目的建立一个列线图来预测老年患者胰腺神经内分泌肿瘤(pancreatic neuroendocrine tumors,pNETs)远处转移的风险。方法从美国"肿瘤监测、流行病学和预后(Surveillance,Epidemiology,and End Results,SEER)数据库"中提取1973...目的建立一个列线图来预测老年患者胰腺神经内分泌肿瘤(pancreatic neuroendocrine tumors,pNETs)远处转移的风险。方法从美国"肿瘤监测、流行病学和预后(Surveillance,Epidemiology,and End Results,SEER)数据库"中提取1973年至2015年之间年龄≥65岁pNETs患者的数据。所有符合条件的患者随机分为训练队列和验证队列。对训练队列进行单因素和多因素Logistic回归分析以确定远处转移的独立风险因素。使用R软件的rms软件包基于独立风险因素开发列线图。使用C指数和校准曲线在训练队列进行内部验证,在验证队列进行外部验证。结果研究共确定了411名老年pNETs患者,260名被分配到训练队列,151名被分配到验证队列。单因素和多因素Logistic回归分析表明,肿瘤部位(胰腺体/尾:比值比[OR]=2.282;95%可信区间[CI]:1.174–4.436,P<0.05),组织学分级(低分化/未分化:OR=2.600,95%CI:1.266–5.339,P<0.05),T分期(T2:OR=8.913,95%CI:1.985–40.010,P<0.05;T3:OR=11.830,95%CI:2.530–55.350,P<0.05;T4:OR=68.650,95%CI:8.020–587.600,P<0.05)和N分期(N1:OR=3.480,95%CI:1.807–6.703,P<0.05)被确定为老年人pNETs远处转移的独立危险因素。列线图显示出良好的预测准确性,内部验证的C指数为0.809(95%CI:0.757–0.861),外部验证的C指数为0.795(95%CI:0.723–0.867),预测的远处转移率与校准曲线的观察值吻合良好。结论我们建立的列线图在评估老年pNETs患者远处转移风险方面具有较好的辨别能力和准确性,可为老年pNETs患者的个体化评估和治疗决策提供参考。展开更多
The limited molecular classifications and disease signatures of osteoarthritis(OA)impede the development of prediagnosis and targeted therapeutics for OA patients.To classify and understand the subtypes of OA,we colle...The limited molecular classifications and disease signatures of osteoarthritis(OA)impede the development of prediagnosis and targeted therapeutics for OA patients.To classify and understand the subtypes of OA,we collected three types of tissue including cartilage,subchondral bone,and synovium from multiple clinical centers and constructed an extensive transcriptome atlas of OA patients.By applying unsupervised clustering analysis to the cartilage transcriptome,OA patients were classified into four subtypes with distinct molecular signatures:a glycosaminoglycan metabolic disorder subtype(C1),a collagen metabolic disorder subtype(C2),an activated sensory neuron subtype(C3),and an inflammation subtype(C4).Through ligand-receptor crosstalk analysis of the three knee tissue types,we linked molecular functions with the clinical symptoms of different OA subtypes.For example,the Gene Ontology functional term of vasculature development was enriched in the subchondral bone-cartilage crosstalk of C2 and the cartilage-subchondral bone crosstalk of C4,which might lead to severe osteophytes in C2 patients and apparent joint space narrowing in C4 patients.Based on the marker genes of the four OA subtypes identified in this study,we modeled OA subtypes with two independent published RNA-seq datasets through random forest classification.The findings of this work contradicted traditional OA diagnosis by medical imaging and revealed distinct molecular subtypes in knee OA patients,which may allow for precise diagnosis and treatment of OA.展开更多
Many management strategies are available for pancreatic neuroendocrine neoplasms with liver metastases.However,a lack of biological,molecular,and genomic information and an absence of data from rigorous trials limit t...Many management strategies are available for pancreatic neuroendocrine neoplasms with liver metastases.However,a lack of biological,molecular,and genomic information and an absence of data from rigorous trials limit the validity of these strategies.This review presents the viewpoints from an international conference consisting of several expert working groups.The working groups reviewed a series of questions of particular interest to clinicians taking care of patients with pancreatic neuroendocrine neoplasms with liver metastases by reviewing the existing management strategies and literature,evaluating the evidence on which management decisions were based,developing internationally acceptable recommendations for clinical practice,and making recommendations for clinical and research endeavors.The review for each question will be followed by recommendations from the panel.展开更多
