Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Department of Orthopaedic Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Endocrinol Metab (Seoul). 2020 Jun;35(2):435-442. doi: 10.3803/EnM.2020.35.2.435. Epub 2020 Jun 24.
The aim of this study was to develop a scoring system to stratify the risk of papillary thyroid cancer (PTC) and to select the proper management.
We performed a systematic search of MEDLINE and Embase. Data regarding patients' prognoses were obtained from the included studies. Odds ratios (ORs) with statistical significance were extracted from the publications. To generate a risk scoring system (RSS), ORs were summed (RSS1), and summed after natural-logarithmic transformation (RSS2). RSS1 and RSS2 were compared to the eighth edition of the American Joint Committee on Cancer (AJCC) staging system and the 2015 American Thyroid Association (ATA) guidelines for thyroid nodules and differentiated thyroid carcinoma.
Five meta-analyses were eligible for inclusion in the study. Eight variables (sex, tumour size, extrathyroidal extension, BRAF mutation, TERT mutation, histologic subtype, lymph node metastasis, and distant metastasis) were included. RSS1 was the best of the analysed models.
We developed and validated a new RSS derived from previous meta-analyses for patients with PTC. This RSS seems to be superior to previously published systems.
本研究旨在建立一个评分系统来分层甲状腺乳头状癌（PTC）的风险，并选择合适的治疗方案。
我们对 MEDLINE 和 Embase 进行了系统检索。从纳入的研究中获取有关患者预后的数据。从出版物中提取具有统计学意义的比值比（OR）。为了生成风险评分系统（RSS），将 OR 相加（RSS1），并进行自然对数转换后相加（RSS2）。将 RSS1 和 RSS2 与第八版美国癌症联合委员会（AJCC）分期系统和 2015 年美国甲状腺协会（ATA）甲状腺结节和分化型甲状腺癌指南进行比较。
有五项荟萃分析符合纳入研究标准。纳入了 8 个变量（性别、肿瘤大小、甲状腺外侵犯、BRAF 突变、TERT 突变、组织学亚型、淋巴结转移和远处转移）。RSS1 是分析模型中最好的。
我们基于先前的荟萃分析为 PTC 患者开发并验证了一个新的 RSS。该 RSS 似乎优于先前发表的系统。
