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目的:评价保留乳房手术治疗早期青年乳腺癌的疗效。方法:计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库和清华同方数据库,并手工检索相关领域其他杂志。纳入比较保留乳房手术与乳房切除手术治疗早期青年乳腺癌的临床对照试验。按照Cochrane系统评价方法,评价纳入研究质量,对同质研究采用RevMan 5.0软件进行Meta分析。结果:按照入选标准,纳入8个研究共1 307例。Meta分析结果显示,与乳房切除术比,远期生存率相似〔比值比(OR)=1.19,95%CI为0.80～1.77,P>0.05〕,远处转移率差异无统计学意义(OR=1.47,95%CI为0.92～2.35,P>0.05),保留乳房术后局部复发率高,OR=1.96,95%CI为1.50～2.56,P<0.05。结论:早期青年乳腺癌患者保留乳房治疗是可行的,以上结论尚需大量高质量的临床对照研究证实。
Objective: To evaluate the efficacy of preserving breast surgery in the treatment of early-stage breast cancer. METHODS: Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, Chinese Journal Full-text Database and Tsinghua Tongfang Database were searched by computer, and other related journals were searched by hand. A controlled clinical trial comparing breast conserving versus mastectomy for early-stage breast cancer was included. According to the Cochrane systematic review method, the quality of included studies was evaluated and the meta-analysis was conducted using RevMan 5.0 software for homogeneous studies. Results: According to the inclusion criteria, a total of 1 307 cases were included in 8 studies. Meta-analysis showed that the long-term survival rate was similar to that of mastectomy (odds ratio = 1.19, 95% CI 0.80-1.77, P> 0.05). There was no significant difference in distant metastasis rate (OR = 1.47, 95% CI 0.92-2.35, P> 0.05). The rate of local recurrence after retained breast surgery was high, OR = 1.96, 95% CI 1.50-2.56, P <0.05. Conclusion: Breast preservation in early stage breast cancer patients is feasible. The above conclusions still need a large number of high quality clinical control studies confirmed.