Acute pancreatitis(AP)is a common acute abdominal condition of the digestive system.In recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role...Acute pancreatitis(AP)is a common acute abdominal condition of the digestive system.In recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients.On the basis of previous guidelines and expert consensus,this guideline adopts an evidence-based,problem-based expression;synthesizes important clinical research data at home and abroad in the most recent 5 years;and forms 29 recommendations through multidisciplinary expert discussion,including diagnosis,treatment,and follow-up.It is expected to provide evidence support for the treatment of AP in the clinical setting in China.展开更多
Objective:The aim of this study is to investigate the current status of the diagnosis and treatment of patients with pancreatic neuroendocrine neoplasms(pNENs)undergoing surgery in China.Methods:This is a multicenter ...Objective:The aim of this study is to investigate the current status of the diagnosis and treatment of patients with pancreatic neuroendocrine neoplasms(pNENs)undergoing surgery in China.Methods:This is a multicenter cross-sectional study performed in China.Data from patients with pNENs undergoing surgery at 33 high-volume medical centers,where the number of pancreatectomies exceeds 20 cases per year,were collected and analyzed between March 1,2016 and February 28,2017.Results:In total,392 patients with pNENs were enrolled.The male to female ratio was 1.4.The majority of patients were aged between 40 and 70 years.65.6%of the patients had non-functional tumors.Among those with functional tumors,the percentages of insulinomas,gastrinomas,glucagonomas,and vasoactive intestinal peptide-secreting tumors were 94.8%,1.5%,2.2%,and 1.5%,respectively.Multidisciplinary team(MDT)discussion was conducted for 39.0%of the patients.Minimally invasive surgery was performed on 31.1%of the 392 patients.The incidence of grade B/C pancreatic fistula formation was 4.4%.A total of 89.0%of the surgeries achieved R0 resection,and 41.6%of the tumors were well differentiated.Lymph node metastasis was present in 8.9%of the patients.The percentages of patients with grades G1,G2,and G3 disease were 49.2%,45.7%,and 5.1%,respectively.Conclusion:This multicenter cross-sectional study systematically presents the current status of the diagnosis and treatment of patients with pNENs undergoing surgery in China.MDT consultation for pNENs has not been widely implemented in China.Although the incidence of surgical complications is relatively low,minimally invasive procedures should be further promoted.This study shows us how to improve the outcomes of these patients.展开更多
Objective: The aim of this study is to investigate the current status of pancreatic cancer patients undoing surgical treatment in China and to find ways to improve the survival of these patients in the future. Methods...Objective: The aim of this study is to investigate the current status of pancreatic cancer patients undoing surgical treatment in China and to find ways to improve the survival of these patients in the future. Methods: This study is a national, multicenter, cross-sectional study in China. Information regarding pancreatic cancer patients undergoing surgical treatment from 34 high-volume tertiary IIIA level hospitals was collected and analyzed from the March 1, 2016 to the February 28, 2017. Results: In total, 2200 pancreatic cancer patients were enrolled from 34 tertiary IIIA level hospitals in 16 provinces across China. The male-to-female ratio was 1.5. More than 80% of the patients were between 50 and 70 years old. The top 4 symptoms were epigastric discomfort, abdominal pain, jaundice, and weight loss. Carbohydrate antigen 19-9 and carcinoembryonic antigen were elevated in 70.9% and 27.1% of patients, respectively. A multidisciplinary team (MDT) discussion was carried out for 35.0% of patients before surgery. The proportion of minimally