CAJ | 학술논문

目的：评价影响分化型甲状腺癌预后的诸多因素。方法检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Medline、OVID、Cochrone library、SciVerse ScienceDirect等数据库中关于分化型甲状腺癌患者预后的文献。依据纳入和排除标准，纳入符合要求的文献，并提取相应观测指标(性别、年龄、肿瘤大小、病理分型、远处转移、淋巴结转移、复发)的10年生存率，利用Revman 5.2软件对纳入文献的相关指标进行Meta分析。结果12篇文献，4140例患者纳入研究，对各指标的10年生存率进行Meta分析。结果显示：不同性别、年龄、肿瘤大小、远处转移、复发患者的10年生存率差异均有统计学意义(P<0.05)，其中，女性预后优于男性(OR=1.94)，年龄<45岁者预后优于年龄≥45岁者(OR=7.18)，肿瘤≤4 cm者预后优于肿瘤>4 cm者(OR=3.69)，无远处转移者预后优于有远处转移者(OR=0.13)，无复发的患者预后优于有复发者(OR=0.32)。不同病理分型和淋巴结转移患者预后差异无统计学意义(P>0.05)。结论性别、年龄、肿瘤大小、远处转移、复发与分化型甲状腺癌预后相关，病理分型、淋巴结转移对预后的影响尚有待进一步的证明。
목적：평개영향분화형갑상선암예후적제다인소。방법검색중국지망、만방、유보、중국생물의학문헌수거고、PubMed、Medline、OVID、Cochrone library、SciVerse ScienceDirect등수거고중관우분화형갑상선암환자예후적문헌。의거납입화배제표준，납입부합요구적문헌，병제취상응관측지표(성별、년령、종류대소、병리분형、원처전이、림파결전이、복발)적10년생존솔，이용Revman 5.2연건대납입문헌적상관지표진행Meta분석。결과12편문헌，4140례환자납입연구，대각지표적10년생존솔진행Meta분석。결과현시：불동성별、년령、종류대소、원처전이、복발환자적10년생존솔차이균유통계학의의(P<0.05)，기중，녀성예후우우남성(OR=1.94)，년령<45세자예후우우년령≥45세자(OR=7.18)，종류≤4 cm자예후우우종류>4 cm자(OR=3.69)，무원처전이자예후우우유원처전이자(OR=0.13)，무복발적환자예후우우유복발자(OR=0.32)。불동병리분형화림파결전이환자예후차이무통계학의의(P>0.05)。결론성별、년령、종류대소、원처전이、복발여분화형갑상선암예후상관，병리분형、림파결전이대예후적영향상유대진일보적증명。
Objective To systematically assess the factors that influence the prognosis of differentiated thyroid carci-noma. Methods Papers regarding to factors that influence the prognosis of differentiated thyroid carcinoma in databases such as CNKI, Wanfang date, VIP, CBM, PubMed, Medline, OVID, Cochrone library and SciVerse ScienceDirect were searched. Based on inclusion and exclusion criterions, qualified references about the 10 years survival rate of patients with different gender, age, tumor size, pathological type, distant metastasis, lymph node metastasis and recurrence were picked up. Then Meta-analysis was performed to evaluate the results by RevMan 5.2 software. Results A total of 12 studies with 4140 cases of patients were included. The differences of ten years survival rate of patients with different gender, age, size of tumor, distant metastasis and relapse were proved to be statistical significant (P< 0.05), the prog-nosis of female (OR=1.94), age<45 years old (OR=7.18), size of tumor≤ 4 cm (OR=3.69,), no distant metastasis (OR=0.13), no recurrence (OR=0.32) were better than the rest among the patients; while pathological type, lymph node metastasis had no statistically significant differences (P>0.05). Conclusion Gender, age, tumor size, distant metastasis and recurrence are associated with differentiated thyroid cancer prognosis, but the influence of pathological type, lymph node metastasis on prognosis are remain to be confirmed.