淋巴转移性甲状腺乳头状癌治疗反应的预测因素:组织病理学研究。

IF 5.3 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
C. V. van Kinschot, Lindsey Oudijk, C. van Noord, T. Korevaar, F H van Nederveen, Robin P Peeters, F. V. van Kemenade, W. E. Visser
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引用次数: 0

摘要

背景甲状腺乳头状癌(PTC)的淋巴结转移会增加疾病持续和复发的风险。然而,有关淋巴结转移组织病理学特征预测价值的数据并不一致。方法根据预定方案重新检查了 129 名 PTC 患者的 1042 个淋巴结转移灶,并评估了直径、结节外扩展、囊性改变、坏死、钙化和肿瘤细胞占淋巴结的比例。结果淋巴结转移超过 5 个是唯一预测治疗完全反应失败的独立因素(OR 3.39 [95% CI 1.57-7.33],P < 0.05)。结论对淋巴结的详细复查显示,只有出现 5 个以上淋巴结转移才是治疗完全反应失败的独立预测因素。其他组织病理学特征(包括淋巴结转移灶的直径)没有预测价值。这些发现有望改善对患有 PTC 并有临床明显淋巴结转移的患者的风险分层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of treatment response in lymphogenic metastasized papillary thyroid cancer: a histopathological study.
BACKGROUND Lymph node metastases in papillary thyroid cancer (PTC) increase the risk for persistent and recurrent disease. Data on the predictive value of histopathological features of lymph node metastases, however, are inconsistent. The aim of this study was to evaluate the prognostic significance of known and new histopathological features of lymph node metastases in a well-defined cohort of PTC patients with clinically evident lymph node metastases. METHODS A total of 1042 lymph node metastases, derived from 129 PTC patients, were re-examined according to a predefined protocol and evaluated for diameter, extranodal extension, cystic changes, necrosis, calcifications and the proportion of the lymph node taken up by tumor cells. Predictors for a failure to achieve a complete biochemical and structural response to treatment were determined. RESULTS The presence of more than 5 lymph node metastases was the only independent predictor for a failure to achieve a complete response to treatment (OR 3.39 [95% CI 1.57-7.33], p < 0.05). Diameter nor any of the other evaluated lymph node features were significantly associated with the response to treatment. CONCLUSIONS Detailed re-examination of lymph nodes revealed that only the presence of more than 5 lymph node metastases was an independent predictor of failure to achieve a complete response to treatment. No predictive value was found for other histopathological features, including the diameter of the lymph node metastases. These findings have the potential to improve risk stratification in patients with PTC and clinically evident lymph node metastases.
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来源期刊
European Journal of Endocrinology
European Journal of Endocrinology 医学-内分泌学与代谢
CiteScore
9.80
自引率
3.40%
发文量
354
审稿时长
1 months
期刊介绍: European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.
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