invasive pancreatic surgeries was approximately 20%. A total of 83.4% of the operations achieved R0 resection, and the incidence of grade 3/4 postoperative complications was 7.7%. Only 13.4% of the patients received postoperative adjuvant chemotherapy. The percentage of pathological stage I tumors was only 24.5%. Conclusion: The majority of pancreatic cancer patients undergoing surgical resection in China are in an advanced stage. The MDT consultations for pancreatic cancer have not been widely carried out. R0 resection has been achieved in most cases, with relatively low incidence of serious complications, but minimally invasive pancreatic surgery should be further promoted. The application of postoperative chemotherapy remains low. This national, multicentre, cross-sectional study comprehensively presents the current status of pancreatic cancer patients undergoing surgical treatment and shows the road to improve survival of these patients in the future.展开更多
Pancreatic neuroendocrine neoplasms(pNENs)are highly heterogeneous,and the management of pNENs patients can be intractable.To address this challenge,an expert committee was established on behalf of the Chinese Pancrea...Pancreatic neuroendocrine neoplasms(pNENs)are highly heterogeneous,and the management of pNENs patients can be intractable.To address this challenge,an expert committee was established on behalf of the Chinese Pancreatic Surgery Association,which consisted of surgical oncologists,gastroenterologists,medical oncologists,endocrinologists,radiologists,pathologists,and nuclear medicine specialists.By reviewing the important issues regarding the diagnosis and treatment of pNENs,the committee concluded evidence-based statements and recommendations in this article,in order to further improve the management of pNENs patients in China.展开更多
The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreat...The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years,Chinese Pancreatic Association,the Chinese Society of Surgery,Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China(2014)after reviewing evidence-based and problem-oriented literature published during 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer.Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system.This guideline aims to standardize the clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and further improve the prognosis of patients with pancreatic cancer.展开更多
Background:Differentiated thyroid cancer(DTC)is commonly diagnosed in women of child-bearing age,but whether pregnancy influences the prognosis of DTC remains controversial.This study aimed to summarize existing evide...Background:Differentiated thyroid cancer(DTC)is commonly diagnosed in women of child-bearing age,but whether pregnancy influences the prognosis of DTC remains controversial.This study aimed to summarize existing evidence regarding the association of pregnancy with recurrence risk in patients previously treated for DTC.Methods:We searched PubMed,Embase,Web of Science,Cochrane,and Scopus based on the prespecified protocol registered at PROSPERO(CRD42022367896).After study selection,two researchers independently extracted data from the included studies.For quantitative data synthesis,we used random-effects meta-analysis models to pool the proportion of recurrence(for pregnant women only)and odds ratio(OR;comparing the risk of recurrence between the pregnancy group and the nonpregnancy group),respectively.Then we conducted subgroup analyses to explore whether risk of recurrence differed by response to therapy status or duration of follow-up time.We also assessed quality of the included studies.Results:A total of ten studies were included.The sample size ranged from 8 to 235,with participants’age at pregnancy or delivery ranging from 28 to 35 years.The follow-up time varied from 0.1 to 36.0 years.The pooled proportion of recurrence in all pregnant