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目的:黏液腺癌对于结直肠癌患者TNM分期及预后的影响目前仍然处于争论之中,本研究对结直肠癌患者TNM分期和预后特点进行Meta分析,旨在全面评估黏液腺癌这一相对少见的组织类型。方法:检索1995年1月至2012年3月间发表的关于结直肠黏液腺癌的文献。英文文献采用WebofKnowledge和MEDLINE(PubMed)数据库,中文文献采用中国期刊全文数据库(CNKI),数字化期刊全文数据库(万方),和维普数据库进行检索。使用RevMan5软件对黏液腺癌与TNM分期的关系及黏液腺癌预后特点分别进行Meta分析。结果:共纳入符合标准的文献30篇。黏液腺癌与TNM分期关系的Meta分析提示与非黏液腺癌患者相比,黏液腺癌患者中TNM分期IV期病例所占比例较大,OR值为1.4(895%CI:1.28-1.71;P<0.001)。黏液腺癌预后估计的Meta分析提示与非黏液腺癌患者相比,黏液腺癌患者预后较差,HR值为1.06(CI:1.04-1.08;P<0.001),经过异质性检验,去除异质性较大文献后再次分析所得结果与整体分析一致,HR值为1.4(8CI:1.35-1.62;P<0.001)。结论:与非黏液腺癌患者相比,黏液腺癌患者中TNM分期较晚病例所占比例较大,且黏液腺癌是一个独立的预后危险因素。
OBJECTIVE: The impact of mucinous adenocarcinoma on TNM staging and prognosis in patients with colorectal cancer is still in controversy. This meta-analysis of TNM staging and prognostic characteristics in patients with colorectal cancer is designed to fully evaluate mucinous adenocarcinoma. This is relatively rare. The type of organization. METHODS: The literature on colorectal mucinous adenocarcinoma published between January 1995 and March 2012 was searched. WebfKnowledge and MEDLINE (PubMed) databases were used in English literature, and Chinese journals were searched using the Chinese Journal Full-text Database (CNKI), Digital Periodical Full-text Database (Wanfang), and the VIP database. The RevMan5 software was used to perform meta-analysis of the relationship between mucinous adenocarcinoma and TNM staging and the prognostic features of mucinous adenocarcinoma. Results: A total of 30 articles that meet the criteria were included. The meta-analysis of the relationship between mucinous adenocarcinoma and TNM staging indicated that compared with patients with non-mucinous adenocarcinoma, the proportion of TNM stage IV stages in patients with mucinous adenocarcinoma was larger, with an OR of 1.4 (895% CI: 1.28-1.71; P <0.001). Meta-analysis of the prognosis of mucinous adenocarcinoma suggests that compared with patients with non-mucinous adenocarcinoma, the prognosis of patients with mucinous adenocarcinoma is poor, with a HR value of 1.06 (CI: 1.04-1.08; P<0.001). After heterogeneity testing, the difference is removed. The results of reanalysis after qualitatively larger literature were consistent with the overall analysis, with a HR of 1.4 (8CI:1.35-1.62; P<0.001). Conclusion: Compared with non-mucinous adenocarcinoma patients, the proportion of late TNM staging in mucinous adenocarcinoma patients is larger, and mucinous adenocarcinoma is an independent prognostic risk factor.