Risk factors of transient and permanent hypoparathyroidism after thyroidectomy: a systematic review and meta-analysis.

BACKGROUND: Postoperative hypoparathyroidism (hypoPT) is a common complication following thyroid surgery. However, current research findings on the risk factors for post-thyroid surgery hypoPT are not entirely consistent, and the same risk factors may have different impacts on transient and permanent hypoPT. Therefore, there is a need for a comprehensive study to summarize and explore the risk factors for both transient and permanent hypoPT after thyroid surgery. MATERIALS AND METHODS: Two databases (PubMed and Embase) were searched from inception to 2024. The Newcastle-Ottawa Scale was used to rate study quality. Pooled odds ratios (OR) were used to calculate the relationship of each risk factor with transient and permanent hypoPT. Subgroup analyses were conducted for hypoPT with different definition-time (6 or 12 mo). Publication bias was assessed using Begg's test, and Egger's test. RESULTS: A total of 19 risk factors from the 93 studies were included in the analysis. Among them, sex and parathyroid autotransplantation were the most frequently reported risk factors. Meta-analysis demonstrated that sex (female vs. male), cN stage, central neck dissection, lateral neck dissection, extent of central neck dissection (bilateral vs. unilateral), surgery (total thyroidectomy (TT) vs. lobectomy), surgery type (TT vs. sub-TT), incidental parathyroidectomy, and pathology (cancer vs. benign) were significantly associated with transient and permanent hypoPT. Preoperative calcium and parathyroid autotransplantation were only identified as risk factors for transient hypoPT. Additionally, node metastasis and parathyroid in specimen were associated with permanent hypoPT. CONCLUSION: The highest risk of hypoPT occurs in female thyroid cancer patients with lymph node metastasis undergoing TT combined with neck dissection. The key to preventing postoperative hypoPT lies in the selection of surgical approach and intraoperative protection.

Effectiveness of prognostic nutritional index in predicting overall survival and evaluating immunotherapy response in anaplastic thyroid carcinoma.

BACKGROUND: The prognostic value of nutritional status in anaplastic thyroid carcinoma (ATC) remains unclear. The Prognostic Nutritional Index (PNI) is a reliable indicator of overall nutritional and immune status, and it has emerged as a significant prognostic factor in various malignancies. This study aimed to explore the utility of PNI in ATC. METHODS: We systematically reviewed ATC patients in our institute from January 2000 to June 2023 and categorized them into high and low PNI groups based on the median PNI value. Kaplan-Meier analysis and Cox regression were employed to assess the impact of PNI on overall survival, while ROC curve analysis evaluated the predictive value of PNI. Mimics software was used for three-dimensional reconstruction of pre- and post-immunotherapy tumor volumes, enabling the assessment of treatment response. RESULTS: A total of 77 ATC patients were included in this study. Low baseline PNI was associated with significantly shorter overall survival (1-year survival rate: 5.26% vs 30.77%; median survival time: 5.30 months vs 8.87 months). The 1-year, 2-year, and 3-year AUC values for PNI were 0.82, 0.79, and 0.77, respectively. In the multivariate analysis, both PNI and tumor size emerged as independent prognostic factors for patient overall survival. Among ATC patients receiving 2-3 cycles of immunotherapy, an increase in post-treatment PNI levels was positively correlated with a reduction in tumor volume. CONCLUSION: PNI is an independent predictor of overall survival and holds the potential to serve as a valuable indicator for assessing and predicting immunotherapy efficacy in ATC patients.

Intratumor microbiome: selective colonization in the tumor microenvironment and a vital regulator of tumor biology.