patients was 0.13(95%confidence intervals[CI]:0.06-0.25;I^(2):0.58).Among six included studies reporting response to therapy status before pregnancy,we observed a trend for increasingly higher risk of recurrence from excellent,indeterminate,and biochemically incomplete to structurally incomplete response to therapy(P trend<0.05).The pooled risk of recurrence in the pregnancy group showed no evidence of a significant difference from that in the nonpregnancy group(OR:0.75;95%CI:0.45-1.23;I^(2):0).The difference in follow-up time(below/above five years)was not associated with either the proportion of recurrence in all pregnant patients(P>0.05)or the OR of recurrence in studies with a comparison group(P>0.05).Two included studies that focused on patients with distant metastasis also did not show a significant difference in disease recurrence between pregnancy and nonpregnancy groups(OR:0.51[95%CI:0.14-1.87;I^(2):59%]).Conclusion:In general,pregnancy appears to have a minimal association with the disease recurrence of DTC with initial treatment.Clinicians should pay more attention to progression of DTC among pregnant women with biochemical and/or structural persistence.Registration:PROSPERO,https://www.crd.york.ac.uk/PROSPERO/;No.CRD42022367896.展开更多
文摘目的建立一个列线图来预测老年患者胰腺神经内分泌肿瘤(pancreatic neuroendocrine tumors,pNETs)远处转移的风险。方法从美国"肿瘤监测、流行病学和预后(Surveillance,Epidemiology,and End Results,SEER)数据库"中提取1973年至2015年之间年龄≥65岁pNETs患者的数据。所有符合条件的患者随机分为训练队列和验证队列。对训练队列进行单因素和多因素Logistic回归分析以确定远处转移的独立风险因素。使用R软件的rms软件包基于独立风险因素开发列线图。使用C指数和校准曲线在训练队列进行内部验证,在验证队列进行外部验证。结果研究共确定了411名老年pNETs患者,260名被分配到训练队列,151名被分配到验证队列。单因素和多因素Logistic回归分析表明,肿瘤部位(胰腺体/尾:比值比[OR]=2.282;95%可信区间[CI]:1.174–4.436,P<0.05),组织学分级(低分化/未分化:OR=2.600,95%CI:1.266–5.339,P<0.05),T分期(T2:OR=8.913,95%CI:1.985–40.010,P<0.05;T3:OR=11.830,95%CI:2.530–55.350,P<0.05;T4:OR=68.650,95%CI:8.020–587.600,P<0.05)和N分期(N1:OR=3.480,95%CI:1.807–6.703,P<0.05)被确定为老年人pNETs远处转移的独立危险因素。列线图显示出良好的预测准确性,内部验证的C指数为0.809(95%CI:0.757–0.861),外部验证的C指数为0.795(95%CI:0.723–0.867),预测的远处转移率与校准曲线的观察值吻合良好。结论我们建立的列线图在评估老年pNETs患者远处转移风险方面具有较好的辨别能力和准确性,可为老年pNETs患者的个体化评估和治疗决策提供参考。
基金the National Key R&D Program of China(2017YFA0104900)the National Natural Science Foundation of China(81630065,31830029,and 81802195)the China Postdoctoral Science Foundation(2017M621913).
文摘The limited molecular classifications and disease signatures of osteoarthritis(OA)impede the development of prediagnosis and targeted therapeutics for OA patients.To classify and understand the subtypes of OA,we collected three types of tissue including cartilage,subchondral bone,and synovium from multiple clinical centers and constructed an extensive transcriptome atlas of OA patients.By applying unsupervised clustering analysis to the cartilage transcriptome,OA patients were classified into four subtypes with distinct molecular signatures:a glycosaminoglycan metabolic disorder subtype(C1),a collagen metabolic disorder subtype(C2),an activated sensory neuron subtype(C3),and an inflammation subtype(C4).Through ligand-receptor crosstalk analysis of the three knee tissue types,we linked molecular functions with the clinical symptoms of different OA subtypes.For example,the Gene Ontology functional term of vasculature development was enriched in the subchondral bone-cartilage crosstalk of C2 and the cartilage-subchondral bone crosstalk of C4,which might lead to severe osteophytes in C2 patients and apparent joint space narrowing in C4 patients.Based on the marker genes of the four OA subtypes identified in this study,we modeled OA subtypes with two independent published RNA-seq datasets through random forest classification.The findings of this work contradicted traditional OA diagnosis by medical imaging and revealed distinct molecular subtypes in knee OA patients,which may allow for precise diagnosis and treatment of OA.
基金supported by the National Natural Science Foundation of China(Grant number,82141127).
