Abstract：
OBJECTIVE: This study aimed to perform a systematic review and meta-analysis on the efficacy of empirical high-dose radioiodine therapy in treating differentiated thyroid cancer patients with thyroglobulin (Tg)-elevated negative iodine scintigraphy (TENIS) syndrome.
METHODS: We searched PubMed, EMBASE, and the Cochrane Library to identify relevant studies published until April 2022. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and registered in an international prospective register of systematic reviews (PROSPERO). Meta-analyses of proportions and odds ratios were performed to assess the beneficial effect of empirical high-dose radioiodine therapy in patients with TENIS syndrome. Subgroup analysis was also performed according to the presence of micrometastasis or macrometastasis.
RESULTS: We identified 14 studies including 690 patients who received empirical high-dose radioiodine therapy for TENIS syndrome. Those who had micrometastasis exhibited additional lesions not previously observed on diagnostic whole-body scan (prop = 0.64, 95% confidence interval [CI], 0.51-0.77) and had reduced serum Tg levels (prop = 0.69; 95% CI, 0.52-0.84) after empirical radioiodine treatment. No such findings were observed among patients with macrometastasis. Moreover, we found that the empirical radioiodine treatment group had lower serum Tg levels than did controls (odds ratio = 0.27; 95% CI, 0.09-0.87), which suggests a lower risk of disease progression.
CONCLUSIONS: Our findings indicate that empirical high-dose radioiodine therapy promoted beneficial effects and could be recommended for patients with TENIS syndrome, especially those with micrometastasis.
METHODS: We searched PubMed, EMBASE, and the Cochrane Library to identify relevant studies published until April 2022. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and registered in an international prospective register of systematic reviews (PROSPERO). Meta-analyses of proportions and odds ratios were performed to assess the beneficial effect of empirical high-dose radioiodine therapy in patients with TENIS syndrome. Subgroup analysis was also performed according to the presence of micrometastasis or macrometastasis.
RESULTS: We identified 14 studies including 690 patients who received empirical high-dose radioiodine therapy for TENIS syndrome. Those who had micrometastasis exhibited additional lesions not previously observed on diagnostic whole-body scan (prop = 0.64, 95% confidence interval [CI], 0.51-0.77) and had reduced serum Tg levels (prop = 0.69; 95% CI, 0.52-0.84) after empirical radioiodine treatment. No such findings were observed among patients with macrometastasis. Moreover, we found that the empirical radioiodine treatment group had lower serum Tg levels than did controls (odds ratio = 0.27; 95% CI, 0.09-0.87), which suggests a lower risk of disease progression.
CONCLUSIONS: Our findings indicate that empirical high-dose radioiodine therapy promoted beneficial effects and could be recommended for patients with TENIS syndrome, especially those with micrometastasis.
摘要：
目的：本研究旨在对经验性高剂量放射性碘治疗甲状腺球蛋白（Tg）升高阴性碘闪烁显像（TENIS）综合征的分化型甲状腺癌患者的疗效进行系统评价和荟萃分析。
方法：我们搜索了PubMed，EMBASE,和Cochrane图书馆，以确定直到2022年4月发表的相关研究。该系统评价是根据系统评价和荟萃分析的首选报告项目清单进行的，并在国际前瞻性系统评价登记册（PROSPERO）中注册。进行比例和比值比的荟萃分析，以评估经验性高剂量放射性碘治疗对TENIS综合征患者的有益效果。还根据微转移或大转移的存在进行亚组分析。
结果：我们确定了14项研究，包括690例接受经验性高剂量放射性碘治疗的TENIS综合征患者。那些有微转移的患者在诊断性全身扫描中表现出以前未观察到的额外病变(prop=0.64,95%置信区间[CI],0.51-0.77），并且在经验性放射性碘治疗后血清Tg水平降低（prop=0.69；95％CI，0.52-0.84）。在大转移患者中未观察到此类发现。此外，我们发现，经验性放射性碘治疗组的血清Tg水平低于对照组（比值比=0.27;95％CI，0.09-0.87），这表明疾病进展的风险较低。
结论：我们的研究结果表明，经验性高剂量放射性碘治疗可促进有益效果，可推荐用于TENIS综合征患者，特别是那些有微转移的。
方法：我们搜索了PubMed，EMBASE,和Cochrane图书馆，以确定直到2022年4月发表的相关研究。该系统评价是根据系统评价和荟萃分析的首选报告项目清单进行的，并在国际前瞻性系统评价登记册（PROSPERO）中注册。进行比例和比值比的荟萃分析，以评估经验性高剂量放射性碘治疗对TENIS综合征患者的有益效果。还根据微转移或大转移的存在进行亚组分析。
结果：我们确定了14项研究，包括690例接受经验性高剂量放射性碘治疗的TENIS综合征患者。那些有微转移的患者在诊断性全身扫描中表现出以前未观察到的额外病变(prop=0.64,95%置信区间[CI],0.51-0.77），并且在经验性放射性碘治疗后血清Tg水平降低（prop=0.69；95％CI，0.52-0.84）。在大转移患者中未观察到此类发现。此外，我们发现，经验性放射性碘治疗组的血清Tg水平低于对照组（比值比=0.27;95％CI，0.09-0.87），这表明疾病进展的风险较低。
结论：我们的研究结果表明，经验性高剂量放射性碘治疗可促进有益效果，可推荐用于TENIS综合征患者，特别是那些有微转移的。
