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甲状腺叶切除术后低危分化型甲状腺癌促甲状腺激素抑制治疗的必要性:一项系统评价和荟萃分析。

The necessity of thyroid-stimulating hormone suppression therapy for low-risk differentiated thyroid carcinoma following hemithyroidectomy: A systematic review and meta-analysis.

作者信息

Wang Xinyu, Ye Yuqian, Amdulla Mizaniya, Ren Chenglong, Liu Yunhe, Ni Song

机构信息

Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

出版信息

Heliyon. 2024 Nov 22;10(23):e40574. doi: 10.1016/j.heliyon.2024.e40574. eCollection 2024 Dec 15.

Abstract

BACKGROUND AND OBJECTIVE

Thyroidectomy, followed by postoperative thyroid-stimulating hormone (TSH) suppression therapy, is the established therapeutic approach for low-risk differentiated thyroid carcinoma (DTC). Recently, there has been a growing body of research dedicated to postoperative TSH suppression therapy in low-risk DTC. This study aims to conduct a comprehensive literature review concerning the necessity of TSH suppression therapy in DTC after hemithyroidectomy.

METHODS

A systematic search of publicly available literature on postoperative TSH suppression therapy in DTC was conducted by querying databases such as PubMed, Embase, Cochrane, and Web of Science. Patients were stratified into two groups: the experimental group (patients who received TSH suppression therapy) and the control group (patients who did not receive TSH suppression therapy). Concurrently, the five selected studies were categorized into two groups based on the average follow-up period (5-8.6 years).

RESULTS

A total of five eligible studies, involving 2964 participants, were included in the analysis. The analysis of these five studies indicated low heterogeneity (I = 40 %). During the follow-up period, patients who received TSH suppression therapy had similar recurrence rate ( = 0.13) compared to those who did not. In both average follow-up period less than 6 years group ( = 0.85) and more than or equal to 6 years group ( = 0.07), postoperative TSH suppression therapy did not affect the recurrence of DTC after hemithyroidectomy.

CONCLUSION

This study demonstrates that postoperative TSH suppression therapy does not reduce the recurrence rate of low-risk DTC patients after hemithyroidectomy.

摘要

背景与目的

甲状腺切除术,随后进行术后促甲状腺激素(TSH)抑制治疗,是低风险分化型甲状腺癌(DTC)的既定治疗方法。最近,越来越多的研究致力于低风险DTC的术后TSH抑制治疗。本研究旨在对甲状腺半切术后DTC患者TSH抑制治疗的必要性进行全面的文献综述。

方法

通过查询PubMed、Embase、Cochrane和Web of Science等数据库,对公开可用的关于DTC术后TSH抑制治疗的文献进行系统检索。将患者分为两组:实验组(接受TSH抑制治疗的患者)和对照组(未接受TSH抑制治疗的患者)。同时,根据平均随访期(5 - 8.6年)将五项入选研究分为两组。

结果

共有五项符合条件的研究,涉及2964名参与者,纳入分析。对这五项研究的分析显示异质性较低(I² = 40%)。在随访期间,接受TSH抑制治疗的患者与未接受治疗的患者相比,复发率相似(RR = 0.13)。在平均随访期小于6年的组(RR = 0.85)和大于或等于6年的组(RR = 0.07)中,甲状腺半切术后TSH抑制治疗均不影响DTC的复发。

结论

本研究表明,甲状腺半切术后TSH抑制治疗并不能降低低风险DTC患者的复发率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a17c/11626026/0da71ef99061/gr1.jpg

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