目的:探讨分化型甲状腺癌(DTC)合并桥本甲状腺炎(HT)的临床特点,为HT患者的个性化RAIT提供最新证据。
方法:从2000年1月到2023年1月,PubMed,Embase,在WebofScience数据库中搜索了以英文发表的有关HT对DTC的RAIT功效的相关原始文章。Revman5.4和Stata17.0用于日期分析。
结果:11项研究涉及16,605例DTC患者(3,321例HT)。HT在女性中更常见(OR:2.90,95%CI:1.77至4.76,P<0.00001)。肿瘤大小(MD:-0.20,95%CI:-0.30至-0.11),甲状腺外延伸率(OR:0.77,95%CI:0.67~0.90)和转移率(OR:0.18,95%CI:0.08~0.41)较低,但HT与非HT组的TNM分期差异无统计学意义。DFS率(OR:1.96,95%CI:1.57至2.44,P<0.00001),HT组5年和10年DFS(OR:1.73,95%CI:1.04至2.89,P=0.04;OR:1.56,95%CI:1.17至2.09,P=0.003)较高。复发(OR:0.62,95%CI:0.45至0.83,P=0.002),HT组的RAIT剂量(MD=-38.71,95%CI:-60.86至-16.56,P=0.0006)和治疗(MD:-0.13,95%CI:-0.22至-0.03,P=0.008)较低。
结论:DTC与HT共存与较少的侵袭有关。RAIT后HT组的DFS高于非HT组。低剂量治疗不会损害RAIT在DTC伴HT中的疗效。
结论:桥本甲状腺炎是DTC的风险,但它可以最大限度地减少癌症的进展,提高RAIT的疗效,在个性化RAIT时应该考虑这一点。
OBJECTIVE: To investigate the clinical character of differentiated thyroid cancer (DTC) coexisting with Hashimoto\'s thyroiditis (HT) and provide state-of-art evidence for personalized radioactive iodine-131 therapy (RAIT) for patients coexisting with HT.
METHODS: From January 2000 to January 2023, PubMed, Embase, and Web of Science databases were searched for relevant original articles that published in English on the RAIT efficacy for DTC with HT. RevMan 5.4 and Stata 17.0 were used for data analysis.
RESULTS: Eleven studies involving 16 605 DTC patients (3321 with HT) were included. HT was more frequent in female (OR: 2.90, 95% confidence interval [CI]: 1.77-4.76, P < .00001). The size of tumour (MD: -0.20, 95% CI: -0.30 to -0.11), extrathyroidal extension rate (OR: 0.77, 95% CI: 0.67-0.90), and metastasis rate (OR: 0.18, 95% CI: 0.08-0.41) were less in HT, but tumour, node, metastasis (TNM) stage had no significant difference among HT and non-HT group. Disease-free survival (DFS) rate (OR: 1.96, 95% CI: 1.57-2.44, P < .00001), 5-year DFS (OR: 1.73, 95% CI: 1.04-2.89, P = .04), and 10-year DFS (OR: 1.56, 95% CI: 1.17-2.09, P = .003) were higher in HT group. The recurrent (OR: 0.62, 95% CI: 0.45-0.83, P = .002), RAIT dosage (MD = -38.71, 95% CI: -60.86 to -16.56, P = .0006), and treatment (MD: -0.13, 95% CI: -0.22 to -0.03, P = .008) were less in HT group.
CONCLUSIONS: DTC coexisting with HT was associated with less invasion. DFS of HT group was higher than non-HT group after RAIT. Low-dose treatment did not impair the efficacy of RAIT in DTC with HT.
CONCLUSIONS: Hashimoto\'s thyroiditis is a risk for DTC, but it minimalizes the progression of cancer and enhance the efficacy of RAIT, which should be considered in personalizing RAIT.