乳腺不可触及病灶的放射导向定位与传统导丝定位对比的Meta分析被引量：2

Radioguided versus wire-guided localization for non-palpable breast lesions: a meta-analysis

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摘要目的比较放射导向定位技术,包括导向放射隐匿性病灶定位(ROLL)和放射性粒子定位(RSL)技术与导丝定位(WGL)的临床效果,评估放射导向定位技术在不可触及的乳腺病灶(NPBL)检测中的应用价值。方法检索PubMed、Embase、Cochrane、万方、中国知网、维普数据库,收集截至2017年4月关于放射导向定位与WGL对比的随机对照临床试验。由2名研究者独立完成文献筛选、数据提取,运用Cochrane协作网系统评价手册推荐的偏倚风险评价工具进行文献质量评价。采用风险比(RR)和95%置信区间(CI)评价二分类数据的差异,采用均数差(MD)和95%CI评价连续性数据的差异,使用RevMan 5.3软件进行Meta分析。结果共纳入14项随机对照研究,纳入患者2 311例,其中,ROLL组562例,RSL组614例,WGL组1 135例。ROLL组与WGL组的定位并发症发生率(RR=0.53,95%CI:0.24～1.18,P=0.120)、病灶成功切除率(RR=1.01,95%CI:0.99～1.02,P=0.240)、切缘阳性率(RR=0.88,95%CI:0.68～1.13,P=0.310)、术中再切除率(RR=1.07,95%CI:0.71～1.61,P=0.750)、再次手术率(RR=0.54,95%CI:0.23～1.25,P=0.150),术后并发症发生率(RR=0.88,95%CI:0.56～1.40,P=0.590)及切除标本体积(MD=-2.11,95%CI:-8.39～4.16,P=0.510)比较,差异均无统计学意义。RSL组与WGL组的定位并发症发生率(RR=1.02,95%CI:0.21～5.08,P=0.980)、切缘阳性率(RR=0.84,95%CI:0.65～1.09,P=0.190)、再次手术率(RR=0.78,95%CI:0.55～1.11,P=0.170)及术后并发症发生率(RR=1.34, 95%CI:0.81～2.22,P=0.260)比较,差异也均无统计学意义。结论在NPBL的定位技术中,放射导向定位技术具有与传统导丝定位技术相似的定位效果及广泛的临床应用前景。 Objective To compare the therapeutic outcome of radioguided occult lesion localization(ROLL)and radioactive seed localization(RSL)with wire-guided localization(WGL) in patients with non-palpable breast lesions(NPBL). Methods The PubMed, Embase, Cochrane, CNKI, Wanfang and VIP databases were searched for randomized control studies which compared ROLL/RSL with WGL from the earliest available date up to April 2017. Two researchers independently completed literature retrieval and data extraction, and evaluated the quality of the studies based on Cochrane handbook. Risk ratio(RR)and mean difference(MD)with 95% confidence interval(CI)were pooled for dichotomous and continuous variables, respectively. RevMan 5.3 software was adopted for a meta-analysis. Results Fourteen randomized controlled trials(RCT) were eligible, involving a total of 2 311 patients(ROLL:n=562,RSL:n=614,WGL:n=1 135). There was no significant difference in localization-related complication rate(RR=0.53,95%CI:0.24-1.18,P=0.120), successful excision rate(RR=1.01,95%CI:0.99-1.02,P=0.240),positive margin rate(RR=0.88,95%CI:0.68-1.13, P=0.310), intra-operative re-excision rate(RR=1.07, 95%CI:0.71-1.61, P=0.750), re-operation rate(RR=0.54, 95%CI:0.23-1.25, P=0.150), postoperative complication rate(RR=0.88, 95%CI:0.56-1.40, P=0.590) and specimen volume(MD=-2.11, 95%CI:-8.39-4.16, P=0.510)between ROLL group and WGL group. No significant difference was observed in localization-related complication rate(RR=1.02,95%CI:0.21-5.08, P=0.980), positive margin rate(RR=0.84,95%CI:0.65-1.09, P=0.190), re-operation rate(RR=0.78, 95%CI:0.55-1.11, P=0.170) and postoperative complication rate(RR=1.34,95%CI:0.81-2.22,P=0.260) between RSL group and WGL group. Conclusion With similar effect to WGL, ROLL and RSL are feasible for the localization of non-palpable breast lesions in clinic.

