Center of Breast and Thyroid Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
Front Endocrinol (Lausanne). 2024 Oct 18;15:1353923. doi: 10.3389/fendo.2024.1353923. eCollection 2024.
It remains unclear which category of patients with clinically lymph node negative (cN0) papillary thyroid carcinoma (PTC) might have higher risk of occult lateral lymph node metastasis (OLLNM) due to the conflicting results in previous studies. This systematic review and meta-analysis aimed to investigate factors associated with OLLNM in patients with cN0 PTC.
PubMed, EMBASE, Cochrane Library and Web of Science were comprehensively searched by two independent investigators to 15 August 2022. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for the pooled analysis. This systematic review and meta-analysis was registered in PROSPERO (CRD42022353567).
Fifteen eligible studies involving 8369 patients with cN0 PTC were included in this meta-analysis. We found 7 factors significantly associated with OLLNM, including male (OR, 1.47; 95% CI, 1.30 to 1.66; P < 0.001), age<45y (OR, 1.65; 95% CI, 1.31 to 2.06; P < 0.001), tumor size > 10mm (OR, 3.17; 95% CI, 2.04 to 4.93; P <0.001), tumor located in upper pole (OR, 1.81; 95% CI, 1.44 to 2.27; P <0.001), bilaterality (OR, 1.66; 95% CI, 1.37 to 2.02; P <0.001), extrathyroidal extension (ETE) (OR, 2.52; 95% CI, 1.72 to 3.68; P <0.001) and increased number of central lymph node metastasis (CLNM) (OR, 6.84; 95% CI, 5.66 to 8.27; P <0.001). The results of sensitivity analysis and subgroup analysis were similar to the pooled results. No significant publication bias was observed.
The systematic review and meta-analysis identified 7 factors associated with OLLNM in patients with cN0 PTC. Future studies are needed to validate our results.
https://www.crd.york.ac.uk/prospero, identifier CRD42022353567.
由于先前研究结果存在冲突，临床上淋巴结阴性（cN0）甲状腺乳头状癌（PTC）患者中哪些患者存在更高的隐匿性侧方淋巴结转移（OLLNM）风险仍不清楚。本系统评价和荟萃分析旨在研究与 cN0 PTC 患者 OLLNM 相关的因素。
两位独立研究者全面检索了PubMed、EMBASE、Cochrane 图书馆和 Web of Science，检索截至 2022 年 8 月 15 日。采用合并分析计算比值比（OR）和 95%置信区间（CI）。本系统评价和荟萃分析在 PROSPERO（CRD42022353567）中进行注册。
纳入了 15 项涉及 8369 例 cN0 PTC 患者的研究，对其进行了荟萃分析。我们发现 7 个因素与 OLLNM 显著相关，包括男性（OR，1.47；95%CI，1.30 至 1.66；P<0.001）、年龄<45 岁（OR，1.65；95%CI，1.31 至 2.06；P<0.001）、肿瘤大小>10mm（OR，3.17；95%CI，2.04 至 4.93；P<0.001）、肿瘤位于上极（OR，1.81；95%CI，1.44 至 2.27；P<0.001）、双侧性（OR，1.66；95%CI，1.37 至 2.02；P<0.001）、甲状腺外侵犯（ETE）（OR，2.52；95%CI，1.72 至 3.68；P<0.001）和中央淋巴结转移（CLNM）数目增加（OR，6.84；95%CI，5.66 至 8.27；P<0.001）。敏感性分析和亚组分析的结果与合并结果相似。未观察到明显的发表偏倚。
本系统评价和荟萃分析确定了与 cN0 PTC 患者 OLLNM 相关的 7 个因素。需要进一步的研究来验证我们的结果。
https://www.crd.york.ac.uk/prospero，标识符 CRD42022353567。
