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前哨淋巴结定位在默克尔细胞癌中的预后意义：预后研究的系统评价和荟萃分析

Prognostic significance of sentinel lymph node mapping in Merkel cell carcinoma: systematic review and meta-analysis of prognostic studies.

作者信息

Sadeghi Ramin, Adinehpoor Zohreh, Maleki Masoud, Fallahi Babak, Giovanella Luca, Treglia Giorgio

机构信息

Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad 9176699199, Iran.

Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad 9137913316, Iran.

出版信息

Biomed Res Int. 2014;2014:489536. doi: 10.1155/2014/489536. Epub 2014 May 26.

DOI:10.1155/2014/489536
PMID:24971335
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4058204/
Abstract

AIM

To assess through a systematic review and meta-analysis of the literature the prognostic implication of sentinel lymph node mapping in Merkel cell carcinoma (MCC).

MATERIALS AND METHODS

PubMed and SCOPUS databases were searched by using "Merkel AND sentinel" as keywords. All studies with prognostic information regarding SLN mapping in cN0 MCC patients were included. Hazard ratio (HR) for overall survival (OS) and disease free survival (DFS) was used as effect size.

RESULTS

SLN biopsy predicted better DFS and OS as compared to the nodal observation in cN0 MCC patients (pooled HR for DFS: 1.61 (95% CI: 1.05-2.46), P = 0.028; pooled HR for OS: 1.08 (95% CI: 0.55-2.10), P = 0.8). Pathologically negative SLN (SLN-) patients had better OS (pooled HR: 4.42 (95% CI: 1.82-10.7), P = 0.0009) and DFS (pooled HR: 2.58 (95% CI: 1.78-3.73)) as compared to SLN+ patients.

CONCLUSION

SLN mapping can provide strong prognostic information regarding OS and DFS in cN0 MCC patients. More importantly, SLN mapping can improve DFS and possibly OS in cN0 MCC patients as compared to nodal observation. As MCC is a rare tumor, large multicenter prospective studies are still needed to validate the survival benefit of SLN mapping.

摘要

目的

通过对文献的系统评价和荟萃分析，评估前哨淋巴结定位在默克尔细胞癌（MCC）中的预后意义。

材料与方法

以“默克尔 AND 前哨”为关键词检索 PubMed 和 SCOPUS 数据库。纳入所有有关 cN0 期 MCC 患者前哨淋巴结定位预后信息的研究。采用总生存期（OS）和无病生存期（DFS）的风险比（HR）作为效应量。

结果

与 cN0 期 MCC 患者的淋巴结观察相比，前哨淋巴结活检预测的 DFS 和 OS 更佳（DFS 的合并 HR：1.61（95%CI：1.05 - 2.46），P = 0.028；OS 的合并 HR：1.08（95%CI：0.55 - 2.10），P = 0.8）。与前哨淋巴结阳性（SLN+）患者相比，病理检查前哨淋巴结阴性（SLN-）的患者 OS 更佳（合并 HR：4.42（95%CI：1.82 - 10.7），P = 0.0009），DFS 也更佳（合并 HR：2.58（95%CI：1.78 - 3.73））。

结论

前哨淋巴结定位可为 cN0 期 MCC 患者提供有关 OS 和 DFS 的有力预后信息。更重要的是，与淋巴结观察相比，前哨淋巴结定位可改善 cN0 期 MCC 患者的 DFS，并可能改善 OS。由于 MCC 是一种罕见肿瘤，仍需要大型多中心前瞻性研究来验证前哨淋巴结定位的生存获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/3323ebe1051a/BMRI2014-489536.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/1dc396dc8611/BMRI2014-489536.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/d3b0c6eeb059/BMRI2014-489536.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/5e82a021bc92/BMRI2014-489536.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/3323ebe1051a/BMRI2014-489536.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/1dc396dc8611/BMRI2014-489536.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/d3b0c6eeb059/BMRI2014-489536.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/5e82a021bc92/BMRI2014-489536.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8419/4058204/3323ebe1051a/BMRI2014-489536.004.jpg

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