甲状腺乳头状癌颈侧区淋巴结转移率对复发的预测价值。
Predictive value of metastatic cervical lymph node ratio in papillary thyroid carcinoma recurrence.
机构信息
Department of Medicine, Endocrine Division, University of Toronto, Toronto, Ontario, Canada.
出版信息
Head Neck. 2013 Apr;35(4):592-8. doi: 10.1002/hed.23047. Epub 2012 Jun 23.
BACKGROUND
The purpose of this study was to determine whether the proportion of metastatic cervical lymph nodes resected (metastatic lymph node ratio [MLNR]) predicted papillary thyroid carcinoma (PTC) recurrence, and whether MLNR could alter the predictive ability of TNM nodal classification for recurrence in PTC.
METHODS
We conducted a retrospective review of patients with PTC who underwent a total or near-total thyroidectomy with at least 1 lymph node removed at our institution.
RESULTS
Of 253 patients, 35 (13.8%) developed recurrent disease. The total MLNR (ratio between total metastatic lymph nodes and total number of lymph nodes resected) independently predicted PTC recurrence (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.010-1.039; p = .001). In receiver operating characteristic (ROC) curve analysis, TNM nodal classification with total MLNR had greater accuracy in predicting PTC recurrence than did TNM nodal classification alone (0.726 and 0.675, respectively).
CONCLUSION
MLNR is an independent predictor of PTC recurrence and enhances the predictive value of TNM nodal classification.
背景
本研究旨在确定切除的转移性颈淋巴结比例（转移性淋巴结比[MLNR]）是否可以预测甲状腺乳头状癌（PTC）的复发，以及 MLNR 是否可以改变 TNM 淋巴结分类对 PTC 复发的预测能力。
方法
我们对在我院接受全甲状腺或近全甲状腺切除术且至少切除 1 个淋巴结的 PTC 患者进行了回顾性研究。
结果
在 253 例患者中，有 35 例（13.8%）发生了疾病复发。总 MLNR（转移淋巴结总数与切除淋巴结总数之比）独立预测 PTC 复发（优势比[OR]，1.024；95%置信区间[CI]，1.010-1.039；p =.001）。在接收者操作特征（ROC）曲线分析中，总 MLNR 联合 TNM 淋巴结分类比单独 TNM 淋巴结分类更能准确预测 PTC 复发（分别为 0.726 和 0.675）。
结论
MLNR 是 PTC 复发的独立预测指标，并增强了 TNM 淋巴结分类的预测价值。
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