The polymorphic microbiome has been proposed as a new hallmark of cancer. Intratumor microbiome has been revealed to play vital roles in regulating tumor initiation and progression, but the regulatory mechanisms have not been fully uncovered. In this review, we illustrated that similar to other components in the tumor microenvironment, the reside and composition of intratumor microbiome are regulated by tumor cells and the surrounding microenvironment. The intratumor hypoxic, immune suppressive, and highly permeable microenvironment may select certain microbiomes, and tumor cells may directly interact with microbiome via molecular binding or secretions. Conversely, the intratumor microbiomes plays vital roles in regulating tumor initiation and progression via regulating the mutational landscape, the function of genes in tumor cells and modulating the tumor microenvironment, including immunity, inflammation, angiogenesis, stem cell niche, etc. Moreover, intratumor microbiome is regulated by anti-cancer therapies and actively influences therapy response, which could be a therapeutic target or engineered to be a therapy weapon in the clinic. This review highlights the intratumor microbiome as a vital component in the tumor microenvironment, uncovers potential mutual regulatory mechanisms between the tumor microenvironment and intratumor microbiome, and points out the ongoing research directions and drawbacks of the research area, which should broaden our view of microbiome and enlighten further investigation directions.

miR-30e-5p-mediated FOXD1 promotes cell proliferation by blocking cellular senescence and apoptosis through p21/CDK2/Rb signaling in head and neck carcinoma.

Forkhead box D1 (FOXD1) belongs to the FOX protein family, which has been found to function as a oncogene in multiple cancer types, but its role in head and neck squamous cell carcinoma (HNSCC) requires further investigation. Our research aimed to investigate the function of FOXD1 in HNSCC. Bioinformatics analysis indicated that mRNA level of FOXD1 was highly expressed in HNSCC tissues, and over-expressed FOXD1 was related to poor prognosis. Moreover, FOXD1 knockdown increased the ratio of senescent cells but decreased the proliferation ability, while FOXD1 overexpression obtained the opposite results. In vitro experiments revealed that FOXD1 bound to the p21 promoter and inhibited its transcription, which blocked the cyclin dependent kinase 2 (CDK2)/retinoblastoma (Rb) signaling pathway, thus preventing senescence and accelerating proliferation of tumor cells. CDK2 inhibitor could reverse the process to some extent. Further research has shown that miR-3oe-5p serves as a tumor suppressant by repressing the translation of FOXD1 through combining with the 3'-untranslated region (UTR). Thus, FOXD1 resists cellular senescence and facilitates HNSCC cell proliferation by affecting the expression of p21/CDK2/Rb signaling, suggesting that FOXD1 may be a potential curative target for HNSCC.

Prognostic Utility of Nutritional Risk Index in Patients with Head and Neck Soft Tissue Sarcoma.

BACKGROUND: The nutritional risk index (NRI) is an excellent indicator of nutritional status and a significant prognostic factor in several malignancies, but the relationship between NRI and the prognosis of head and neck soft tissue sarcoma (HNSTS) patients remains unclear. The aim of this study was to investigate the role of NRI in patients with HNSTS. METHODS: We retrospectively reviewed patients with HNSTS between 1990 and 2021. In order to determine the optimal cut-off value of NRI, the Maximally selected log-rank statistic was performed. We evaluated the effect of NRI on overall survival (OS) and progression-free survival (PFS) by using the Kaplan-Meier method and Cox regression analysis. Then, OS and PFS nomograms based on NRI were constructed. RESULTS: In total, 436 HNSTS patients were included in this study. The optimal cut-off value of NRI was 99.34. Patients with low-NRI showed significantly worse OS and PFS than patients with high-NRI, respectively (5-year OS rate of 43.0 vs. 70.8%, 5-year PFS rate of 29.0 vs. 45.0%, all p < 0.05). In the multivariate analysis, distant metastasis, deep tumor depth, tumor grade, and NRI were prognostic factors for both PFS and OS, and treatment modality was associated with OS but not PFS. The concordance indexes (C-indexes) of OS and PFS nomograms were 0.794 (95% CI, 0.759-0.829) and 0.663 (95% CI, 0.626-0.700), respectively, which also performed well in the validation set. CONCLUSIONS: NRI is an independent predictor of OS and PFS in HNSTS patients. The validated nomograms based on NRI provide useful predictions of OS and PFS for patients with HNSTS.

