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甲状腺乳头状癌患者 TERT 启动子突变的危险因素:Meta 分析和系统评价。

Risk Factors for TERT Promoter Mutations with Papillary Thyroid Carcinoma Patients: A Meta-Analysis and Systematic Review.

机构信息

Chongqing Medical and Pharmaceutical College, Chongqing 401331, China.

College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China.

出版信息

Comput Math Methods Med. 2022 Apr 30;2022:1721526. doi: 10.1155/2022/1721526. eCollection 2022.

DOI:10.1155/2022/1721526
PMID:35535227
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9078812/
Abstract

Whether TERT promoter mutation is related to more aggressive clinicopathologic features and worse outcomes in papillary thyroid carcinoma patients (PTCs) is still variable and controversial. Our intention was to investigate the risk or prognostic factors that may additionally predict the TERT promoter mutation doable of these lesions and new prevention techniques in PTCs. A total of 2,539 PTC patients with 11.50% TERT mutation have been analyzed using Revman 5.3 software in this study. The PubMed and Embase databases were systematically searched for works published until November 9, 2021. The following variables had been associated with an extended chance of TERT promoter mutation in PTC patients: age < 45 years (MD = 10.93, 95%CI = 7.25-14.61); gender = male (pooled OR = 1.63, 95%CI = 1.17-2.28); tumor size > 1 cm (MD = 0.56, 95%CI = 0.34-0.77); lymph node metastasis (pooled OR = 1.29, 95%CI = 0.93-1.79); vascular invasion (pooled OR = 1.78, 95%CI = 0.83-3.84); extrathyroidal extension (pooled OR = 2.00, 95%CI = 1.32-3.02); distant metastasis (pooled OR = 1.46, 95%CI = 1.04-2.04); advanced TNM stage (pooled OR = 3.19, 95%CI = 2.28-4.45). In addition, multifocality (pooled OR = 0.67, 95%CI = 0.14-3.24) had no affiliation with TERT promoter mutation in PTC patients. Our finding showed that age < 45 years, male, tumor size > 1 cm, lymph node metastasis, vascular invasion, and superior/advanced TNM stage were dangerous elements for TERT promoter mutation of worse effect in PTCs while that multifocality was once negatively correlated. TERT promoter mutation is drastically associated with recurrence and PTC-related mortality.

摘要

TERT 启动子突变是否与甲状腺乳头状癌(PTC)患者更具侵袭性的临床病理特征和更差的预后相关仍存在差异和争议。我们的目的是研究可能另外预测这些病变的 TERT 启动子突变的风险或预后因素,以及 PTC 中的新预防技术。本研究使用 Revman 5.3 软件对 2539 名 TERT 突变率为 11.50%的 PTC 患者进行了分析。系统地检索了截至 2021 年 11 月 9 日发表的 PubMed 和 Embase 数据库中的研究。以下变量与 PTC 患者 TERT 启动子突变的机会增加有关:年龄<45 岁(MD=10.93,95%CI=7.25-14.61);男性(合并 OR=1.63,95%CI=1.17-2.28);肿瘤大小>1cm(MD=0.56,95%CI=0.34-0.77);淋巴结转移(合并 OR=1.29,95%CI=0.93-1.79);血管侵犯(合并 OR=1.78,95%CI=0.83-3.84);甲状腺外延伸(合并 OR=2.00,95%CI=1.32-3.02);远处转移(合并 OR=1.46,95%CI=1.04-2.04);晚期 TNM 分期(合并 OR=3.19,95%CI=2.28-4.45)。此外,多灶性(合并 OR=0.67,95%CI=0.14-3.24)与 PTC 患者的 TERT 启动子突变无关。我们的发现表明,年龄<45 岁、男性、肿瘤大小>1cm、淋巴结转移、血管侵犯和高级/晚期 TNM 分期是 PTC 中 TERT 启动子突变预后不良的危险因素,而多灶性与 TERT 启动子突变呈负相关。TERT 启动子突变与 PTC 的复发和相关死亡率密切相关。

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