Ahmed Mohamed Badie, Naem Emad, Saman Harman, Alsherawi Abeer, Syed Asma, Al-Abdulla Noora, Alkaabi Latifa, Zirie Mahmoud A, Doi Suhail A
Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
Department of Plastic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Cancer Rep (Hoboken). 2025 May;8(5):e70183. doi: 10.1002/cnr2.70183.
Differentiated thyroid cancer has become a prevalent malignant tumor, particularly papillary thyroid carcinoma (PTC), constituting over 90% of cases. Most PTC lesions are asymptomatic and remain subclinical throughout life, and active surveillance is now being used to monitor the progression of these lesions and intervene when appropriate. This evidence synthesis aims to assess PTC progression in size over time during active surveillance in terms of PTC tumor size progression to or beyond 3 mm during the surveillance period.
A dose-response meta-analysis was conducted using the robust error meta-regression method, using time as the "dose" and cumulative progression (%) was assessed. A comprehensive literature review was done using PubMed/MEDLINE and EMBASE from inception till August 2024.
A total of 21 studies from 7 different countries, including 14 648 participants, were included. Incident progression at 2 years of follow-up was 1%, and this increased linearly to 12% at 20 years of follow-up.
It was concluded that progression over the threshold increases linearly over time at approximately less than 1% per year. Therefore, size progression beyond the threshold occurs in a minority and in less than one eighth of subjects by two decades of follow-up.
分化型甲状腺癌已成为一种常见的恶性肿瘤，尤其是甲状腺乳头状癌（PTC），占病例的90%以上。大多数PTC病变无症状，终生处于亚临床状态，目前正在采用主动监测来监测这些病变的进展并在适当时候进行干预。本证据综合分析旨在根据PTC肿瘤大小在监测期内进展至3毫米或超过3毫米的情况，评估主动监测期间PTC大小随时间的进展。
采用稳健误差元回归方法进行剂量反应荟萃分析，以时间为“剂量”，评估累积进展率（%）。使用PubMed/MEDLINE和EMBASE对从创刊到2024年8月的文献进行了全面综述。
纳入了来自7个不同国家的21项研究，包括14648名参与者。随访2年时的新发进展率为1%，在随访20年时线性增加至12%。
得出的结论是，超过阈值的进展随时间呈线性增加，每年约低于1%。因此，经过二十年的随访，超过阈值的大小进展发生在少数人身上，且不到八分之一的受试者会出现这种情况。
