Rashid Faiza Abdul, Munkhdelger Jijgee, Fukuoka Junya, Bychkov Andrey
Department of Biological Sciences, Faculty of Basic and Applied Sciences, International Islamic University, Islamabad, Pakistan.
Department of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan.
Gland Surg. 2020 Oct;9(5):1878-1900. doi: 10.21037/gs-20-430.
Papillary thyroid carcinoma (PTC), the most common malignancy of the endocrine system, is frequently driven by mutation, which was reported in 35-60% cases in Western series. Numerous studies have recently emerged from Asian countries and regions; however sufficient summary is lacking to date. mutation serves as a diagnostic and prognostic tool in thyroid cancer, therefore establishing a rate of on the national scale could be of practical significance. We performed systematic reviews of available literature to investigate the prevalence of mutation in series of PTC from various Asian countries and regions. Out of the total 3,966 reports identified via initial screening, 138 studies encompassing over 40,000 PTCs were included for the final analysis. A vast majority (90.2%) of PTCs with known status were from East Asia, including China, South Korea, and Japan, with mutation rates of 71.2%, 75.5%, and 70.6%, respectively. Less abundant Indian and Saudi Arabian series found 45.6% and 46.3% prevalence of in PTC, respectively. Much limited evidence was available from Thailand, Iran, Kazakhstan, Taiwan, Singapore, Indonesia, Hong Kong, Philippines, Vietnam, Iraq, and Myanmar. No relevant publications were found from other highly populated countries, such as Pakistan, Bangladesh, and Malaysia. After grouping by geographic region, we found that the highest rate of was reported in the PTC series from East Asia (76.4%). Much lower rate (45-48%) was seen in PTC cohorts from South Asia, Central Asia, and the Middle East while the Southeast Asian series were in between (57%). Further subgroup analysis revealed that studies employing fresh frozen tissue and fine-needle aspirates showed higher rates of compared to those used formalin-fixed paraffin-embedded tissues. We found that the PTC series enrolled patients' cohorts after 2010 demonstrated a higher rate of compared to the earlier series. Finally, pediatric PTCs had lower prevalence compared to the baseline rate for the country. In conclusion, despite considerable among and within countries heterogeneity, the Asian PTC series showed a higher prevalence of mutation than that in Western series. Causes of geographic heterogeneity, whether genuine (etiology, genetics) or methodology-related should be further investigated.
甲状腺乳头状癌（PTC）是内分泌系统最常见的恶性肿瘤，常由 突变驱动，在西方系列研究中，35%-60%的病例有该突变报道。最近亚洲国家和地区涌现出大量研究；然而，迄今为止仍缺乏充分的总结。 突变在甲状腺癌中可作为诊断和预后工具，因此在全国范围内确定其发生率可能具有实际意义。我们对现有文献进行系统综述，以调查亚洲不同国家和地区PTC系列中 突变的患病率。通过初步筛选共识别出3966份报告，最终纳入138项研究，涵盖超过40000例PTC进行分析。绝大多数（90.2%）已知 状态的PTC来自东亚，包括中国、韩国和日本，其 突变率分别为71.2%、75.5%和70.6%。印度和沙特阿拉伯的研究系列样本量较少，PTC中 突变的患病率分别为45.6%和46.3%。泰国、伊朗、哈萨克斯坦、台湾、新加坡、印度尼西亚、香港、菲律宾、越南、伊拉克和缅甸的相关证据非常有限。在其他人口众多的国家，如巴基斯坦、孟加拉国和马来西亚，未发现相关出版物。按地理区域分组后，我们发现东亚PTC系列中报道的 突变率最高（76.4%）。南亚、中亚和中东的PTC队列中该突变率低得多（45%-48%），而东南亚系列则介于两者之间（57%）。进一步的亚组分析显示，与使用福尔马林固定石蜡包埋组织的研究相比，采用新鲜冷冻组织和细针穿刺抽吸物的研究显示 突变率更高。我们发现，与早期系列相比，2010年后纳入患者队列的PTC系列显示出更高的 突变率。最后，儿童PTC的 突变患病率低于该国的基线率。总之，尽管国家之间和国家内部存在相当大的异质性，但亚洲PTC系列显示出比西方系列更高的 突变患病率。地理异质性的原因，无论是真实的（病因、遗传学）还是与方法学相关的，都应进一步研究。
