| Objective:The aim of this study was to evaluate the factors affecting postoperative biochemical remission rate,to provide a basis for individualized treatment of acromegaly of growth hormone adenoma,to improve the biochemical remission rate of patients,and to improve the long-term prognosis.Methods:PubMed,Embase,and Cochrane Library were systematically searched using an computer.Through searching the established keyword group,all the literatures related to surgical treatment of acromegaly and biochemical remission published before August 2018 were comprehensively searched.Strict criterias were developed to screen out the final included literatures.Data were extracted and analyzed by using the Review Manager 5.3 software.The correlation of the factors was evaluated by OR,MD and 95% CI after the combination of the studies.Sensitivity and publication bias were analyzed by forest maps and funnel maps.Results:Meta-analysis showed that biochemical remission rate was correlated with tumor size(OR=2.10,95%CI=1.27-3.47,P=0.004),invasiveness(OR=8.78,95%CI=6.31-12.21,P<0.05),preoperative GH(MD=19.97,95%CI=13.78-26.15,P<0.05)and,IGF-1(MD=135.08,95%CI= 77.31-192.86,P<0.05)levels,residual tumors(OR=46.98,95%CI=10.30-214.29,P<0.05)and age(MD=6.35,95%CI=1.71-10.99,P<0.05),but not with sex(OR=1.41,95%CI= 0.64-3.12,P>0.05).Conclusion:This study found that the biochemical remission rate was higher in patients with microadenoma,non-invasive adenoma,lower preoperative GH and IGF-1 levels,and complete resection of tumors.The average age of remission cases was higher than that of non-remission cases.No correlation between gender and biochemical remission rate was found. |
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