放射性粒子定位与导丝定位引导切除不可触及乳腺癌病灶有效性和安全性的Meta分析

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摘要目的系统评价放射性粒子定位（RSL）和金属导丝定位（WGL）引导切除不可触及乳腺癌病灶的有效性和安全性。方法计算机检索中国知网、Web of Science、PubMed、EMBASE、OVID、EBSCO、Cochrane Library 等数据库，检索时限均从建库至2019年3月1日，纳入研究质量评价后，用RevMan 5.3 软件进行Meta 分析。结果共纳入13项研究，RSL 组的切缘阳性率和再次手术率均低于WGL 组，差异有统计学意义（OR=0.79，95%CI 0.68～0.92，P=0.002；OR=0.71，95%CI 0.59～0.84，P＜0.0001）；RSL 组和WGL 组的术中再次切除率及术后并发症发生率比较，差异无统计学意义（OR=0.85，95%CI 0.68～1.07，P=0.16；OR=1.40，95%CI 0.86～2.27，P=0.18）。结论与WGL 相比，RSL 具有更低的阳性切缘率和再次手术率，在未来可能具有更广泛的应用前景。

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	张茂泉
	肖坚
	陈文新
	王合兵
	杨炳林
	陈基铖

关键词 ：触诊阴性乳腺病灶, 放射性粒子, 金属导丝, Meta 分析

Abstract：Objective To systematically review the efficacy and safety of radioactive seed localization (RSL) and versus wire-guided localization (WGL) guiding the resection of the non-palpable breast cancer lesions.Methods Databases of CNKI, Web of Science, PubMed, EMBASE, OVID, EBSCO and Cochrane Library were searched by computer, and the retrieval time was from the database construction to March 1, 2019.Meta-analysis was conducted by RevMan 5.3 after the quality of studies was evaluated.Results A total of 13 studies were included，the positive rate of incised margin and the rate of reoperation in the RSL group were lower than those in the WGL group, the differences were statistically significant (OR=0.79, 95%CI 0.68-0.92, P=0.002; OR=0.71, 95%CI 0.59-0.84，P＜0.0001].There was no significant difference in the intra-operative re-excision rate and postoperative complication rate between two groups (OR=0.85,95%CI 0.68-1.07, P=0.16; OR=1.40, 95%CI 0.86-2.27, P=0.18).Conclusion Compared with WGL, RSL has lower rate of positive excision margins rate and reoperation rate, and may have a wider application prospect in the future.

Key words： Non-palpable breast lesions Radioactive seed Wire-guided Meta-analysis

引用本文:

张茂泉；肖坚；陈文新；王合兵；杨炳林；陈基铖. 放射性粒子定位与导丝定位引导切除不可触及乳腺癌病灶有效性和安全性的Meta分析[J]. 中国当代医药, 2020, 27(3): 8-11转16.
ZHANG Mao-quan； XIAO Jian； CHEN Wen-xin； WANG He-bing； YANG Bing-lin； CHEN Ji-cheng. Efficacy and safety of radioactive seed localization and versus wire-guided localization guiding the resection of non-palpable breast cancer lesions：a Meta-analysis. 中国当代医药, 2020, 27(3): 8-11转16.

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