副肿瘤综合征中的口腔表现：系统评价与Meta分析
Oral Manifestations in Paraneoplastic Syndromes: A Systematic Review and Meta-Analysis
DOI 原文链接
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影响因子:2.9
分区:医学3区 / 牙科与口腔外科4区
发表日期:2025 Jan
作者:
Sabrina Messina, Domenico De Falco, Massimo Petruzzi
DOI:
10.1111/odi.15158
摘要
本研究旨在探讨副肿瘤综合征患者的口腔体征和症状的患病率。通过在MEDLINE/PubMed、Ovid和Scopus数据库进行系统检索，涵盖至2024年4月1日的相关文献，评估偏倚风险采用MURAD或预后研究质量工具，并进行随机效应Meta分析。证据质量采用GRADE方法评级。研究样本包括来自487篇研究的811名参与者。口腔表现主要影响副肿瘤天疱疮、粘膜性天疱疮和角化扁平苔藓患者。腭部是最常受累部位（18.2%；95%置信区间[CI] 14.7-21.9），而侵蚀为最常见的病变类型（83.3%；95% CI 72.2-92.0），与基础恶性肿瘤相关。副肿瘤综合征患者的死亡患病率为50.9%（95% CI 39.9-61.7），肿瘤治疗后的缓解率为63.4%（95% CI 49.9-76.0）。GRADE评估显示所有研究结果的证据均为低至非常低的确定性。未来研究需探明这些口腔表现背后的机制，以实现更早的副肿瘤综合征诊断和更优的患者管理。PROSPERO注册号：CRD42022328921。
Abstract
This study examined the prevalence of oral signs and symptoms in paraneoplastic syndromes.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.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.Further research is needed to understand the mechanisms behind these oral manifestations, which is crucial for earlier paraneoplastic syndrome diagnosis and optimal patient management.PROSPERO number: CRD42022328921.