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目的探讨中国女性乳腺癌患者术后复发的影响因素,为改善乳腺癌患者预后提供参考依据。方法检索中国学术文献总库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、Web Of Science数据库、Pubmed数据库、Science Direct数据库和BIOSIS数据库,并辅以手工检索和文献追溯法收集2000年1月1日—2013年12月31日公开发表的关于中国女性乳腺癌患者术后复发影响因素的相关文献;应用Rev Man 5.2和SAS 9.2软件对纳入的文献进行meta分析。结果最终纳入25篇中文文献,共累计女性乳腺癌患者16 471例,其中术后复发患者1 048例,复发率为6.36%;meta分析结果显示,肿瘤直径>2 cm(OR=2.89,95%CI=1.76~4.74)、肿瘤分期>Ⅱ期(OR=3.79,95%CI=3.08~4.66)、原发灶T分期>T2期(OR=3.78,95%CI=2.47~5.78)、有淋巴结转移(OR=2.68,95%CI=1.67~4.31)、淋巴结转移数目>3个(OR=3.17,95%CI=2.49~4.03)和人表皮生长因子2阳性(OR=2.85,95%CI=2.21~3.67)为中国女性乳腺癌患者术后复发的危险因素,雌激素受体/孕激素受体阳性(OR=0.47,95%CI=0.38~0.59)和术后放疗(OR=0.21,95%CI=0.12~0.36)为中国女性乳腺癌患者术后复发的保护因素;敏感性分析和发表偏倚评估结果显示,纳入的文献不存在发表偏倚,结果较为可靠。结论肿瘤直径、肿瘤分期、淋巴结转移状态、淋巴结转移数目、原发灶T分期、人表皮生长因子2状态、雌激素受体/孕激素受体状态和术后放疗情况是中国女性乳腺癌患者术后复发的主要影响因素。
Objective To investigate the influencing factors of postoperative recurrence in Chinese women with breast cancer and provide a reference for improving the prognosis of patients with breast cancer. Methods CNKI, Wanfang database, CBM, Web Of Science database, Pubmed database, Science Direct database and BIOSIS database were searched and retrieved by manual search and traceability 2000 January 1, 2013 - December 31, 2013 published on the Chinese women with breast cancer recurrence after the impact of factors related literature; using Rev Man 5.2 and SAS 9.2 software included in the meta-analysis of the literature. Results A total of 25 Chinese literatures were included in this study. A total of 16 471 female breast cancer patients were enrolled, of which 1 048 were recurrent and the recurrence rate was 6.36%. The meta-analysis showed that the tumor diameter was> 2 cm (OR = 2.89, 95% (OR = 3.79, 95% CI = 3.08-4.66), T stage of primary tumor> T2 (OR = 3.78,95% CI = 2.47-5.78), lymph node (OR = 3.17, 95% CI = 2.49 ~ 4.03) and human epidermal growth factor 2 (OR = 2.85, 95% CI = 1.67-4.31) (OR = 0.47, 95% CI = 0.38-0.59) and postoperative radiotherapy (OR = 0.21, 95% CI = 0.38-0.59) were the risk factors of postoperative recurrence in Chinese women with breast cancer % CI = 0.12-0.36) were the protective factors for the recurrence of breast cancer in Chinese women. The sensitivity analysis and publication bias assessment showed that there was no publication bias in the included literature, and the results were more reliable. Conclusions The tumor diameter, tumor stage, lymph node metastasis, lymph node metastasis, T stage of primary tumor, human epidermal growth factor 2 status, estrogen receptor / progesterone receptor status and postoperative radiotherapy are the most common causes of breast cancer in Chinese women After the recurrence of the main influencing factors.