肾母细胞瘤临床预后因素的Meta分析
摘要
普数据库、Pubmed、Springer-link、Embase、The Cochrane Library等。搜索与肾母细胞瘤预后相关的样本病例对照研究，
检索的时限为建库至2022年11月30日。由2名研究人员独立筛选文献、提取出与患者生存时间及状态相关的资料，
采用纽卡斯尔渥太华（NOS）量表评价纳入研究文献的质量，应用Review Manager 5.3软件、Engauge Digitizer 4.1等
计算数据、提取信息并进行Meta分析。结果：共有7项研究符合纳入标准，总样本量为1858例。Meta分析的结果提
示：基于5年生存状态的部分预后因素与5年无事件生存率（EFS）的Meta分析结果提示：临床分期为Ⅲ、Ⅳ、Ⅴ的
肾母细胞瘤患儿5年无事件生存率明显低于临床分期为Ⅰ、Ⅱ患儿［比值比（OR）=4.19，95% CI（0.13，0.42），P
＜0.0000 1］；预后良好型肾母细胞瘤患儿5年无事件生存率明显高于预后不良型肾母细胞瘤患儿［比值比（OR）
=0.10，95% CI（0.02，0.46），P=0.003］。基于Kaplan-metier法绘制生存曲线单因素分析与肾母细胞瘤预后的Meta结
果提示：肿瘤出现转移［比值比（OR）=5.41，95% CI（3.57，8.22），P＜0.00001］、具备放疗指征而未采取放疗［比
值比（OR）=0.39，95% CI（0.23，0.65），P＜0.0003］的肾母细胞瘤患儿随访5到10年后其死亡率明显高于未出现
转移及已放疗的患儿。结论：临床分期愈晚，患儿预后愈差；肿瘤出现远处转移，患儿死亡率增高，预后较差；依
据临床诊疗指南规范化放疗可提高患儿生存期，改善患儿预后。
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