自体脂肪移植在乳腺癌基础科学和临床研究中的肿瘤安全性的荟萃分析。
Meta-Analysis of the Oncological Safety of Autologous Fat Grafting After Breast Cancer on Basic Science and Clinical Studies.
机构信息
Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Department of Plastic Surgery, 987 Hospital of Joint Logistics Support Force, P.L.A., No. 45 Dongfeng Road, Baoji, China.
出版信息
Aesthetic Plast Surg. 2023 Aug;47(4):1245-1257. doi: 10.1007/s00266-022-03217-7. Epub 2022 Dec 21.
BACKGROUND
The purpose of the present study was to comprehensively evaluate the oncological safety of autologous fat grafting after breast cancer by combining experimental and clinical studies.
METHODS
All studies published before August 2021 were collected by searching PubMed, Cochrane, Embase, Web of Science, SINOMED, and China National Knowledge Infrastructure. After screening the research and extracting the data, RevMan was used to perform the meta-analysis.
RESULTS
Five basic science studies and 26 clinical studies, involving a total of 10,125 patients, were eventually included. In the basic science studies, adipose-derived stem cells promoted breast cancer growth, but fat grafting and adipose-derived stem cells plus fat grafting were not associated with breast cancer growth. An overall analysis of clinical studies showed that autologous fat grafting does not increase the risk of breast cancer recurrence. Subgroup analyses indicated that autologous fat grafting did not increase the risk of breast cancer recurrence in Asian or Caucasian patients, in patients undergoing breast-conserving surgery or modified radical mastectomy, in patients with in situ carcinomas or invasive carcinomas, or in patients undergoing postoperative radiotherapy.
CONCLUSION
This study combined experimental and clinical studies to conclude that autologous fat grafting does not increase the risk of breast cancer recurrence. However, the experimental results suggest that adipose-derived stem cells should be used with caution after breast cancer surgery.
LEVEL OF EVIDENCE III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
背景
本研究旨在通过实验和临床研究相结合,全面评估乳腺癌患者自体脂肪移植的肿瘤安全性。
方法
通过检索 PubMed、Cochrane、Embase、Web of Science、SINOMED 和中国知网,收集截至 2021 年 8 月前发表的所有研究。筛选研究并提取数据后,采用 RevMan 进行荟萃分析。
结果
最终纳入 5 项基础科学研究和 26 项临床研究,共涉及 10125 例患者。基础科学研究中,脂肪来源干细胞促进乳腺癌生长,但脂肪移植和脂肪来源干细胞加脂肪移植与乳腺癌生长无关。临床研究的总体分析表明,自体脂肪移植不会增加乳腺癌复发的风险。亚组分析表明,自体脂肪移植不会增加亚洲或白种人患者、保乳手术或改良根治性乳房切除术患者、原位癌或浸润性癌患者、或术后接受放疗患者的乳腺癌复发风险。
结论
本研究结合实验和临床研究得出结论,自体脂肪移植不会增加乳腺癌复发的风险。然而,实验结果表明,乳腺癌手术后应谨慎使用脂肪来源干细胞。
证据水平 III:本杂志要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266 。