Chinese General Practice ›› 2023, Vol. 26 ›› Issue (17): 2147-2154.DOI: 10.12114/j.issn.1007-9572.2022.0568
• Evidence-based Medicine • Previous Articles Next Articles
Received:
2022-06-15
Revised:
2022-10-12
Published:
2023-06-15
Online:
2022-10-31
Contact:
ZHOU Fenghai
通讯作者:
周逢海
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0568
步骤 | 检索词 |
---|---|
#1 | ( "Prostatectomy" [Title/Abstract] OR "Prostatectomies" [Title/Abstract] OR "suprapubic prostatectomies" [Title/Abstract] OR "suprapubic prostatectomy " [Title/Abstract] OR "retropubic prostatectomies" [Title/Abstract] OR "retropubic prostatectomy" [Title/Abstract] OR "radical prostatectomy" [Title/Abstract] OR(( "radical" [All Fields] OR "radical's" [All Fields] OR "radicals" [All Fields]) AND( "resect" [All Fields] OR "resectability" [All Fields] OR "resectable" [All Fields] OR "resectates" [All Fields] OR "resected" [All Fields] OR "resecting" [All Fields] OR "Resection" [All Fields] OR "resectional" [All Fields] OR "resectioned" [All Fields] OR "resectioning" [All Fields] OR "resections" [All Fields] OR "resective" [All Fields] OR "resects" [All Fields]) AND " prostate cancer" [Title/Abstract])) |
#2 | ( "positive margin" [Title/Abstract] OR "positive excision margins" [Title/Abstract] OR "margins of excision" [Title/Abstract] OR "excision margin" [Title/Abstract] OR "excision margins" [Title/Abstract] OR "resection margin" [Title/Abstract] OR "resection margins" [Title/Abstract] OR "surgical margins" [Title/Abstract] OR "surgical margin" [Title/Abstract] OR "positive surgical margins" [Title/Abstract] OR "positive surgical margin" [Title/Abstract] OR "negative surgical margins" [Title/Abstract] OR "negative surgical margin" [Title/Abstract] OR "tumor free margins" [Title/Abstract] OR "tumor free margins" [Title/Abstract] OR "tumor free margin" [Title/Abstract]) |
#3 | ( "Risk factors" [Title/Abstract] OR "social risk factors" [Title/Abstract] OR "social risk factor" [Title/Abstract] OR "health correlates" [Title/Abstract] OR "population at risk" [Title/Abstract] OR "populations at risk" [Title/Abstract] OR "risk scores" [Title/Abstract] OR "risk score" [Title/Abstract] OR "risk factor scores" [Title/Abstract] OR "risk factor score" [Title/Abstract] OR "dangerous factor" [Title/Abstract] OR "hazardous factors" [Title/Abstract] OR "risky factors" [Title/Abstract] OR "risks factors" [Title/Abstract] OR "Risk-factors" [Title/Abstract] OR "danger factors" [Title/Abstract] OR "danger factor" [Title/Abstract] OR "hazard factors" [Title/Abstract] OR "Factor" [Title/Abstract] OR "Factors" [Title/Abstract] OR " elements" [Title/Abstract] OR "element" [Title/Abstract]) |
#4 | #1 AND #2 AND #3 |
Table 1 Strategy for searching studies
步骤 | 检索词 |
---|---|
