窄带成像技术膀胱镜与普通白光膀胱镜诊疗非肌层浸润性膀胱肿瘤价值的meta分析

doi:10.19558/j.cnki.10-1020/r.2017.04.009

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摘要 目的: 系统探索评价窄带成像技术膀胱镜(NBI)膀胱镜相对于普通白光膀胱镜(WLI)在非肌层浸润性膀胱肿瘤(NMIBC)患者的诊疗价值。方法: 收集PubMed、Medline、EMBASE,CNKI(中国国家知识基础设施数据库)和万方数字化期刊群在2016年8月前国内外公开发表的有关NBI与WLI对非肌层浸润性膀胱肿瘤的诊疗疗效比较的临床对照研究文献,使用以下搜索关键词:“bladder cancer”、“White-Light Imaging”、“Narrow Band Imaging”。此外,手工检索相关的相关的参考书目检索所有发表评论和文章,通过Revman 5.3软件进行meta分析。结果: 共计20篇文献纳入研究,其中随机对照研究4篇,系统回顾性研究16篇;在非肌层浸润性膀胱肿瘤患者检出率的比较中,纳入研究对象NBI组560例和与WLI组560例,RD=0.12,[95% CI:0.091,0.12],P<0.000 01,I²=0%;在原位膀胱肿瘤患者检出率的比较中,纳入研究对象NBI组360例和与WLI组334例,RD=0.17,[95% CI:0.11,0.23],P<0.000 01,I²=66%;在TURBT术后复发的比较中,NBI组与WLI组分别有754例和764例研究对象纳入,OR=0.62,[95% CI:0.45,0.86],P=0.005,I²=55%。结论: NBI膀胱镜在非肌层浸润性膀胱肿瘤患者检出率和原位膀胱肿瘤患者检出率中相对于WLI膀胱镜具有明显优势,并且能够降低TURBT术后患者肿瘤复发率。

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	王云汉
	李响

关键词 ： Meta分析, 非肌层浸润性膀胱肿瘤, 窄带成像技术膀胱镜, 普通白光膀胱镜

Abstract：Objective: To systematically evaluate the value of cystoscopy by narrow-band imaging (NBI) for non-muscle-invasive bladder caner. Methods: We searched through the major medical databases such as Pub Med, EMBASE, Medline, Science Citation Index, Web of Science and Chinese National Knowledge Infrastructure Database (CNKI) and Wangfang ( Database of Chinese Ministry of Science & Technology) for all published studies from 2007 until July 2016. The following search terms were used: "bladder cancer", "White-Light Imaging", "Narrow Band Imaging" . Furthermore, additional related studies were manually searched in the reference lists of all published reviews and retrieved articles. We used the Review Manager software (RevMan 5.3, Cochrane Collaboration) to carry out the meta-analysis. Results: There were 20 eligible studies included. We found the detection rate on bladder cancer patients was significantly higher in NBI group than in WLI group (RR=1.17, [95% CI: 1.11,1.23], P<0.000 01, I²=0%), and the detection rate of carcinoma in situ also was higher in NBI group than in WLI group (RR=1.47, [95% CI: 1.27,1.69], P<0.000 01, I²=66%). Meanwhile, the recurrence rate of TURBT was significantly lower in NBI group than in WLI group (RR=0.67, [95% CI: 0.50, 0.89], P=0.006, I²=52%). Conclusions: Cystoscopy by NBI was considered to detect more patients of non-muscle-invasive bladder cancer and carcinoma in situ than WLI, and it might reduce the recurrence rate after TURBT.

Key words： meta-analysis non-muscle-invasive bladder cancer narrow-band imaging white light imaging.

收稿日期: 2016-11-29

ZTFLH:

R737.14

通讯作者: 李响,xiangli.87@163.com

引用本文:

王云汉, 李响. 窄带成像技术膀胱镜与普通白光膀胱镜诊疗非肌层浸润性膀胱肿瘤价值的meta分析[J]. 微创泌尿外科杂志, 2017, 6(4): 224-229.
Wang Yunhan, Li Xiang. Narrow-band imaging and white light imaging for non-muscle invasive bladder cancer: a meta-analysis. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(4): 224-229.

链接本文:

http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1291.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2017/V6/I4/224

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