Prevalence of Differentiated High-Grade Thyroid Carcinoma Among Well-Differentiated Tumors: A Systematic Review and Meta-Analysis
Authors' conclusion
Following the current WHO indications, some tumors will be reclassified as DHGTC. The proportion of tumors with high-grade features is relevant in FTC, solid trabecular, and histologically aggressive PTC subtypes. A remarkable enrichment in DHGTC among patients with poor prognosis confirms the negative impact of high-grade features on outcome.
Study context
- Population
- Studies reporting necrosis and/or mitoses in well-differentiated thyroid carcinoma (WDTC)
- Outcome
- Prevalence of differentiated high-grade thyroid carcinoma (DHGTC) in WDTC
Methodological detailsPRISMA guidelines followed, quality assessment by modified Newcastle-Ottawa scale
- PRISMA guidelines followed
- Quality assessment by modified Newcastle-Ottawa scale
Pooled result
As reported in the abstract
Prevalence of differentiated high-grade thyroid carcinoma (DHGTC) in WDTC (clinically unselected patients), 95% CI 0.045-0.113
0.072
Further pooled results
Prevalence of DHGTC by tumor type: Follicular thyroid carcinoma (FTC) vs papillary thyroid carcinoma (PTC)
- FTC (CI 0.101-0.205); higher than PTC
- 0.146
- PTC
- 0.059 (CI 0.036-0.097)
Prevalence of DHGTC by PTC subtype
- Diffuse sclerosing PTC
- 0.018 (CI 0.004-0.084)
- Follicular subtype PTC
- 0.036 (CI 0.010-0.124)
- Classic subtype PTC
- 0.042 (CI 0.027-0.066)
- Solid trabecular PTC
- 0.154 (CI 0.067-0.314)
- Histologically aggressive PTC
- 0.168 (CI 0.108-0.252)
Prevalence of DHGTC by FTC invasiveness
- Minimally invasive FTC
- 0.136 (CI 0.058-0.287)
- Widely invasive FTC
- 0.152 (CI 0.086-0.254)
- Similar proportions
Proportion of DHGTC in patients with poor prognosis (fatal, metastatic and RAI-resistant tumors, biochemical recurrence)
- Poor-prognosis cohort
- 0.287 (CI 0.155-0.469)
Original publication
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