#1 | ( "Prostatectomy" [Title/Abstract] OR "Prostatectomies" [Title/Abstract] OR "suprapubic prostatectomies" [Title/Abstract] OR "suprapubic prostatectomy " [Title/Abstract] OR "retropubic prostatectomies" [Title/Abstract] OR "retropubic prostatectomy" [Title/Abstract] OR "radical prostatectomy" [Title/Abstract] OR(( "radical" [All Fields] OR "radical's" [All Fields] OR "radicals" [All Fields]) AND( "resect" [All Fields] OR "resectability" [All Fields] OR "resectable" [All Fields] OR "resectates" [All Fields] OR "resected" [All Fields] OR "resecting" [All Fields] OR "Resection" [All Fields] OR "resectional" [All Fields] OR "resectioned" [All Fields] OR "resectioning" [All Fields] OR "resections" [All Fields] OR "resective" [All Fields] OR "resects" [All Fields]) AND " prostate cancer" [Title/Abstract])) |
#2 | ( "positive margin" [Title/Abstract] OR "positive excision margins" [Title/Abstract] OR "margins of excision" [Title/Abstract] OR "excision margin" [Title/Abstract] OR "excision margins" [Title/Abstract] OR "resection margin" [Title/Abstract] OR "resection margins" [Title/Abstract] OR "surgical margins" [Title/Abstract] OR "surgical margin" [Title/Abstract] OR "positive surgical margins" [Title/Abstract] OR "positive surgical margin" [Title/Abstract] OR "negative surgical margins" [Title/Abstract] OR "negative surgical margin" [Title/Abstract] OR "tumor free margins" [Title/Abstract] OR "tumor free margins" [Title/Abstract] OR "tumor free margin" [Title/Abstract]) |
#3 | ( "Risk factors" [Title/Abstract] OR "social risk factors" [Title/Abstract] OR "social risk factor" [Title/Abstract] OR "health correlates" [Title/Abstract] OR "population at risk" [Title/Abstract] OR "populations at risk" [Title/Abstract] OR "risk scores" [Title/Abstract] OR "risk score" [Title/Abstract] OR "risk factor scores" [Title/Abstract] OR "risk factor score" [Title/Abstract] OR "dangerous factor" [Title/Abstract] OR "hazardous factors" [Title/Abstract] OR "risky factors" [Title/Abstract] OR "risks factors" [Title/Abstract] OR "Risk-factors" [Title/Abstract] OR "danger factors" [Title/Abstract] OR "danger factor" [Title/Abstract] OR "hazard factors" [Title/Abstract] OR "Factor" [Title/Abstract] OR "Factors" [Title/Abstract] OR " elements" [Title/Abstract] OR "element" [Title/Abstract]) |
#4 | #1 AND #2 AND #3 |
第一作者 | 发表年份(年) | 研究地区 | 样本量(例) | 手术方式 | 结局指标 | NOS评分(分) | |
---|---|---|---|---|---|---|---|
病例组 | 对照组 | ||||||
张靖博[ | 2021 | 河南 | 64 | 188 | LRP | ①②⑦⑧ | 8 |
张平新[ | 2020 | 新疆 | 26 | 73 | LRP | ⑧ | 6 |
阎乙夫[ | 2011 | 北京 | 76 | 112 | LRP | ⑦⑧ | 8 |
陈星[ | 2021 | 福建 | 36 | 86 | LRP | ①③④⑦⑧ | 7 |
张争[ | 2019 | 北京 | 57 | 120 | LRP | ⑧ | 7 |
吴丹[ | 2020 | 江苏 | 34 | 82 | LRP | ⑧ | 6 |
缪志俊[ | 2021 | 江苏 | 79 | 420 | LRP | ①③⑤ | 7 |
王硕[ | 2021 | 北京 | 97 | 83 | — | ⑦⑧ | 8 |
侯惠民[ | 2018 | 北京 | 94 | 226 | — | ② | 7 |
范效铮[ | 2021 | 陕西 | 158 | 360 | RARP | ①⑤ | 8 |
屈武功[ | 2021 | 河南 | 106 | 204 | RARP | ② | 7 |
张春雷[ | 2018 | 上海 | 47 | 143 | RARP | ①⑧ | 7 |
沈诞[ | 2012 | 上海 | 258 | 1 390 | RARP | ⑤ | 7 |
