Comparison of the efficacy and feasibility of laser enucleation of bladder tumor versus transurethral resection of bladder tumor: a meta-analysis

原文： 2017 年发布于 J Med Imaging Radiat Sci  浏览量：198次

作者： Yang H. Wang N. Han S. Male M. Zhao C. Yao D. Chen Z.

作者单位： Department of Radiology, University of Ottawa, Ottawa, ON, Canada. Department of Oncology, Queen's University, Kingston, ON, Canada. Department of Urology, University of Ottawa, Ottawa, ON, Canada. Ottawa Hospital Research Institute Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada. Department of Pathology, University of Ottawa, Ottawa, ON, Canada. Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

归属分类：膀胱肿瘤诊断证据

DOI： 10.1016/j.euo.2018.07.006

PURPOSE: This meta-analysis evaluated the prognostic significance of Ki-67 in non-muscle invasive bladder cancer (NMIBC). MATERIALS AND METHODS: We selected 39 articles including 5,229 patients from Embase, Scopus, and PubMed searches. The primary outcomes, recurrence-free survival (RFS), progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) were determined using time-to event hazard ratios (HRs) with 95% confidence intervals (CIs). Study heterogeneity was tested by chi-square and I(2) statistics. Heterogeneity sources were identified by subgroup meta-regression analysis. RESULTS: Two studies were prospective; 37 were retrospective. Immunohistochemistry was performed in tissue microarrays or serial sections. A wide range of antibody dilutions and Ki-67 positivity thresholds were used. Study heterogeneity was attributed to analysis results in studies of RFS (p < 0.0001). Meta-regression analysis revealed that region and analysis results accounted for heterogeneity in PFS studies (p = 0.00471, p < 0.0001). High Ki-67 expression was associated with poor RFS (pooled HR, 1.78; 95% CI, 1.48-2.15), poor PFS (pooled HR, 1.28; 95% CI, 1.13-2.15), poor DSS (pooled HR, 2.24; 95% CI, 1.47-2.15), and worse OS (pooled HR, 2.29; 95% CI, 1.24-4.22). CONCLUSIONS: The meta-analysis found that current evidence supports the prognostic value of Ki-67 in NMIBC patients.