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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 nonsmall 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=1.842.14,P<0.01) and the mortality rate of stage Ⅰ(clinical staging of nonsmall cell lung cancer,RR=2.10, 95%CI=1.852.39, P<0.01) five years after the pulmonary resection , the total relapse rate (RR=2.54, 95%CI=2.212.92, P<0.01) pleural metastasis (RR=8.17, 95%CI=6.0211.10, P<0.01), and the distant recurrence of the two groups were all of statistical significance(RR=2.65,95%CI=2.123.31,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, nonsmallcell lung, cytological techniques, Metaanalysis
Wu Qinxun1,2, Liu Hua2, Li Yujing1,Ma Jilong1. Prognosis of pneumonectomy in patients with nonsmall cell lung cancer by pleural lavage cytology:a metaanalysis[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2018.07.012.
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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2018.07.012
https://huicui.hebmu.edu.cn/EN/Y2018/V33/I7/603