Wang Xiaofei, Cheng Wenli, Li Jingdong, Su Anping, Wei Tao, Liu Feng, Zhu Jingqiang
Department of Thyroid and Breast SurgeryWest China Hospital, Sichuan University, Chendu 610041, ChinaDepartments of General SurgeryOtolaryngology-Head and Neck SurgeryAffiliated Hospital of North Sichuan Medical College, Nanchong 637000, China Department of Thyroid and Breast SurgeryWest China Hospital, Sichuan University, Chendu 610041, ChinaDepartments of General SurgeryOtolaryngology-Head and Neck SurgeryAffiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Department of Thyroid and Breast SurgeryWest China Hospital, Sichuan University, Chendu 610041, ChinaDepartments of General SurgeryOtolaryngology-Head and Neck SurgeryAffiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Eur J Endocrinol. 2015 Jun;172(6):R253-62. doi: 10.1530/EJE-14-0960. Epub 2015 Jan 30.
There is controversy as to whether familial nonmedullary thyroid carcinoma (FNMTC) is more aggressive than sporadic NMTC (SNMTC). The aim of the study was to evaluate the biological characteristics of patients with FNMTC by a meta-analysis.
Four databases (PubMed, EMBASE, the Cochrane library databases, and the Web of Science) were searched to identify studies published before September, 2014. All original studies that compared clinical characteristics and prognosis of patients with FNMTC and SNMTC were included. The pooled effect sizes of interesting parameters were calculated by odds ratio (OR), standard mean difference (SMD), or hazard ratio (HR).
Twelve studies with a total of 12 741 participants were included in this analysis. FNMTC patients had an increased rate of recurrence (OR=1.72, 95% CI: 1.34 to 2.20) and decreased disease-free survival (DFS) (HR=1.83, 95% CI: 1.34 to 2.52) in comparison with SNMTC patients. FNMTC possessed more aggressive biological behaviors, characterized by younger age at diagnosis (SMD=-0.91, 95% CI: -1.59 to -0.22), higher risk of multifocal (OR=1.50, 95% CI: 1.32 to 1.71), bilateral (OR=1.29, 95% CI: 1.00 to 1.66), extrathyroidal invasion (OR=1.20, 95% CI: 1.02 to 1.41), and lymph node metastasis (OR=1.18, 95% CI: 1.01 to 1.38).
FNMTC is a more aggressive disease and possesses higher recurrence rate and lower DFS. More attention and careful consideration should be paid regarding the decision about treatment for patients with FNMTC.
家族性非髓样甲状腺癌（FNMTC）是否比散发性非髓样甲状腺癌（SNMTC）更具侵袭性存在争议。本研究的目的是通过荟萃分析评估FNMTC患者的生物学特征。
检索四个数据库（PubMed、EMBASE、Cochrane图书馆数据库和Web of Science）以识别2014年9月之前发表的研究。纳入所有比较FNMTC和SNMTC患者临床特征及预后的原始研究。通过比值比（OR）、标准化均数差（SMD）或风险比（HR）计算感兴趣参数的合并效应量。
本分析纳入了12项研究，共12741名参与者。与SNMTC患者相比，FNMTC患者的复发率增加（OR = 1.72，95%可信区间：1.34至2.20），无病生存期（DFS）降低（HR = 1.83，95%可信区间：1.34至2.52）。FNMTC具有更具侵袭性的生物学行为，其特征为诊断时年龄较小（SMD = -0.91，95%可信区间：-1.59至-0.22）、多灶性风险较高（OR = 1.50，95%可信区间：1.32至1.71）、双侧性（OR = 1.29，95%可信区间：1.00至1.66）、甲状腺外侵犯（OR = 1.20，95%可信区间：1.02至1.41）和淋巴结转移（OR = 1.18，95%可信区间：1.01至1.38）。
FNMTC是一种更具侵袭性的疾病，具有更高的复发率和更低的DFS。对于FNMTC患者的治疗决策应给予更多关注和谨慎考虑。
