Zhou Y Q, Zhou Z, Qian M F, Gong T, Wang J D
Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P.R. China.
Mol Clin Oncol. 2015 Mar;3(2):341-346. doi: 10.3892/mco.2014.472. Epub 2014 Dec 2.
A number of scholars reported that reproductive factors play a significant role in thyroid cancer and the correlation between the two may affect the diagnosis and treatment of thyroid carcinoma during pregnancy. To determine whether pregnancy reproductive factors affect thyroid carcinoma, we conducted a meta-analysis of studies that investigated the association between pregnancy factors and thyroid carcinoma. PubMed, OVID and the Cochrane Library were searched from their inception to April 1st, 2013. The searched publications mainly investigated reproductive factors and the morbidity or prognosis of female thyroid carcinoma. The studies were filtered by predetermined standards and the quality of the included studies was evaluated by the Newcastle-Ottawa scale inventory. Two researchers independently extracted information on first author, year of publication, study design (case-control or prospective cohort), compared populations, inclusion and exclusion criteria and total sample size. Other researchers assessed the studies for publication bias and performed statistical analyses. Discrepancies were resolved by consensus. A total of 21 studies were selected for the meta-analysis, including 406,329 cases in total. Compared to the control group, the risk of thyroid carcinoma in women with a history of pregnancy was not significantly discrepant, [odds ratio (OR)=1.00, 95% confidence interval (CI): 0.91-1.11]. However, the risk of thyroid carcinoma in women with a history of ≥ 3 pregnancies was significantly increased (OR=1.39, 95% CI: 1.21-1.59). Furthermore, an interval of ≤ 5 years since the last pregnancy was closely associated with thyroid carcinoma (OR=1.53, 95% CI: 1.29-1.81). The patients developed thyroid carcinoma during pregnancy did not exhibit an increased risk of lymphatic metastasis (OR=0.94, 95% CI: 0.53-1.67); the risk of distant metastasis also did not increase significantly (OR=1.03, 95% CI: 0.86-1.24). Therefore, multiple pregnancies and a ≤ 5-year interval between pregnancies were identified as high-risk factors for thyroid carcinoma, whereas thyroid carcinoma during pregnancy was not associated with a significant risk of lymphatic and distant metastasis.
一些学者报告称，生殖因素在甲状腺癌中起着重要作用，二者之间的关联可能会影响孕期甲状腺癌的诊断和治疗。为了确定妊娠生殖因素是否会影响甲状腺癌，我们对研究妊娠因素与甲状腺癌之间关联的研究进行了荟萃分析。检索了PubMed、OVID和Cochrane图书馆自建库至2013年4月1日的文献。检索到的出版物主要研究了生殖因素与女性甲状腺癌的发病率或预后。研究按照预定标准进行筛选，纳入研究的质量通过纽卡斯尔-渥太华量表进行评估。两名研究人员独立提取了第一作者、发表年份、研究设计（病例对照或前瞻性队列）、比较人群、纳入和排除标准以及总样本量等信息。其他研究人员评估了研究的发表偏倚并进行了统计分析。分歧通过协商解决。总共选择了21项研究进行荟萃分析，共计406329例病例。与对照组相比，有妊娠史的女性患甲状腺癌的风险无显著差异，[比值比（OR）=1.00，95%置信区间（CI）：0.91-1.11]。然而，有≥3次妊娠史的女性患甲状腺癌的风险显著增加（OR=1.39，95%CI：1.21-1.59）。此外，末次妊娠后间隔≤5年与甲状腺癌密切相关（OR=1.53，95%CI：1.29-1.81）。孕期患甲状腺癌的患者发生淋巴结转移的风险未增加（OR=0.94，95%CI：0.53-1.67）；远处转移的风险也未显著增加（OR=1.03，95%CI：0.86-1.24）。因此，多次妊娠以及妊娠间隔≤5年被确定为甲状腺癌的高危因素，而孕期甲状腺癌与淋巴结和远处转移的显著风险无关。
