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。%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.
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