关键词: 癌, 非小细胞肺, 细胞学技术, Meta分析

Abstract: Objective  To systematically evaluate the effectiveness of intraoperative pleural lavage cytology(PLC)  positive  and  negative  on mortality,recurrence  and relapse rate in five years after pneumonectomy in patients with nonsmall cell lung cancer(NSCLC). Methods  We searched PubMed,EMBASE, Cochrane, library, CNKI, VIP, and Wanfang Data databases to collect  cohort study of the prognosis of pneumonectomy in patients with NSCLC from construction of database to November  2017. RevMan 5.3 software was used to process the data, and to figure out the risk ratio (RR) and 95% of the confidence intervals （confidence interval，CI）. Results  A total of 11 retrospective controlled studies were conducted, including 11 856 patients with NSCLC,among which, 533 were positive PLC patients and 11 323 were PLC negative patients.   The Meta analysis results showed that,compared to PLC negtive patients were not only associated with poor survival rate, but also with  recurrence and metastasis, especially pleural metastasis.  The total mortality rate  (RR=1.99, 95%CI=1.842.14,P<0.01)  and the mortality rate of stage Ⅰ(clinical staging of nonsmall cell lung cancer,RR=2.10, 95%CI=1.852.39, P<0.01）  five years after the pulmonary resection  , the total relapse rate (RR=2.54, 95%CI=2.212.92, P<0.01) pleural metastasis (RR=8.17, 95%CI=6.0211.10, P<0.01), and the distant recurrence of the two groups were all of statistical significance(RR=2.65,95%CI=2.123.31,P<0.01). Conclusion  The prognosis of patients with positive PLC is worse than that of patients with negative PLC, and PLC can serve as an independent prognostic factor in NSCLC patients. Given that the   quantity and quality of the  inclued studies are limited, the above conclusion still needs to be verified by  higher quality studies.

Key words: carcinoma, nonsmallcell lung, cytological techniques, Metaanalysis