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首页> 外文期刊>Sao Paulo Medical Journal >Relevance of micrometastases detected by reverse transcriptase-polymerase chain reaction for melanoma recurrence: systematic review and meta-analysis
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Relevance of micrometastases detected by reverse transcriptase-polymerase chain reaction for melanoma recurrence: systematic review and meta-analysis

机译：逆转录酶-聚合酶链反应检测微转移与黑色素瘤复发的相关性：系统评价和荟萃分析

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CONTEXT: Cutaneous melanoma presents significant morbidity and mortality. Nowadays, about 90% of them are diagnosed by clinical examination and most are localized melanomas. Sentinel node biopsy has brought about a new and interesting approach towards localized cutaneous melanoma. The meaning of micrometastases in sentinel nodes diagnosed by the reverse transcriptase-polymerase chain reaction is not well established. OBJECTIVE: To define the real value of micrometastases diagnosed by the reverse transcriptase-polymerase chain reaction in relation to melanoma recurrence. METHODS: Systematic literature review and meta-analysis. The Cochrane Library, Medline, Embase and Lilacs were the databases searched. We used the following key words: sentinel node and melanoma; sentinel node and reverse transcriptase-polymerase chain reaction; melanoma and reverse transcriptase-polymerase chain reaction. Cohort studies enrolling localized cutaneous melanoma patients who underwent sentinel node biopsy were selected. Sentinel node evaluations included hematoxylin and eosin, immunohistochemistry and reverse transcriptase-polymerase chain reaction. RESULTS: Out of the 1,542 studies evaluated, four were eligible. The four studies, when combined, were statistically homogeneous. The sample totaled 450 patients grouped as follows: 163 with a sentinel node negative to hematoxylin eosin and immunohistochemistry and positive to the reverse transcriptase-polymerase chain reaction; 192 with a sentinel node negative to hematoxylin eosin, immunohistochemistry and the reverse transcriptase-polymerase chain reaction and 95 patients with a sentinel node positive to hematoxylin eosin and/or immunohistochemistry. We analyzed the first two groups. The meta-analysis for the random model showed an increased effect from a positive reverse transcriptase-polymerase chain reaction on the recurrence rate. A similar result occurred in the meta-analysis for the fixed effect model. CONCLUSION: Patients with a positive reverse transcriptase-polymerase chain reaction had a greater recurrence rate than those with a negative reverse transcriptase-polymerase chain reaction. This suggests an important role for the reverse transcriptase-polymerase chain reaction in sentinel node examinations. In view of the small sample, a clinical trial could better evaluate this question.
机译：背景：皮肤黑色素瘤具有很高的发病率和死亡率。如今，其中约90％是通过临床检查诊断出来的，大多数是局部黑色素瘤。前哨淋巴结活检带来了一种针对局部皮肤黑色素瘤的有趣新方法。通过反转录酶-聚合酶链反应诊断的前哨淋巴结微转移的意义尚不明确。目的：确定逆转录酶-聚合酶链反应诊断与黑色素瘤复发相关的微转移的真实价值。方法：系统的文献综述和荟萃分析。搜索的数据库是Cochrane图书馆，Medline，Embase和Lilacs。我们使用以下关键词：前哨淋巴结和黑色素瘤;前哨淋巴结和逆转录聚合酶链反应;黑色素瘤与逆转录聚合酶链反应。选择参加了前哨淋巴结活检的局部皮肤黑色素瘤患者的队列研究。前哨淋巴结评估包括苏木精和曙红，免疫组化和逆转录酶-聚合酶链反应。结果：在评估的1,542项研究中，有四项符合条件。将这四项研究合并后，在统计上是一致的。该样本共450例患者，分为以下类别：163例前哨淋巴结对苏木精曙红和免疫组化阴性，对逆转录酶-聚合酶链反应呈阳性。 192例前哨淋巴结对苏木精曙红，免疫组化和逆转录酶-聚合酶链反应阴性，95例前哨淋巴结对苏木精曙红和/或免疫组织化学呈阳性。我们分析了前两组。对随机模型的荟萃分析显示，阳性逆转录聚合酶链反应对复发率的影响增加。在固定效应模型的荟萃分析中也发生了类似的结果。结论：逆转录酶-聚合酶链反应阳性的患者复发率高于逆转录酶-聚合酶链反应阴性的患者复发率。这表明在前哨淋巴结检查中逆转录酶-聚合酶链反应的重要作用。鉴于样本量少，一项临床试验可以更好地评估该问题。

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