瞿旻[ | 2017 | 上海 | 151 | 249 | RARP | ①⑤ | 8 |
韩涛[ | 2013 | 江苏 | 98 | 162 | LRP | ④⑥ | 6 |
张铁龙[ | 2015 | 上海 | 61 | 184 | ORP | ①⑦ | 6 |
丁攀[ | 2019 | 江西 | 118 | 114 | — | ①②④⑥ | 7 |
洪锴[ | 2008 | 北京 | 9 | 24 | LRP | ⑤⑦ | 7 |
YANG[ | 2017 | 江苏 | 86 | 210 | LRP | ③④⑥ | 7 |
WANG[ | 2021 | 北京 | 106 | 94 | — | ④⑤ | 8 |
ZHOU[ | 2021 | 天津 | 267 | 230 | — | ①⑦ | 8 |
Table 2 Table of basic characteristics and risk of bias in included studies
第一作者 | 发表年份(年) | 研究地区 | 样本量(例) | 手术方式 | 结局指标 | NOS评分(分) | |
---|---|---|---|---|---|---|---|
病例组 | 对照组 | ||||||
张靖博[ | 2021 | 河南 | 64 | 188 | LRP | ①②⑦⑧ | 8 |
张平新[ | 2020 | 新疆 | 26 | 73 | LRP | ⑧ | 6 |
阎乙夫[ | 2011 | 北京 | 76 | 112 | LRP | ⑦⑧ | 8 |
陈星[ | 2021 | 福建 | 36 | 86 | LRP | ①③④⑦⑧ | 7 |
张争[ | 2019 | 北京 | 57 | 120 | LRP | ⑧ | 7 |
吴丹[ | 2020 | 江苏 | 34 | 82 | LRP | ⑧ | 6 |
缪志俊[ | 2021 | 江苏 | 79 | 420 | LRP | ①③⑤ | 7 |
王硕[ | 2021 | 北京 | 97 | 83 | — | ⑦⑧ | 8 |
侯惠民[ | 2018 | 北京 | 94 | 226 | — | ② | 7 |
范效铮[ | 2021 | 陕西 | 158 | 360 | RARP | ①⑤ | 8 |
屈武功[ | 2021 | 河南 | 106 | 204 | RARP | ② | 7 |
张春雷[ | 2018 | 上海 | 47 | 143 | RARP | ①⑧ | 7 |
沈诞[ | 2012 | 上海 | 258 | 1 390 | RARP | ⑤ | 7 |
瞿旻[ | 2017 | 上海 | 151 | 249 | RARP | ①⑤ | 8 |
韩涛[ | 2013 | 江苏 | 98 | 162 | LRP | ④⑥ | 6 |
张铁龙[ | 2015 | 上海 | 61 | 184 | ORP | ①⑦ | 6 |
丁攀[ | 2019 | 江西 | 118 | 114 | — | ①②④⑥ | 7 |
洪锴[ | 2008 | 北京 | 9 | 24 | LRP | ⑤⑦ | 7 |
YANG[ | 2017 | 江苏 | 86 | 210 | LRP | ③④⑥ | 7 |
WANG[ | 2021 | 北京 | 106 | 94 | — | ④⑤ | 8 |
ZHOU[ | 2021 | 天津 | 267 | 230 | — | ①⑦ | 8 |
危险因素 | 纳入研究数(篇) | 异质性分析结果 | 效应模型 | Meta分析结果 | ||
---|---|---|---|---|---|---|
I2值(%) | P值 | OR(95%CI) | P值 | |||
LRP | ||||||
术前PSA | 3[ | 87.7 | <0.001 | 随机效应模型 | 1.47(0.42,5.09) | 0.548 |
穿刺阳性针数 | 3[ | 84.3 | 0.002 | 随机效应模型 | 2.17(0.98,4.80) | 0.057 |
术前临床T分期 | 2[ | 43.9 | 0.182 | 固定效应模型 | 4.57(2.57,8.12) | <0.001 |
术后病理T分期 | 6[ | 79.2 | <0.001 | 随机效应模型 | 4.80(2.20,10.48) | <0.001 |
术后Gleason评分 | 3[ | 0 | 0.739 | 固定效应模型 | 2.46(1.57,3.86) | <0.001 |
RARP | ||||||
术前PSA | 3[ | 22.4 | 0.275 | 固定效应模型 | 2.17(1.60,2.94) | <0.001 |
术前临床T分期 | 3[ | 81.6 | 0.004 | 随机效应模型 | 1.19(0.52,2.74) | 0.678 |
Table 3 Subgroup analysis of different risk factors for PSMs after radical prostatectomy
危险因素 | 纳入研究数(篇) | 异质性分析结果 | 效应模型 | Meta分析结果 | ||
---|---|---|---|---|---|---|
I2值(%) | P值 | OR(95%CI) | P值 | |||
LRP | ||||||
术前PSA | 3[ | 87.7 | <0.001 | 随机效应模型 | 1.47(0.42,5.09) | 0.548 |
穿刺阳性针数 | 3[ | 84.3 | 0.002 | 随机效应模型 | 2.17(0.98,4.80) | 0.057 |
术前临床T分期 | 2[ | 43.9 | 0.182 | 固定效应模型 | 4.57(2.57,8.12) | <0.001 |
术后病理T分期 | 6[ | 79.2 | <0.001 | 随机效应模型 | 4.80(2.20,10.48) | <0.001 |
术后Gleason评分 | 3[ | 0 | 0.739 | 固定效应模型 | 2.46(1.57,3.86) | <0.001 |
RARP | ||||||
术前PSA | 3[ | 22.4 | 0.275 | 固定效应模型 | 2.17(1.60,2.94) | <0.001 |
术前临床T分期 | 3[ | 81.6 | 0.004 | 随机效应模型 | 1.19(0.52,2.74) | 0.678 |
危险因素 | 随机效应模型 | 固定效应模型 | ||
---|---|---|---|---|
OR(95%CI) | P值 | OR(95%CI) | P值 | |
