乳晕下与肿瘤周围注射示踪剂定位乳腺癌前哨淋巴结的Meta分析
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郭丽英, Email: 410633810@qq.com

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新疆重大疾病医学重点实验室资助项目(SKLIB-XJMDR-ZX-2014-1)。


Subareolar versus peritumoral tracer injection for location of sentinel lymph node in breast carcinoma: a Meta-analysis
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    摘要:

    目的:比较乳晕下与肿瘤周围注射示踪剂定位乳腺癌前哨淋巴结(SLN)的检出率与准确性。 方法:检索国内外数据库收集关于乳晕下及肿瘤周围注射示踪剂定位乳腺癌对比研究的文献,提取数据后,用Metadisc 1.4软件进行统计学分析。 结果:最终纳入7项研究,共1 350例患者,其中乳晕下注射总共794例,检出SLN 747例,检出率为94.08%,肿瘤周围注射总共556例,检出SLN 506例,检出率为91.01%,前者检出率明显高于后者(P=0.031)。乳晕下与肿瘤周围注射示踪剂定位前哨淋巴结合并后的灵敏度分别为0.962 (95% CI=0.929~0.983)、0.937(95% CI=0.890~0.968);特异性为1.000(95% CI=0.988~1.000)、1.000(95% CI=0.988~1.000);SROC曲线下面积分别为0.983 3、0.956 3。 结论:在确定乳腺癌SLN方面,乳晕下注射法检出率高于肿瘤周围注射法,但两种方法的准确性均较高。

    Abstract:

    Objective: To compare the detection rate and accuracy of subareolar versus peritumoral tracer injection for location of sentinel lymph nodes (SLNs) in breast carcinoma. Methods: The literature regarding subareolar compared to peritumoral tracer injection for location of SLNs in breast cancer was collected by searching the national and international databases. After data extraction, statistical analysis was performed by using Metadisc 1.4 softeware. Results: Seven studies were finally included involving 1 350 patients. In the 794 patients undergoing subareolar injection, SLNs were detected in 747 cases, and the detection rate was 94.08%, while in the 556 patients undergoing peritumoral injection, SLNs were detected in 506 cases, and the detection rate was 91.01%, which in the former was significantly higher than that in the latter (P=0.031). For subareolar and peritumoral injection, the pooled sensitivity for was 0.962 (95% CI=0.929–0.983) and 0.937 (95% CI=0.890–0.968), specificity was 1.000 (95% CI=0.988–1.000) and 1.000 (95% CI=0.988–1.000), and area under curve of SROC was 0.983 3 and 0.956 3, respectively. Conclusion: For location of SLNs in breast cancer, the detection rate of subareolar injection is higher than that of peritumoral injection, but both methods have relatively high accuracy.

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付明刚,刘莎,郭丽英.乳晕下与肿瘤周围注射示踪剂定位乳腺癌前哨淋巴结的Meta分析[J].中国普通外科杂志,2015,24(5):663-668.
DOI:10.3978/j. issn.1005-6947.2015.05.009

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  • 收稿日期:2014-06-16
  • 最后修改日期:2014-11-13
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  • 在线发布日期: 2015-05-15