Crystallographically Textured and Magnetic LaCu-Substituted Ba-Hexaferrite with Excellent Gyromagnetic Properties.

Excellent gyromagnetic properties of textured, bulk Ba-hexaferrite samples are required for low-loss, self-biased applications for microwave and millimeter-wave (MMW) devices. However, conventionally processed bulk Ba-hexaferrite ceramics typically demonstrate low remanent magnetization values, 4πMr, of 2.0~3.0 kG, and relatively large ferromagnetic resonance (FMR) linewidths, ΔHFMR, of 0.8~2 kOe. These properties lead to the development of high-performance, practical devices. Herein, crystallographically textured Ba-hexaferrite samples, of the composition Ba0.8La0.2Fe11.8Cu0.2O19, having excellent functional properties, are proposed. These materials exhibit strong anisotropy fields, Ha, of ~14.6 kOe, high remanent magnetization, 4πMr, of 3.96 kGs, and a low ΔHFMR of 401 Oe at zero-bias field at the Q-band. Concomitantly, the broadband millimeter-wave transmittance was utilized to determine the complex permeability, µ*, and permittivity, ε*, of textured hexaferrites. Based on Schlöemann's theory of complex permeability, µ*, the remanent magnetization, 4πMr, anisotropy field, Ha, and effective linewidth, ΔHeff, were estimated; these values agree well with measured values.

Optically-Controlled Terahertz Multifunctional Polarization Conversion Metasurface with Reflection and Transmission Modes.

In the terahertz band, how integrating multiple functions into a device with a tiny unit structure is a challenge. In this paper, an optically-controlled multifunctional linear polarization conversion metasurface working in the terahertz band is proposed. The reflection and transmission polarization conversion functions can be realized by irradiating the metasurface with pump light with different wavelengths. The metasurface is designed with a multilayer structure, and a photosensitive semiconductor alone is used to control multiple functions, which makes the manipulation of multifunctional devices easy. When the photosensitive semiconductor germanium (Ge) and silicon (Si) are in different states, the metasurface can realize broadband reflection and transmission polarization conversion functions, the corresponding relative bandwidth are 102.4% and 98.9%, respectively, and the work efficiency can be regulated by pump light with different intensity and wavelength. In addition, the working principle of the metasurface is analyzed by eigenmode theory and surface current distributions. The stability of the metasurface to structural parameters and incident angles are discussed.

Real-World Evidence on the Sensitivity of Preoperative Ultrasound in Evaluating Central Lymph Node Metastasis of Papillary Thyroid Carcinoma.

Introduction: Guidelines for prophylactic dissection in clinical central negative node (cN0) of papillary thyroid carcinoma vary among different countries due to the uncertainty on the benefit of dissection. The Chinese guidelines recommend prophylactic central compartment lymph node dissection (pCLND) under professional technology. Preoperative ultrasound (US) evaluation of central lymph node determines the surgical strategy used. Sensitivity differs significantly when US is conducted by different physicians even in diverse hospitals. In this study, the aim was to explore why the Chinese guidelines were different from the America Thyroid Association (ATA) guidelines through the real-world evidence on the preoperative diagnosis of cN0. Methods: Preoperative US and surgical pathology data for 1,015 patients with PTC attending 13 Grade-A tertiary hospitals in 2017 were collected. A retrospective analysis using US assessment of CLNM was the conducted to explore the benefits of this approach in China. US physicians in our hospital were trained on scanning the thyroid gland and its regional lymph nodes in normalization. Data of 1,776 patients were collected under the same condition from 2012 to 2017, whose ultrasonography was performed by diverse physicians and doctors. Further, data of 339 patients evaluated by the same sonographer and operated by the same surgical team was collected between 2015 and 2017. In this set of data, US combined CT versus US alone was compared. Patients were grouped into metastasis group and non-metastasis group based on postoperative pathological diagnosis of CLNM. Diagnostic efficacy of US was evaluated. Results: A total of 925 patients who underwent preoperative ultrasonography in central lymph node, including 825 cases who underwent thyroidectomy and central lymph node dissection were included in this study. The sensitivity of ultrasonography in detecting CLNM was 23.18%, with occult metastasis rate of 40.8%. Data for 1,776 patients comprising paired ultrasonic report and pathological report were collected in our hospital, whose physicians underwent standardized training. The sensitivity was 37.58%. Furthermore, specialized evaluation showed high sensitivity in US/CT (84.58%) than US (58.21%) alone. Conclusion: Although the sensitivity of US could be enhanced by standardized training and combination with CT, the prevalence of low sensitivity of US in real-world multicenter data and the high occult metastasis rate indicated that the Chinese guidelines were based on the current conditions.

