确定 MACIS 评分的截断值以预测儿童和青年分化型甲状腺癌的预后。
Identification of a cut-off for the MACIS score to predict the prognosis of differentiated thyroid carcinoma in children and young adults.
机构信息
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
Head Neck. 2012 May;34(5):696-701. doi: 10.1002/hed.21808. Epub 2011 Jul 11.
BACKGROUND
The metastases, age at diagnosis, completeness of resection, invasion, size of the tumor (MACIS) scoring system was developed to predict disease-specific survival in patients with differentiated thyroid carcinoma (DTC), mainly for adults, with a cut-off score of 6. The purpose of this study was to evaluate its ability to predict prognosis of DTC in children and young adults.
METHODS
The medical records of 66 children and young adult (<21 years old) patients with DTC were reviewed retrospectively. Receiver operating characteristic (ROC) analysis was performed to determine the cut-off for predicting poor prognosis.
RESULTS
Extrathyroidal invasion and regional lymph node metastasis were noted in 64% each, and distant metastases were found in 8%. The optimal cut-off for the MACIS score for poor prognosis was 4 (93% sensitivity, 67% specificity). The overall 10-year recurrence-free survival was better in patients with MACIS score <4 than score ≥4 (p < .05).
CONCLUSION
A MACIS score of more than 4 was associated with a poor prognosis in children and young adult patients with DTC.
背景
MACIS 评分系统是为预测分化型甲状腺癌（DTC）患者的疾病特异性生存而开发的，该评分系统考虑了转移、诊断时的年龄、切除的完整性、侵袭性、肿瘤大小（MACIS），主要针对成年人，截断值为 6。本研究旨在评估其预测儿童和年轻成人 DTC 预后的能力。
方法
回顾性分析 66 例儿童和年轻成人（<21 岁）DTC 患者的病历。采用接收者操作特征（ROC）分析确定预测不良预后的截断值。
结果
甲状腺外侵犯和区域淋巴结转移各占 64%，远处转移占 8%。MACIS 评分预测不良预后的最佳截断值为 4（敏感性为 93%，特异性为 67%）。MACIS 评分<4 的患者总 10 年无复发生存率优于评分≥4 的患者（p<0.05）。
结论
MACIS 评分>4 与儿童和年轻成人 DTC 患者的不良预后相关。
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