国人脊柱原发肿瘤流行病学特征的Meta分析

Epidemiological characteristics of primary spinal tumors in China: a Meta-analysis

中文关键词:  原发肿瘤  脊柱  流行病学  Meta分析

英文关键词:Primary tumor  Spine  Epidemiology  Meta-analysis

中文摘要:

  【摘要】 目的：系统评价中国人脊柱原发肿瘤的流行病学特征。方法：计算机检索Pubmed、Medline、Ovid、ScienceDirect、Embase、Web of Science、万方、中国知网（China national knowledge infrastructure，CNKI）、维普（vip citation databases，VIP）、中国生物医学文献（China biology medicine disc，CBM）数据库，检索时间为1980年1月~2017年6月，收集有关中国地区脊柱原发肿瘤流行病学特征及临床病例分析的研究，对文献所报道的各肿瘤占比、男女比例、年龄分布、解剖学部位分布等数据进行提取，按照澳大利亚循证护理中心推荐的标准（JBI-criteria）对文献质量进行评价，采用RevMan 5.3软件对数据进行Meta分析。结果：纳入符合标准的中英文文献23篇，文献质量评分均在7分以上。对文献中报道的3462例脊柱原发肿瘤进行Meta合并分析，结果显示：（1）在脊柱原发肿瘤中，良性肿瘤所占比例为61%（95%CI：56%~66%），恶性肿瘤所占比例为39%（95%CI：34%~44%）。（2）良、恶性肿瘤分类中，男性所占比例均高于女性，但骨巨细胞瘤中女性所占比例为52%（95%CI：47%~58%），男性为48%（95%CI：42%~53%）。（3）良性肿瘤21~40岁患者占40%（95%CI：35%~45%），恶性肿瘤41~60岁患者占44%（95%CI：40%~48%），超过70%的脊柱原发肿瘤患者年龄在21~60岁。（4）颈、胸、腰、骶椎肿瘤分别占25%、26%、22%、27%，良性肿瘤好发于颈椎，恶性肿瘤以骶椎多见。敏感性分析结果显示，Meta分析结果可靠，除解剖学分布外漏斗图基本对称，不存在较大发表偏倚。结论：中国人脊柱原发肿瘤中，良性肿瘤比例高于恶性，男性比例高于女性；良性肿瘤好发于21~40岁，恶性肿瘤好发于41~60岁；脊柱原发肿瘤在颈、胸、腰、骶节段的分布大致相当，良性肿瘤颈椎居多，恶性肿瘤骶椎居多。

英文摘要:

  【Abstract】 Objectives: To systematically evaluate the epidemiological and demographic characteristics of primary spinal tumors in China. Methods: Pubmed, Medline, Ovid, ScienceDirect, Embase, Web of Science, CNKI, VIP, CBM and Wan Fang databases were searched to retrieve studies published from January 1980 to June 2017, reporting the epidemiological characteristics of primary spinal tumors in China. Data were extracted from the literatures, including the proportion of tumors, the ratio of male to female, age distribution and anatomical location distribution. The quality of literature was evaluated according to JBI-criteria. A Meta-analysis was performed by using RevMan 5.3 software. Results: 23 articles consistent with the criteria were included in the study. The quality score of the articles were all above 7 points. Meta-analysis of 3462 patients with primary spinal tumors revealed: (1)in primary spinal tumors, benign tumors accounted for 61%(95%CI: 56%-66%), while malignant tumors for 39%(95%CI: 34%-44%); (2)in benign or malignant tumors, the proportion of males was higher than that of females, but for giant cell tumor, females accounting for about 52%(95%CI: 47%-58%) while males for 48%(95%CI: 42%-53%); (3)patients between 21 and 40 years old accounted for 40% of all benign tumors(95%CI: 35%-45%), patients between 41 and 60 years old accounted for 44% of all malignant tumors(95%CI: 40%-48%), more than 70% of patients with primary spinal tumors were between 21 to 60 years old; (4)the tumors in the cervical, thoracic, lumbar and sacral regions accounted for 25%, 26%, 22% and 27% respectively, benign tumors were common in cervical vertebra while malignant tumors in sacrum. The results of sensitivity analysis showed that the outcomes of meta-analysis were credible. The funnel plot was basically symmetrical except for the distribution of anatomical parts, and there was no significant publication bias. Conclusions: In Chinese, the proportion of benign tumors is higher than that of malignant, and the proportion of male is higher than that of female. Benign tumors often occur at the age of 21-40 and malignant tumors occur at the age of 41-60. The distribution of the primary spinal tumors in the cervical, thoracic, lumbar and sacral vertebra is roughly equal. Benign tumors often occur in cervical vertebra while malignant tumors in sacrum.