CDH3 is associated with poor prognosis by promoting the malignancy and chemoresistance in oral squamous cell carcinoma.

BACKGROUND: CDH3 is recognized as an oncogene in various malignancies. Here, we aim to explore the association of CDH3 expression and prognostic implication in oral squamous cell carcinoma (OSCC). METHODS: Bioinformatics was used to analyze differentially expressed genes in the TCGA database. The OSCC tissues of 136 cases were used for immunohistochemistry. Cox proportional hazard analysis was used to analyze the relationship between prognostic factors, CDH3 expression and patient survival. Kaplan-Meier analysis was adopted to calculate survival rates. RT-qPCR and Western blot were performed to detect the expression levels of CDH3 in oral squamous cell lines. The cell viability and colony formation abilities were examined by CCK-8 and colony formation assays, respectively. Wound healing assay was performed to examine the invasion ability of cells. RESULTS: CDH3 is up-regulated in oral squamous cell carcinoma and related to bad prognosis. Knock-down of CDH3 limited cell viability, colony formation ability, migration, invasion and chemoresistance of OSCC cells. CONCLUSION: CDH3 is associated with a poor prognosis through promoting migration, invasion and chemoresistance in oral squamous cell carcinoma.

Cyclin-dependent kinase 5 promotes the growth of tongue squamous cell carcinoma through the microRNA 513c-5p/cell division cycle 25B pathway and is associated with a poor prognosis.

BACKGROUND: The objective of this study was to investigate the role and molecular mechanism of cyclin-dependent kinase 5 (CDK5) in regulating the growth of tongue squamous cell carcinoma (TSCC). METHODS: The authors used multiple methods to detect the levels of CDK5 expression in samples of TSCC and to explore the relation between CDK5 expression and various clinicopathologic factors. In vivo and in vitro cell experiments were performed to detect the proliferation, invasion, and migration of TSCC cells with CDK5 knockdown or overexpression. These studies verified that CDK5 regulates the occurrence and development of TSCC cells through the microRNA 513c-5p/cell division cycle 25B pathway. RESULTS: An elevated level of CDK5 expression in TSCC tissues was identified as an independent risk factor affecting TSCC growth and patient prognosis. Patients who had TSCC with low levels of CDK5 expression had a higher survival rate than those with high levels. Knockdown of CDK5 reduced the proliferation, migration, and invasion of TSCC cells both in vitro and in vivo. In addition, the authors observed that CDK5 regulated the growth of TSCC through the microRNA 513c-5p/cell division cycle C25B pathway. CONCLUSIONS: CDK5 functions as an oncogene in TSCC and might serve as a molecular marker for use in the diagnosis and treatment of TSCC. LAY SUMMARY: Tongue squamous cell carcinoma (TSCC) is 1 of the most common malignant tumors of the head and neck, and the survival rate of patients with tongue cancer has been very low. Therefore, it is important to study the molecular mechanism of TSCC progression to identify biomarkers that can be used to improve its clinical diagnosis and treatment. Cyclin-dependent kinase 5 (CDK5) is an atypical member of the cyclin-dependent kinase family and is involved in regulating the cell cycle. Changes in the cell cycle are of great significance for the occurrence and development of tumor cells; and, in recent years, increasing evidence has suggested that CDK5 exists in a disordered state in cancer cells. In this study, the authors demonstrate that CDK5 functions as an oncogene in TSCC and might serve as a molecular marker for use in the diagnosis and treatment of TSCC.

