Moon Shinje, Yi Ka Hee, Park Young Joo
Department of Internal Medicine, Hallym University College of Medicine, Seoul 07440, Korea.
Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul 07061, Korea.
Cancers (Basel). 2022 May 12;14(10):2382. doi: 10.3390/cancers14102382.
This meta-analysis investigated whether thyroidectomy or radioactive iodine treatment (RAIT) in patients with differentiated thyroid cancer (DTC) was associated with an increase in adverse pregnancy outcomes, such as miscarriage, preterm delivery, and congenital malformations. A total of 22 articles (5 case-control and 17 case series studies) from 1262 studies identified through a literature search in the PubMed and EMBASE databases from inception up to 13 September 2021 were included. In patients with DTC who underwent thyroidectomy, the event rates for miscarriage, preterm labor, and congenital anomalies were 0.07 (95% confidence interval [CI], 0.05-0.11; 17 studies), 0.07 (95% CI, 0.05-0.09; 14 studies), and 0.03 (95% CI, 0.02-0.06; 17 studies), respectively. These results are similar to those previously reported in the general population. The risk of miscarriage or abortion was increased in patients with DTC when compared with controls without DTC (odds ratio [OR], 1.80; 95% CI, 1.28-2.53; I = 33%; 3 studies), while the OR values for preterm labor and the presence of congenital anomalies were 1.22 (95% CI, 0.90-1.66; I = 62%; five studies) and 0.73 (95% CI, 0.39-1.38; I = 0%; two studies) respectively, which showed no statistical significance. A subgroup analysis of patients with DTC according to RAIT revealed that the risk of miscarriage, preterm labor, or congenital anomalies was not increased in the RAIT group when compared with patients without RAIT. The results of this meta-analysis suggest that thyroid cancer treatment, including RAIT, is not associated with an increased risk of adverse pregnancy outcomes, including miscarriage, preterm labor, and congenital anomalies.
这项荟萃分析调查了分化型甲状腺癌（DTC）患者接受甲状腺切除术或放射性碘治疗（RAIT）是否会增加不良妊娠结局的风险，如流产、早产和先天性畸形。通过在PubMed和EMBASE数据库中从建库至2021年9月13日进行文献检索，共识别出1262项研究，其中22篇文章（5项病例对照研究和17项病例系列研究）被纳入。接受甲状腺切除术的DTC患者中，流产、早产和先天性异常的发生率分别为0.07（95%置信区间[CI]，0.05 - 0.11；17项研究）、0.07（95% CI，0.05 - 0.09；14项研究）和0.03（95% CI，0.02 - 0.06；17项研究）。这些结果与之前在普通人群中报告的结果相似。与未患DTC的对照组相比，DTC患者流产或堕胎的风险增加（优势比[OR]，1.80；95% CI，1.28 - 2.53；I² = 33%；3项研究），而早产和先天性异常的OR值分别为1.22（95% CI，0.90 - 1.66；I² = 62%；5项研究）和0.73（95% CI，0.39 - 1.38；I² = 0%；2项研究），均无统计学意义。根据RAIT对DTC患者进行的亚组分析显示，与未接受RAIT的患者相比，RAIT组流产、早产或先天性异常的风险并未增加。这项荟萃分析的结果表明，包括RAIT在内的甲状腺癌治疗与流产、早产和先天性异常等不良妊娠结局风险增加无关。
