早期子宫内膜癌诊断性宫腔镜检查的肿瘤学安全性：一项系统评价和荟萃分析
The Oncology Safety of Diagnostic Hysteroscopy in Early-Stage Endometrial Cancer: A Systematic Review and Meta-Analysis.
作者信息
Du Yi, Xu Yu, Qin Zhaojuan, Sun Liang, Chen Yali, Han Ling, Zheng Ai
机构信息
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
出版信息
Front Oncol. 2021 Oct 21;11:742761. doi: 10.3389/fonc.2021.742761. eCollection 2021.
BACKGROUND
Hysteroscopy is becoming a common method for the diagnosis of uterine disorders in developed countries. However, hysteroscopy might worsen the prognosis of endometrial cancer because it could cause cancer dissemination into the peritoneal cavity through the fallopian tubes. Objective: The aim of this systematic review and meta-analysis was to explore the oncological safety of hysteroscopy for early-stage endometrial cancer.
SEARCH STRATEGY
Eligible studies were obtained from PubMed, Embase, and the Cochrane Library up to September 22, 2020.
SELECTION CRITERIA
Studies which compared the oncological safety of hysteroscopy with other methods were included.
DATA COLLECTION AND ANALYSIS
A total of 3980 patients were included in this study, of whom1357 patients had undergone hysteroscopy and2623 had not.
MAIN RESULTS
There was no significant association between hysteroscopy and worse prognosis in early-stage endometrial cancer [disease-free survival: log risk ratio(logRR) -0.22; 95% confidence interval (CI), -0.54 to 0.1; p=0.97; overall survival: logRR 0.03; 95% CI, -0.05 to 0.11; p=0.02; disease-specific survival: logRR 0.03; 95% CI, -0.03 to 0.10; p=0.00].
CONCLUSION
This study suggests that hysteroscopy is a safe diagnostic and treatment method, and has no significant effect on the prognosis of early-stage endometrial cancer.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration number: CRD42020193696.
背景
在发达国家，宫腔镜检查正成为诊断子宫疾病的常用方法。然而，宫腔镜检查可能会使子宫内膜癌的预后恶化，因为它可能导致癌症通过输卵管扩散到腹腔。目的：本系统评价和荟萃分析的目的是探讨宫腔镜检查对早期子宫内膜癌的肿瘤学安全性。
检索策略
截至2020年9月22日，从PubMed、Embase和Cochrane图书馆获取符合条件的研究。
选择标准
纳入比较宫腔镜检查与其他方法的肿瘤学安全性的研究。
数据收集与分析
本研究共纳入3980例患者，其中1357例接受了宫腔镜检查，2623例未接受。
主要结果
宫腔镜检查与早期子宫内膜癌预后较差之间无显著关联[无病生存率：对数风险比（logRR）-0.22；95%置信区间（CI），-0.54至0.1；p = 0.97；总生存率：logRR 0.03；95%CI，-0.05至0.11；p = 0.02；疾病特异性生存率：logRR 0.03；95%CI，-0.03至0.10；p = 0.00]。
结论
本研究表明，宫腔镜检查是一种安全的诊断和治疗方法，对早期子宫内膜癌的预后无显著影响。
系统评价注册
PROSPERO注册号：CRD42020193696。
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