HPRT1 Promotes Chemoresistance in Oral Squamous Cell Carcinoma via Activating MMP1/PI3K/Akt Signaling Pathway.

Hypoxanthine phosphoribosyl transferase 1 (HPRT1) is traditionally believed to be a housekeeping gene. However, recent reports have indicated that HPRT1 overexpression is associated with a poor prognosis in various types of cancers. Using The Cancer Genome Atlas (TCGA), HPRT1 was found to be highly expressed in various cancer types, especially in head and neck squamous cell carcinoma (HNSCC). Therefore, we measured HPRT1 expression in human cancer tissues and adjacent non-carcinoma tissues (ANT) and explored the relationship between HPRT1 expression and clinical pathological factors and prognosis in patients with oral squamous cell carcinoma (OSCC), a common type of HNSCC. We built OSCC cells with stable knockdown and overexpression of HPRT1 to observe its influence on chemoresistance and malignancy in vitro and vivo. We found that highly expressed HPRT1 was associated with a poor prognosis and could promote resistance to cisplatin (CDDP) in OSCC cells in both in vitro and in vivo. An RNA sequence assay was carried out to explore the mechanism of function of HPRT1, we found that HPRT1 could positively regulate the expression of MMP1 and the activation of the PI3K/AKT pathway, to regulate the resistance to CDDP of OSCC. In conclusion, HPRT1 can no longer be simply believed to be a housekeeping gene. HPRT1 overexpression indicates a worse prognosis and can improve CDDP resistance for patients with OSCC by promoting the MMP1/PI3K/Akt axis. HPRT1 may be a potential prognostic biomarker and therapeutic target in OSCC.

Early postoperative calcitonin-to-preoperative calcitonin ratio as a predictive marker for structural recurrence in sporadic medullary thyroid cancer: A retrospective study.

Background: Calcitonin (Ctn) is widely used as a marker in the diagnosis, prognosis, and postoperative follow-up of patients with medullary thyroid carcinoma (MTC). The prognostic value of postoperative calcitonin-to-preoperative calcitonin ratio (CR), reflecting the change in Ctn level of response to initial treatment, remains uncertain in long-term disease outcomes. This study aims to determine the cut-off value of CR for predicting structural recurrence and assess the prognostic role of CR in patients with MTC. Methods: We retrospectively reviewed patients with MTC in Sun Yat-sen University Cancer Center (SYSUCC) between 2000 and 2022. CR is defined as the ratio of postoperative Ctn level on the day of discharge divided by preoperative Ctn level. In order to determine the optimal cut-off value of CR, the receiver operating characteristic (ROC) analysis was performed. We evaluate the effect of CR on recurrence-free survival (RFS) by using the Kaplan-Meier method and Cox regression analysis. Then, a nomogram based on CR was constructed. Results: In total, 112 sporadic MTC patients were included in this study. The optimal cut-off value of CR that predicted disease recurrence was 0.125. Patients with CR≥0.125 showed significantly worse RFS than patients with CR <0.125, respectively (3-years RFS rate of 63.1 vs. 94.7%, 5-years RFS rate of 50.7 vs. 90.3%, P < 0.001). In the multivariate analysis, CR was the strongest independent predictor of structural recurrence (HR: 5.050, 95% CI: 2.247-11.349, P <0.001). Tumor size (HR: 1.321, 95% CI: 1.010-1.726, P =0.042), multifocality (HR: 2.258, 95% CI: 1.008-5.058, P =0.048) and metastasized lymph nodes (HR: 3.793, 95% CI: 1.617-8.897, P <0.001) were also independent predictors of structural recurrence. The uncorrected concordance index (c-index) of the nomogram was 0.827 (95% CI, 0.729-0.925) for RFS, and bias-corrected c-index were similar. As compared to TNM stage, the nomogram based on CR provided better discrimination accuracy. Conclusions: We demonstrate that CR is a strong prognostic marker to predict structural recurrence in patients with sporadic MTC. The nomogram incorporating CR provided useful prediction of RFS for patients with sporadic MTC to provide personalized treatment.

