Sabrina Messina, Domenico De Falco, Massimo Petruzzi
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引用次数: 0
摘要
目的:本研究探讨了副肿瘤综合征中口腔体征和症状的发生率:本研究探讨了副肿瘤综合征中口腔体征和症状的流行情况:在MEDLINE/PubMed、Ovid和Scopus数据库中对口腔副肿瘤综合征进行了系统检索,检索时间从开始到2024年4月1日。使用MURAD或预后研究质量工具评估了偏倚风险,并进行了随机效应荟萃分析。采用 GRADE 方法对证据质量进行评分:研究样本包括来自 487 项研究的 811 名参与者。口腔表现主要影响副肿瘤性丘疹性咽峡炎、粘膜丘疹性咽峡炎和黑棘皮病患者。腭是最常受影响的部位(18.2%;95% 置信区间[CI] 14.7-21.9),而糜烂是与潜在恶性肿瘤相关的最常见病变类型(83.3%;95% CI 72.2-92.0)。副肿瘤综合征患者的死亡发生率为 50.9%(95% CI 39.9-61.7),而肿瘤治疗后病情缓解的发生率为 63.4%(95% CI 49.9-76.0)。GRADE评估显示,所有研究结果的确定性都很低或很低:需要进一步研究以了解这些口腔表现背后的机制,这对更早诊断副肿瘤综合征和优化患者管理至关重要:试验注册:PROSPERO 编号:CRD42022328921。
Oral Manifestations in Paraneoplastic Syndromes: A Systematic Review and Meta-Analysis.
Objective: This study examined the prevalence of oral signs and symptoms in paraneoplastic syndromes.
Materials and methods: A systematic search on oral paraneoplastic syndromes was conducted in MEDLINE/PubMed, Ovid, and Scopus databases from inception to April 1, 2024. Risk of bias was evaluated using the MURAD or Quality in Prognosis Studies tools, and a random-effects meta-analysis was performed. Evidence quality was rated using the GRADE approach.
Results: The study sample comprised 811 participants from 487 studies. Oral manifestations predominantly affected patients with paraneoplastic pemphigus, mucous membrane pemphigoid, and acanthosis nigricans. Palate is the most frequently affected site (18.2%; 95% confidence interval [CI] 14.7-21.9), while erosion was the most common lesion type (83.3%; 95% CI 72.2-92.0) associated with the underlying malignancy. The prevalence of death in people with paraneoplastic syndromes was 50.9% (95% CI 39.9-61.7), while the prevalence of remission after neoplasm treatment was 63.4% (95% CI 49.9-76.0). GRADE assessment revealed uniformly low to very low certainty for all outcomes studied.
Conclusions: Further research is needed to understand the mechanisms behind these oral manifestations, which is crucial for earlier paraneoplastic syndrome diagnosis and optimal patient management.
期刊介绍:
Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.