Vuong Huy Gia, Duong Uyen N P, Pham Thong Quang, Tran Hung Minh, Oishi Naoki, Mochizuki Kunio, Nakazawa Tadao, Hassell Lewis, Katoh Ryohei, Kondo Tetsuo
Department of Pathology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, 70000, Vietnam.
World J Surg. 2018 Apr;42(4):1005-1017. doi: 10.1007/s00268-017-4206-1.
Distant metastasis (DM) is not a frequent event in differentiated thyroid carcinoma (DTC) but has an adverse impact on mortality of patients with DTC. In the current study, we aimed to conduct a comprehensive systematic review and meta-analysis to investigate the risk factors for DM in DTCs and for each histological subtype.
Five electronic databases were searched from inception to December 2016 for relevant articles. Pooled odd ratios and 95% confidence interval were calculated using random-effect model.
Thirty-four articles with 73,219 patients were included for meta-analyses. In DTCs, male gender, age ≥45 years, tumor size ≥4 cm, multifocality, vascular invasion (VI), extrathyroidal extension (ETE), lymph node metastasis (LNM), and lateral LNM were demonstrated to be associated with significant risks for DM. In addition, several clinicopathological factors such as age ≥45 years, VI, ETE, and LNM were shown to be significant risk factors for DM in both PTC and FTC subgroups.
Our study demonstrated the promising value of several clinicopathological factors such as male gender, older age, VI, ETE, and LNM in predicting DM in PTCs and FTCs. Our study affirms the value of the selected clinicopathological factors for tumor risk stratification and assessment of patients' prognosis.
远处转移（DM）在分化型甲状腺癌（DTC）中并不常见，但对DTC患者的死亡率有不利影响。在本研究中，我们旨在进行一项全面的系统评价和荟萃分析，以探讨DTC及其各组织学亚型中DM的危险因素。
检索了5个电子数据库自创建至2016年12月的相关文章。采用随机效应模型计算合并比值比和95%置信区间。
纳入34篇文章，共73219例患者进行荟萃分析。在DTC中，男性、年龄≥45岁、肿瘤大小≥4 cm、多灶性、血管侵犯（VI）、甲状腺外侵犯（ETE）、淋巴结转移（LNM）和侧方LNM被证明与DM的显著风险相关。此外，年龄≥45岁、VI、ETE和LNM等几个临床病理因素在PTC和FTC亚组中均被证明是DM的显著危险因素。
我们的研究证明了男性、年龄较大、VI、ETE和LNM等几个临床病理因素在预测PTC和FTC中DM方面具有重要价值。我们的研究肯定了所选临床病理因素在肿瘤风险分层和评估患者预后方面的价值。