BASP1 is up-regulated in tongue squamous cell carcinoma and associated with a poor prognosis.

OBJECTIVE: To study the relationship between expression of brain acid soluble protein 1 (BASP1) in tongue squamous cell carcinoma (TSCC) tissue and the clinicopathological characteristics and prognosis of patients with TSCC. METHODS: Western blotting was performed to detect BASP1 expression in fresh-frozen specimens of tumor tissue and adjacent normal tissue obtained from 6 patients with TSCC. Immunohistochemical methods were used to detect BASP1 expression in 100 paraffin-embedded specimens of TSCC tissue. The chi-square test was used to analyze the association between BASP1 expression and a variety of clinicopathological parameters. A Kaplan-Meier analysis and the Cox proportional hazard model were used to further evaluate the impact of BASP1 on patient survival. RESULTS: The Oncomine database showed that BASP1 expression was increased in TSCC tissues. The PrognoScan and GEPIA databases suggested that a high level of BASP1 expression is related to a poor prognosis for patients with head and neck cancer. Experimental results showed that when compared to normal tissues adjacent to a cancer, BASP1 was more highly expressed in the TSCC tissues. Univariate and multivariate Cox regression analyses showed that BASP1 expression and the tumor's stage may be independent risk factors that affect the growth and prognosis of TSCC. A survival analysis showed that patients with a low level of BASP1 expression had a higher survival rate. CONCLUSION: Overexpression of BASP1 was found to be associated with distant node metastasis and a poor prognosis among patents with TSCC. BASP1 could possibly serve as a molecular marker for diagnosing and treating the disease.

Low Molecular Weight Heparin Improves the Inflammatory State of Acute Sinusitis Rats Through Inhibiting the TLR4-MyD88-NF-κB Signaling Pathway.

Introduction: Low molecular weight heparin (LMWH), a natural sulfated glycosaminoglycan with an affinity for proangiogenic factors, is produced by chemical or enzymatic depolymerization of unfractionated heparin (UFH). Known for its anticoagulant effects, LMWH has recently been reported to have a strong anti-inflammatory effect on colitis, myocarditis, and airway inflammation. However, as a newly-developed drug, its anti-inflammatory mechanism in upper respiratory tract inflammation has not been well-studied. Methods: SD rats were randomly divided into control and experimental groups. The experimental group was established by building an acute nasal sinusitis model with expansion sponges mixed with Streptococcus pneumoniae. Then the experimental group rats were subcutaneously injected with different concentrations of LMWH. After seven consecutive days of injection, some rats were sacrificed, and blood and nasal mucosa samples were taken to determine their inflammation status. The remaining acute sinusitis rats were randomly selected for a week of nasal irrigation with normal saline or saline mixed with different concentrations of LMWH. One week later, rats were sacrificed, and samples of blood and nasal mucosa were taken to determine the inflammation status. Results: Rat nasal mucosa in the model group had obvious inflammation. The degree of nasal mucosa inflammation damage in the experimental group was lower than in the experimental control group, proving that LMWH has a protective effect on the nasal mucosa and that the effect correlates with dosage. Irrigation of the nose with saline mixed with LMWH can improve the anti-inflammatory effect. Protein related to the TLR4-MyD88-NF-κB signaling pathway was activated in the acute sinusitis rat model, and LMWH can significantly inhibit its expression. Conclusion: This is the first report of the anti-inflammatory effect of LMWH in acute upper respiratory tract inflammation, together with an explanation of its anti-inflammatory mechanism. The findings contribute a theoretical basis for its potential anti-tumor effect.