文摘Many management strategies are available for pancreatic neuroendocrine neoplasms with liver metastases.However,a lack of biological,molecular,and genomic information and an absence of data from rigorous trials limit the validity of these strategies.This review presents the viewpoints from an international conference consisting of several expert working groups.The working groups reviewed a series of questions of particular interest to clinicians taking care of patients with pancreatic neuroendocrine neoplasms with liver metastases by reviewing the existing management strategies and literature,evaluating the evidence on which management decisions were based,developing internationally acceptable recommendations for clinical practice,and making recommendations for clinical and research endeavors.The review for each question will be followed by recommendations from the panel.
文摘Acute pancreatitis(AP)is a common acute abdominal condition of the digestive system.In recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients.On the basis of previous guidelines and expert consensus,this guideline adopts an evidence-based,problem-based expression;synthesizes important clinical research data at home and abroad in the most recent 5 years;and forms 29 recommendations through multidisciplinary expert discussion,including diagnosis,treatment,and follow-up.It is expected to provide evidence support for the treatment of AP in the clinical setting in China.
基金Chinese Academy of Medical Sciences(CAMS)Initiative for Innovative Medicine(CAMS-I2M)2017-I2M-1-001 supported this study.
文摘Objective:The aim of this study is to investigate the current status of the diagnosis and treatment of patients with pancreatic neuroendocrine neoplasms(pNENs)undergoing surgery in China.Methods:This is a multicenter cross-sectional study performed in China.Data from patients with pNENs undergoing surgery at 33 high-volume medical centers,where the number of pancreatectomies exceeds 20 cases per year,were collected and analyzed between March 1,2016 and February 28,2017.Results:In total,392 patients with pNENs were enrolled.The male to female ratio was 1.4.The majority of patients were aged between 40 and 70 years.65.6%of the patients had non-functional tumors.Among those with functional tumors,the percentages of insulinomas,gastrinomas,glucagonomas,and vasoactive intestinal peptide-secreting tumors were 94.8%,1.5%,2.2%,and 1.5%,respectively.Multidisciplinary team(MDT)discussion was conducted for 39.0%of the patients.Minimally invasive surgery was performed on 31.1%of the 392 patients.The incidence of grade B/C pancreatic fistula formation was 4.4%.A total of 89.0%of the surgeries achieved R0 resection,and 41.6%of the tumors were well differentiated.Lymph node metastasis was present in 8.9%of the patients.The percentages of patients with grades G1,G2,and G3 disease were 49.2%,45.7%,and 5.1%,respectively.Conclusion:This multicenter cross-sectional study systematically presents the current status of the diagnosis and treatment of patients with pNENs undergoing surgery in China.MDT consultation for pNENs has not been widely implemented in China.Although the incidence of surgical complications is relatively low,minimally invasive procedures should be further promoted.This study shows us how to improve the outcomes of these patients.
文摘Objective: The aim of this study is to investigate the current status of pancreatic cancer patients undoing surgical treatment in China and to find ways to improve the survival of these patients in the future. Methods: This study is a national, multicenter, cross-sectional study in China. Information regarding pancreatic cancer patients undergoing surgical treatment from 34 high-volume tertiary IIIA level hospitals was collected and analyzed from the March 1, 2016 to the February 28, 2017. Results: In total, 2200 pancreatic cancer patients were enrolled from 34 tertiary IIIA level hospitals in 16 provinces across China. The male-to-female ratio was 1.5. More than 80% of the patients were between 50 and 70 years old. The top 4 symptoms were epigastric discomfort, abdominal pain, jaundice, and weight loss. Carbohydrate antigen 19-9 and carcinoembryonic antigen were elevated in 70.9% and 27.1% of patients, respectively. A multidisciplinary team (MDT) discussion was carried out for 35.0% of patients before surgery. The proportion of minimally invasive pancreatic surgeries was approximately 20%. A total of 83.4% of the operations achieved R0 resection, and the incidence of grade 3/4 postoperative complications was 7.7%. Only 13.4% of the patients received postoperative adjuvant chemotherapy. The percentage of pathological stage I tumors was only 24.5%. Conclusion: The majority of pancreatic cancer patients undergoing surgical resection in China are in an advanced stage. The MDT consultations for pancreatic cancer have not been widely carried out. R0 resection has been achieved in most cases, with relatively low incidence of serious complications, but minimally invasive pancreatic surgery should be further promoted. The application of postoperative chemotherapy remains low. This national, multicentre, cross-sectional study comprehensively presents the current status of pancreatic cancer patients undergoing surgical treatment and shows the road to improve survival of these patients in the future.