作者徐新建吴娟朱芮李静静季文斌刘强 Xu Xinjian;Wu Juan;Zhu Rui;Li Jingjing;Ji Wenbin;Liu Qiang(Department of Interventional Radiology,Jiangyin People’s Hospital,Jiangyin 214400,China;Department of Radiology,Taizhou Hospital of Wenzhou Medical University,Taizhou 317000,China;Department of Radiology,Shandong Medical Imaging Research Institute Affiliated to Shandong University,Jinan 250000,China)

机构地区江苏省江阴市人民医院介入放射科温州医科大学附属台州医院放射科山东大学附属山东医学影像研究所

出处《中华乳腺病杂志（电子版）》 CAS CSCD 2019年第1期30-36,共7页 Chinese Journal of Breast Disease(Electronic Edition)

关键词乳腺肿瘤触诊放射外科手术放射学 META分析 Breast neoplasms Palpation Radiosurgery Radiology Meta-analysis

分类号 R737.9 [医药卫生—肿瘤] R730.55 [医药卫生—肿瘤]

作者简介通信作者:刘强,Email:liuqiangdoc@126.com

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参考文献2

1彭庆蓥,胡大章.全数字化乳腺X线引导下钙化灶导丝定位活检对早期乳腺癌诊断的意义[J].肿瘤基础与临床,2012,25(1):63-64. 被引量：21
2吉华明,张继,夏建国.全数字化X线乳腺钼靶、MRI对乳腺癌的诊断价值探讨[J].中华普通外科学文献（电子版）,2013,7(4):42-44. 被引量：17

二级参考文献14

1张晓鹏彭卫军李洁.乳腺影像学现状与展望.中国肿瘤影像学,2008,1(1):7-11.
2Ferlay J ,Shin HR,Bray F,et al. Estimates of worldwide burden of cancer in 2008 : GLOBOCAN 2008 [ J ]. Int J Cancer,2010,127 (12) : 2893-2917.
3Berry DA, Cronin KA, Plevritis SK, et al. Effect of screening and adjuvant therapy on mortality from breast cancer [ J ]. N Engl J Med,2005,353(17) :1784-1792.
4Nystrom L,Andersson I,Bjurstam N,et al. Long-term effects of mammography screening: updated overview of the Swedish randomised trials [J]. Lancet, 2002,359(9310):909-919.
5Cuzick J. Breast cancer prevention in the developing world [ J ]. Breast Cancer Res ,2010,12 Suppl 4 : S9.
6Kerlikowske K,Grady D,Rubin SM,et al. Efficacy of screening mammography. A meta-analysis [ J ]. JAMA, 1995,273 (2) : 149-154.
7Kopans DB,DeLuea S. A modified needle-hookwire technique to simplify preoperative localization of occult breast lesions [ J ]. Radiology,1980,134(3) :781.
8渠红,鲍春生,邢丽.乳腺癌x线乳腺钼靶与MRI诊断价值比较分析.现在肿瘤医学,201l,19(1):52-54.
9Du TQ, I)ing BZ, Sang CH, et al. Efficacy of dynamic contrast enhanced-MRI in distinguishing begin and malignant breast lesions. Chinese-German J Clin Oncology, 2009, 8(10): 561-566.
10Cilotti A, Iacconi C, Marini, et al. Contrast-enhanced MR imaging in patients,with BI-RADS 3-5 microcalcofications. Radiol Med, 2007, 112(2): 272-286.