肝癌TACE术后复发危险因素的Meta分析

Meta-analysis of risk factors for recurrence of liver cancer after TACE surgery

目的 系统评价肝癌经动脉化疗栓塞术(transcatheter arterial chemoembolization, TACE)后影响复发的危险因素,为预防TACE术后复发提供科学依据。方法 检索PubMed、EmBase、Cochrane Library、Web of Science、中国知网、万方数据库、维普、中国生物医学文献数据库自建库至2023年2月1日发表的有关肝癌TACE术后复发危险因素的文献报道。由2名研究者根据纳入和排除标准进行文献筛选、数据提取和质量评价。使用软件Rev Man 5.3对纳入文献进行Meta分析和发表偏倚评估。结果 通过筛选最终共纳入9篇高质量队列研究进行Meta分析。分析结果显示差异有统计学意义的危险因素包括甲胎蛋白(OR=3.05,95%CI:1.11~8.38,P=0.03)、白蛋白(OR=5.79,95%CI:2.46~13.62,P<0.0001)、肿瘤分化程度(OR=2.64,95%CI:1.00~6.92,P=0.05)、肿瘤数量(OR=3.76,95%CI:1.71~8.27,P=0.001)、肿瘤ADC值(OR=0.01,95%CI:0.00~0.09,P<0.0001)。结论 肿瘤直径、甲胎蛋白、白蛋白、肿瘤分化程度、肿瘤数量和肿瘤ADC值是TACE术后复发的危险因素。

Objective To systematically evaluate the risk factors that affect recurrence after TACE for liver cancer,and provide scientific basis for preventing recurrence after TACE.Methods Retrieve literature reports on risk factors for postoperative recurrence of liver cancer after TACE,including PubMed,EmBase,Cochrane Library,Web of Science,CNKI,WanFang data,VIP,and CBM,published on Feb.1st,2023.Two researchers conducted literature screening,data extraction,and quality evaluation based on inclusion and exclusion criteria.A Meta-analysis was conducted on the included literature using software Rev Man 5.3.Results A total of 9 high-quality cohort study were included for meta analysis through screening.The analysis results showed that statistically significant risk factors included alpha fetoprotein(OR=3.05,95%CI:1.11-8.38,P=0.03),albumin(OR=5.79,95%CI:2.46-13.62,P<0.0001),tumor differentiation degree(OR=2.64,95%CI:1.00-6.92,P=0.05),tumor number(OR=3.76,95%CI:1.71-8.27,P=0.001),and tumor ADC value(OR=0.01,95%CI:0.00-0.09,P<0.0001).Conclusion Tumor diameter,alpha fetoprotein,albumin,tumor differentiation degree,tumor number,and tumor ADC value are risk factors for recurrence after TACE surgery.