Abstract：
Although papillary thyroid carcinoma (PTC) is considered to have an excellent prognosis, some recently identified more aggressive variants show reduced overall survival rates. Hobnail PTC (HPTC) was newly recognized as one of these aggressive forms, affecting recurrence, metastasis, and overall survival rates. Herein, we performed a systematic review and meta-analysis of studies including cases or case series with patients with HPTC. Furthermore, we included our individual case series consisting of six patients. The pooled mortality rate in the cohort, consisting of 290 patients, was 3.57 (95% CI 1.67−7.65) per 100 person/years. No sex differences could be observed concerning mortality (p = 0.62), but older age and tumor size significantly affected mortality (p = 0.004 and p = 0.02, respectively). The percentage of hobnail cells did not affect mortality (p = 0.97), neither did the presence of BRAF mutations. Classical characteristics such as the presence of extrathyroidal extension (p = 0.001), distant metastases (p < 0.001), and lymph node metastases (p < 0.001) all had a significant impact on mortality. Thus, HPTC appears to correlate with worse overall survival, and all PTC cases should be carefully assessed for this variant.
摘要：
尽管甲状腺乳头状癌（PTC）被认为具有良好的预后，一些最近发现的更具侵袭性的变异显示总体生存率降低.HobnailPTC（HPTC）被认为是这些侵略性形式之一，影响复发，转移,和总生存率。在这里，我们对HPTC患者的研究进行了系统回顾和荟萃分析,包括病例或病例系列.此外，我们纳入了由6例患者组成的个体病例系列.队列中的合并死亡率，由290名患者组成，为每100人/年3.57（95%CI1.67−7.65）。在死亡率方面没有观察到性别差异(p=0.62)，但年龄和肿瘤大小显著影响死亡率(分别为p=0.004和p=0.02).Hobnail细胞的百分比不影响死亡率（p=0.97），也没有BRAF突变的存在。经典特征，如甲状腺外延伸的存在（p=0.001），远处转移（p<0.001），和淋巴结转移(p<0.001)均对死亡率有显著影响.因此，HPTC似乎与较差的总生存率相关，所有PTC病例都应仔细评估此变体。
