tc^(m) as an important means of identifying SLN in melanoma.