背景:据报道,甲状腺乳头状癌(PTC)的遗传改变在过去几十年中发生了变化。我们进行了这项系统评价,以进一步检查患者人口统计学的趋势和变化,PTC随时间变化的临床病理特征和分子谱。
方法:在六个电子数据库中进行了文献检索,以确定相关文章。纳入标准是已发表的调查BRAF突变的研究,PTC或经典PTC中的RET/PTC重排或RAS突变。两个审稿人小组独立筛选了所有文章的标题和摘要。阅读潜在文章的全文,并列出提取的数据,并根据国家/地区将其分层为Excel文件,城市,机构,和手术时间。采用Studentt检验和Pearson卡方分析PTC患者的人口统计学和临床病理特征的趋势以及各个机构中每种遗传改变的患病率。
结果:来自3139篇文章,我们纳入了16篇文章进行最终分析。我们的结果表明,随着时间的推移,在PTC和经典PTC中,BRAF呈增加趋势,RET/PTC患病率呈下降趋势,伴随着年龄较大的PTC患者,PTMC比例增加和肿瘤侵袭行为减少。
结论:在过去的几十年中,PTC的人口统计学和临床病理特征以及分子谱一直在变化。这些修饰表明影响PTC肿瘤发生的甲状腺癌的病因和危险因素的变化。
BACKGROUND: The genetic alterations of papillary thyroid carcinoma (PTC) have been reported to change over the past few decades. We performed this systematic
review to further examine the trends and modifications of patient demographic, clinicopathological features and molecular profiles of PTC over time.
METHODS: A literature search was performed within six electronic databases to identify relevant articles. The inclusion criteria were published studies investigating BRAF mutations, RET/PTC rearrangements or RAS mutations in PTCs or classical PTCs. Two teams of reviewers independently screened titles and abstracts of all articles. Full texts of potential articles were read and extracted data were listed and stratified into an excel file according to country, city, institution, and surgical time period. Student t test and Pearson Chi-square were used to analyze the trends of demographic and clinicopathological features of PTC patients and the prevalence of each genetic alteration in individual institutions.
RESULTS: From 3139 articles, we included 16 articles for final analysis. Our results showed an increasing trend of BRAF and a decreasing trend of RET/PTC prevalence over time in PTCs and classical PTCs, accompanied by an older age of PTC patients, an increase in proportion of PTMC and less aggressive behaviours of tumours.
CONCLUSIONS: The demographic and clinicopathological characteristics and molecular profile of PTCs have been changing over the past few decades. These modifications suggest changes in etiologies and risk factors of thyroid cancer that influence the tumorigenesis of PTCs.