Risk Factors for TERT Promoter Mutations with Papillary Thyroid Carcinoma Patients: A Meta-Analysis and Systematic Review

Abstract

Whether TERT promoter mutation is related to more aggressive clinicopathologic features and worse outcomes in papillary thyroid carcinoma patients (PTCs) is still variable and controversial. Our intention was to investigate the risk or prognostic factors that may additionally predict the TERT promoter mutation doable of these lesions and new prevention techniques in PTCs. A total of 2,539 PTC patients with 11.50% TERT mutation have been analyzed using Revman 5.3 software in this study. The PubMed and Embase databases were systematically searched for works published until November 9, 2021. The following variables had been associated with an extended chance of TERT promoter mutation in PTC patients: $\text{age}<45$ years ( $\text{MD}=10.93$ , $95\%\text{CI}=7.25–14.61$ ); $\text{gender}=\text{male}$ ( $\text{pooled}\text{OR}=1.63$ , $95\%\text{CI}=1.17–2.28$ ); $\text{tumor}\text{size}>1\text{cm}$ ( $\text{MD}=0.56$ , $95\%\text{CI}=0.34–0.77$ ); lymph node metastasis ( $\text{pooled}\text{OR}=1.29$ , $95\%\text{CI}=0.93–1.79$ ); vascular invasion ( $\text{pooled}\text{OR}=1.78$ , $95\%\text{CI}=0.83–3.84$ ); extrathyroidal extension ( $\text{pooled}\text{OR}=2.00$ , $95\%\text{CI}=1.32–3.02$ ); distant metastasis ( $\text{pooled}\text{OR}=1.46$ , $95\%\text{CI}=1.04–2.04$ ); advanced TNM stage ( $\text{pooled}\text{OR}=3.19$ , $95\%\text{CI}=2.28–4.45$ ). In addition, multifocality ( $\text{pooled}\text{OR}=0.67$ , $95\%\text{CI}=0.14–3.24$ ) had no affiliation with TERT promoter mutation in PTC patients. Our finding showed that $\text{age}<45$ years, male, $\text{tumor}\text{size}>1\text{cm}$ , lymph node metastasis, vascular invasion, and superior/advanced TNM stage were dangerous elements for TERT promoter mutation of worse effect in PTCs while that multifocality was once negatively correlated. TERT promoter mutation is drastically associated with recurrence and PTC-related mortality.