术前PSA | 1.77(1.18,2.65) | 0.006 | 1.05(1.02,1.08) | <0.001 |
穿刺阳性针数百分比 | 1.83(1.35,2.47) | <0.001 | 1.83(1.35,2.47) | <0.001 |
穿刺阳性针数 | 2.17(0.98,4.80) | 0.057 | 1.24(1.14,1.34) | <0.001 |
穿刺Gleason评分 | 2.25(1.63,3.10) | <0.001 | 2.14(1.67,2.74) | <0.001 |
穿刺神经周围侵犯 | 5.83(2.05,16.59) | 0.001 | 6.09(4.04,9.17) | <0.001 |
术前临床T分期 | 2.17(1.06,4.42) | 0.033 | 2.08(1.58,2.74) | <0.001 |
术后病理T分期 | 4.30(2.43,7.63) | <0.001 | 2.98(2.28,3.88) | <0.001 |
术后Gleason评分 | 2.55(1.75,3.72) | <0.001 | 2.33(1.80,3.01) | <0.001 |
Table 4 Sensitivity analysis of risk factors for PSMs after radical prostatectomy in Chinese men
危险因素 | 随机效应模型 | 固定效应模型 | ||
---|---|---|---|---|
OR(95%CI) | P值 | OR(95%CI) | P值 | |
术前PSA | 1.77(1.18,2.65) | 0.006 | 1.05(1.02,1.08) | <0.001 |
穿刺阳性针数百分比 | 1.83(1.35,2.47) | <0.001 | 1.83(1.35,2.47) | <0.001 |
穿刺阳性针数 | 2.17(0.98,4.80) | 0.057 | 1.24(1.14,1.34) | <0.001 |
穿刺Gleason评分 | 2.25(1.63,3.10) | <0.001 | 2.14(1.67,2.74) | <0.001 |
穿刺神经周围侵犯 | 5.83(2.05,16.59) | 0.001 | 6.09(4.04,9.17) | <0.001 |
术前临床T分期 | 2.17(1.06,4.42) | 0.033 | 2.08(1.58,2.74) | <0.001 |
术后病理T分期 | 4.30(2.43,7.63) | <0.001 | 2.98(2.28,3.88) | <0.001 |
术后Gleason评分 | 2.55(1.75,3.72) | <0.001 | 2.33(1.80,3.01) | <0.001 |
危险因素 | 排除文献 | 排除前 | 排除后 | ||||
---|---|---|---|---|---|---|---|
模型 | OR(95%CI) | P值 | 模型 | OR(95%CI) | P值 | ||
术前PSA | [ | 随机效应模型 | 1.77(1.18,2.65) | 0.006 | 固定效应模型 | 2.31(1.88,2.83) | <0.001 |
穿刺阳性针数 | [ | 随机效应模型 | 2.17(0.98,4.80) | 0.057 | 固定效应模型 | 3.09(1.81,5.26) | <0.001 |
穿刺神经周围侵犯 | [ | 随机效应模型 | 5.83(2.05,16.59) | 0.001 | 固定效应模型 | 3.79(2.30,6.24) | <0.001 |
术前临床T分期 | [ | 随机效应模型 | 2.17(1.06,4.42) | 0.033 | 固定效应模型 | 1.95(1.41,2.71) | <0.001 |
术后病理T分期 | [ | 随机效应模型 | 4.30(2.43,7.63) | <0.001 | 固定效应模型 | 3.77(2.58,5.51) | <0.001 |
Table 5 Exclusion analysis of risk factors for PSMs after radical prostatectomy in Chinese men
危险因素 | 排除文献 | 排除前 | 排除后 | ||||
---|---|---|---|---|---|---|---|
模型 | OR(95%CI) | P值 | 模型 | OR(95%CI) | P值 | ||
术前PSA | [ | 随机效应模型 | 1.77(1.18,2.65) | 0.006 | 固定效应模型 | 2.31(1.88,2.83) | <0.001 |
穿刺阳性针数 | [ | 随机效应模型 | 2.17(0.98,4.80) | 0.057 | 固定效应模型 | 3.09(1.81,5.26) | <0.001 |
穿刺神经周围侵犯 | [ | 随机效应模型 | 5.83(2.05,16.59) | 0.001 | 固定效应模型 | 3.79(2.30,6.24) | <0.001 |
术前临床T分期 | [ | 随机效应模型 | 2.17(1.06,4.42) | 0.033 | 固定效应模型 | 1.95(1.41,2.71) | <0.001 |
术后病理T分期 | [ | 随机效应模型 | 4.30(2.43,7.63) | <0.001 | 固定效应模型 | 3.77(2.58,5.51) | <0.001 |
Figure 11 The funnel plot assessing potential publication bias for the meta-analysis of the impact of pre-radical prostatectomy clinical T stage on PSMs
Figure 12 The funnel plot assessing potential publication bias for the meta-analysis of the impact of post-radical prostatectomy pathological T stage on PSMs
Figure 13 The funnel plot assessing potential publication bias for the meta-analysis of the impact of post-radical prostatectomy Gleason score on PSMs
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