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纵隔淋巴结切除方式对非小细胞肺癌患者术后生存的影响--4个相关研究的Meta分析
引用本文:杨浩贤,吴一龙,凌莉,韩璐.纵隔淋巴结切除方式对非小细胞肺癌患者术后生存的影响--4个相关研究的Meta分析[J].循证医学,2002,2(3):132-140.
作者姓名:杨浩贤  吴一龙  凌莉  韩璐
作者单位:1. 中山大学肺癌研究中心、中山大学附属第三医院胸心外科,广州,510630
2. 中山大学公共卫生学院卫生统计学教研室,广州,510080
基金项目:广东省科技厅重点科技项目(2KM05801S);广东省卫生厅"五个一科教兴医工程"重点项目(粤卫科[2000]15号)
摘    要:目的 用Meta分析(meta-analysis)的方法对国内外已发表的高质量的有关比较纵隔淋巴结清扫术和采样术对非小细胞肺癌患者术后生存期影响的临床研究进行综合定量分析。为非小细胞肺癌外科治疗中纵隔淋巴结处理模式的选择提供参考依据。材料与方法收集已公开发表的有关比较肺叶(全肺)切除加纵隔淋巴结清扫术和肺叶(全肺)切除加纵隔淋巴结采样术对非小细胞肺癌患者术后生存期影响的所有随访严密的临床研究,按Meta分析的要求对检索到的原始研究的质量进行评估,对符合条件的所有研究结果进行Meta分析,计算纵隔淋巴结清扫组相对采样组死亡危险的优势比(odds ratio,OR)评价纵隔淋巴清扫术和采样术对患者生存期的影响。结果符合纳入标准的共4篇文献,总样本量977例。其中纵隔淋巴结清扫组48l例,死亡194例;纵隔淋巴结采样组496例,死亡247例;合并OR=0.67,95%可信区间是(0.52-0.87)。结论 与肺叶(全肺)切除加纵隔淋巴结采样术相比,肺叶(全肺)切除加纵隔淋巴结清扫术可以延长患者的生存期,降低0.33的死亡危险。

关 键 词:纵隔  淋巴结  非小细胞肺癌  Meta  手术治疗
文章编号:1671-5144(2002)03-0132-08

Effectiveness of extent of lymphadenectomy for survival in patients with resectable non-small cell lung cancer--a meta-analysis for 4 relative studies
Yang Haoxian,Wu Yilong,Ling Li,Han Lu . Lung Cancer Research Center.Effectiveness of extent of lymphadenectomy for survival in patients with resectable non-small cell lung cancer--a meta-analysis for 4 relative studies[J].The Journal of Evidence-Based Medicine,2002,2(3):132-140.
Authors:Yang Haoxian  Wu Yilong  Ling Li  Han Lu Lung Cancer Research Center
Institution:Yang Haoxian,Wu Yilong,Ling Li,Han Lu 1. Lung Cancer Research Center,Department of Cardiothoracic Surgery,The Third Affiliated Hospital,Sun Yat-sen University,Guangzhou 510630,P. R. China, 2. Department of Medical Statistics,School of Public Health,Sun Yat-sen University,Guangzhou 510080,P. R. China
Abstract:Objective: Search all studies that have been published in the world with regard to the effectiveness of the extent of lymphadenectomy for survival in patients with resectable non-small cell lung cancer and analyze them which are in high quality by means of meta-analysis, in order to give some evidences for the choice of method dealing with mediastinal lymph node in surgery. Material and Method: Evaluate strictly all the studies that have been searched and adopt the studies in high quality that can be analyzed by means of meta-analysis. Calculate the odds ratio (OR) for death during the time to follow-up between the patients with systematic mediastinal lymph node dissection and the patients with mediastinal lymph node sampling. Evaluate the effectiveness of the extent of lymphadenectomy for survival in patients with resectable non-small cell lung cancer. RevMan4. 1 software was applied to process data. Result: Totally 4 studies including 997 cases were analyzed. The cumulative cases in systematic lymph node dissection group were 481, in which 194 cases were dead; while in lymph node sampling group were 496 and 247 respectively. The pooled OR was 0. 67, with a 95% confidence interval (0. 52 - 0. 87). Conclusion: Systematic mediastinal lymph node dissection can give some benefit for survival to patients with resectable non-small cell lung cancer. The overall OR for death was decreased 0. 33 in patients with mediastinal lymph node dissection compared with mediastinal lymph node sampling.
Keywords:non-small cell lung cancer  mediastimal lymph node dissection  meta-analysis
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