基金supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)2017-I2M-1-001.
文摘Pancreatic neuroendocrine neoplasms(pNENs)are highly heterogeneous,and the management of pNENs patients can be intractable.To address this challenge,an expert committee was established on behalf of the Chinese Pancreatic Surgery Association,which consisted of surgical oncologists,gastroenterologists,medical oncologists,endocrinologists,radiologists,pathologists,and nuclear medicine specialists.By reviewing the important issues regarding the diagnosis and treatment of pNENs,the committee concluded evidence-based statements and recommendations in this article,in order to further improve the management of pNENs patients in China.
文摘The incidence of pancreatic cancer has been rising worldwide,and its clinical diagnosis and treatment remain a great challenge.To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years,Chinese Pancreatic Association,the Chinese Society of Surgery,Chinese Medical Association revised the Guidelines for the Diagnosis and Treatment of Pancreatic Cancer in China(2014)after reviewing evidence-based and problem-oriented literature published during 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer.Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system.This guideline aims to standardize the clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and further improve the prognosis of patients with pancreatic cancer.
基金funded by National Natural Science Foundation of China(No.82373694)Young Elite Scientists Sponsorship Program by CAST(No.2023QNRC001)+1 种基金the Beijing Of ce for Education Sciences Planning(No.BECA23111)the Fundamental Research Funds for the Central Universities(No.BMU2021YJ030).
文摘Background:Differentiated thyroid cancer(DTC)is commonly diagnosed in women of child-bearing age,but whether pregnancy influences the prognosis of DTC remains controversial.This study aimed to summarize existing evidence regarding the association of pregnancy with recurrence risk in patients previously treated for DTC.Methods:We searched PubMed,Embase,Web of Science,Cochrane,and Scopus based on the prespecified protocol registered at PROSPERO(CRD42022367896).After study selection,two researchers independently extracted data from the included studies.For quantitative data synthesis,we used random-effects meta-analysis models to pool the proportion of recurrence(for pregnant women only)and odds ratio(OR;comparing the risk of recurrence between the pregnancy group and the nonpregnancy group),respectively.Then we conducted subgroup analyses to explore whether risk of recurrence differed by response to therapy status or duration of follow-up time.We also assessed quality of the included studies.Results:A total of ten studies were included.The sample size ranged from 8 to 235,with participants’age at pregnancy or delivery ranging from 28 to 35 years.The follow-up time varied from 0.1 to 36.0 years.The pooled proportion of recurrence in all pregnant patients was 0.13(95%confidence intervals[CI]:0.06-0.25;I^(2):0.58).Among six included studies reporting response to therapy status before pregnancy,we observed a trend for increasingly higher risk of recurrence from excellent,indeterminate,and biochemically incomplete to structurally incomplete response to therapy(P trend<0.05).The pooled risk of recurrence in the pregnancy group showed no evidence of a significant difference from that in the nonpregnancy group(OR:0.75;95%CI:0.45-1.23;I^(2):0).The difference in follow-up time(below/above five years)was not associated with either the proportion of recurrence in all pregnant patients(P>0.05)or the OR of recurrence in studies with a comparison group(P>0.05).Two included studies that focused on patients with distant metastasis also did not show a significant difference in disease recurrence between pregnancy and nonpregnancy groups(OR:0.51[95%CI:0.14-1.87;I^(2):59%]).Conclusion:In general,pregnancy appears to have a minimal association with the disease recurrence of DTC with initial treatment.Clinicians should pay more attention to progression of DTC among pregnant women with biochemical and/or structural persistence.Registration:PROSPERO,https://www.crd.york.ac.uk/PROSPERO/;No.CRD42022367896.
