Intraglandular Dissemination Is a Risk Factor for Lymph Node Metastasis and Recurrence in Papillary Thyroid Carcinoma: A Propensity Score Matching Analysis.

IF 2.2 3区 医学 Q1 OTORHINOLARYNGOLOGY
Tiantian Yu, Zishuo Liu, Jingyu Ma, Peng Su, Xiaoyu Ji, Nan Liu, Changyuan Ding, Zhenpeng Yang, Weili Liang, Bin Lv
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Abstract

Background: Intraglandular dissemination (ID) is an important clinicopathological feature, but the statistical evidence of its relationship with lymph node metastasis (LNM) and the prognosis of papillary thyroid carcinoma (PTC) has not been widely reported in the literature. The purpose of this study was to investigate the potential correlation between ID, LNM, and prognosis in PTC patients.

Methods: Patients with PTC were retrospectively collected from Qilu Hospital of Shandong University from 2017 to 2019 and categorized into two groups based on postoperative routine pathology: intraglandular dissemination group (ID group) and the non-intraglandular dissemination group (NID group). The propensity score matching (PSM) was used to analyze and compare the differences in LNM and prognosis between groups.

Results: Among the 2845 patients included in the study, 6.85% had ID. After PSM matching, ID was associated with an increased risk of LNM (OR: 2.143, 95% CI: 1.279-3.591, p = 0.004) and recurrence in PTC patients (HR: 6.585, 95% CI: 1.782-24.335, p = 0.005). Kaplan-Meier curves showed that the recurrence-free survival (RFS) of the ID group before and after PSM was worse than that of the NID group (95.3% vs. 99.0%, p < 0.001; 95.0% vs. 99.0%, p = 0.011).

Conclusion: ID is an independent risk factor for LNM (includes microscopic metastasis) and postoperative recurrence in PTC patients. The recurrence rate of ID-PTC patients with markers of aggressive disease is higher than that of ID-PTC patients alone. Patients with ID-PTC require more intensive follow-up to monitor for recurrence. The necessity of more extensive lymph node dissection for these patients may need to be validated by future multi-center, prospective studies.

腺内播散是甲状腺乳头状癌淋巴结转移和复发的危险因素:倾向评分匹配分析。
背景:腺内播散(ID)是重要的临床病理特征,但其与甲状腺乳头状癌(PTC)淋巴结转移(LNM)及预后关系的统计学证据尚未被广泛报道。本研究的目的是探讨PTC患者ID、LNM与预后之间的潜在相关性。方法:回顾性收集2017 - 2019年山东大学齐鲁医院PTC患者,根据术后常规病理分为腺内播散组(ID组)和非腺内播散组(NID组)。采用倾向评分匹配(PSM)分析比较两组患者LNM及预后的差异。结果:纳入研究的2845例患者中,有6.85%的患者患有ID。PSM匹配后,ID与PTC患者LNM (OR: 2.143, 95% CI: 1.279-3.591, p = 0.004)和复发风险增加相关(HR: 6.585, 95% CI: 1.782-24.335, p = 0.005)。Kaplan-Meier曲线显示,PSM前后ID组的无复发生存率(RFS)较NID组差(95.3% vs. 99.0%), p结论:ID是PTC患者LNM(包括显微转移)和术后复发的独立危险因素。伴有侵袭性疾病标志物的ID-PTC患者的复发率高于单独的ID-PTC患者。ID-PTC患者需要更密切的随访以监测复发。对这些患者进行更广泛淋巴结清扫的必要性可能需要通过未来的多中心前瞻性研究来验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.00
自引率
6.90%
发文量
278
审稿时长
1.6 months
期刊介绍: Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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