Brain Metastases From Differentiated Thyroid Carcinoma: A Retrospective Study of 22 Patients.

Background: Brain metastasis from differentiated thyroid cancer has followed a similar increasing trend to that of thyroid cancer in recent years. However, the characteristics and treatments for brain metastases are unclear. The aim of this study was to understand this disease by analyzing patients with brain metastases from differentiated thyroid cancer (DTC). Methods: Between 2000 and 2020, the database of the Sun Yat-sen University Cancer Center was searched for differentiated thyroid cancer patients. We identified a cohort of 22 patients with brain metastases. The characteristics of the patients, histological features, treatments, and time of death were reviewed. The overall survival (OS) rate was calculated using the Kaplan Meier method. Survival curves of different subgroups were compared according to baseline characteristics and treatments received. Results: A total of 22 (1.09%) out of 2013 DTC patients in the Sun Yat-sen University Cancer Center database were identified as having brain metastases. The overall median survival time was 17.5 months (range from 1-60 months) after diagnosis of brain metastasis. Performance statue (PS), tumor site, and neurosurgery impacted survival, according to Kaplan-Meier analysis. Prognosis of skull metastasis was superior to that of intracranial types. Neurosurgery was the only type of treatment that had an impact on patient OS. Conclusions: Brain metastasis from differentiated thyroid cancer has a poor prognosis. However, it can be improved by comprehensive treatment. PS of the patients can greatly affect survival. Skull metastases have improved prognosis over intracranial types. Radioiodine therapy (RAIT) appears to effectively improve the prognosis of patients with skull metastases from DTC.

Effect of Graves' disease on the prognosis of differentiated thyroid carcinoma: a meta-analysis.

PURPOSE: Several studies have reported different findings on the prognosis of differentiated thyroid carcinoma combined with Graves' disease. To assess the effect of Graves' disease on differentiated thyroid carcinoma, a meta-analysis was undertaken. METHODS: PubMed, OVID and the Cochrane Library were systematically searched for trials published prior to Oct. 2018. Studies containing data on the outcomes of Graves' disease with differentiated thyroid carcinoma were included. Summary estimates of the prevalence of recurrence/disease progression/persistence and mortality as well as odds ratios and weighted mean differences were calculated with a random-effects model. RESULTS: Of the 916 related articles found, 13 fulfilled the inclusion criteria. The recurrence/disease progression/persistent rate was not significantly different between the Graves' disease group and the non-Graves' disease group (P = 0.86). However, the analysis of three studies with K-M curves or HRs showed that there was a significant difference between the two groups (P = 0.04). Subgroup analysis showed that the contradictory results could be due to the location/race assessed in the studies. Graves' disease almost acted as a risk factor (OR = 1.77, 95%C.I. = 0.99-3.16) for differentiated thyroid carcinoma in European studies. When heterogeneous studies were excluded, the analyses show that GD was a risk factor for recurrence/disease progression/persistence (P = 0.03, OR = 1.75, 95%C.I. = 1.04-2.95). The overall mortality rate was significantly higher in the Graves' disease group than in the non-Graves' disease group (P = 0.02, OR = 2.93, 95%C.I. = 1.17-7.37). CONCLUSIONS: Graves' disease acts as a risk factor for the prognosis of differentiated thyroid carcinoma. The recurrence/disease progression/persistent rate may be affected by TSAbs in a specific location/race and with a genetic immunization background. However, the histotypes and subtypes may play an important role in mortality rate.