男性性别是甲状腺微小乳头状癌的一个预后因素吗？
Is Male Gender a Prognostic Factor for Papillary Thyroid Microcarcinoma?
作者信息
Lee Yi Ho, Lee Yu Mi, Sung Tae Yon, Yoon Jong Ho, Song Dong Eun, Kim Tae Yong, Baek Jung Hwan, Ryu Jin Suk, Chung Ki Wook, Hong Suck Joon
机构信息
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
出版信息
Ann Surg Oncol. 2017 Jul;24(7):1958-1964. doi: 10.1245/s10434-017-5788-4. Epub 2017 Jan 27.
BACKGROUND
Male gender is a prognostic factor of poor outcome in papillary thyroid carcinoma (PTC). We investigated the prognostic role of male gender in papillary thyroid microcarcinoma (PTMC).
METHODS
We included 2930 patients who underwent surgery at Asan Medical Center for PTC. Clinicopathologic characteristics from the patients' medical records were compared for male and female PTC patients. Independent prognostic factors for recurrence in PTC and PTMC were evaluated after propensity score matching analysis. The median follow-up period was 82 months.
RESULTS
Recurrence and death were more common in male patients with PTC than in female patients with PTC (12.6 vs. 9.6%, p = 0.03 and 2.2 vs. 0.6%, p < 0.001, respectively). However, there was no difference in disease-free survival between male and female PTMC patients (p = 0.57). Multivariate analysis after propensity score matching revealed that male gender is not an independent prognostic factor of recurrence in PTMC (hazard ratio [HR] 1.5, 95% confidence interval 0.75-5.33, p = 0.17), but that it is an independent prognostic factor in PTC >1 cm (HR = 3.06, 95% confidence interval 1.34-6.98, p = 0.008).
CONCLUSIONS
Male gender is an independent prognostic factor for recurrence in PTC >1 cm, but it is not a prognostic factor in PTMC.
背景
男性是甲状腺乳头状癌（PTC）预后不良的一个因素。我们研究了男性在甲状腺微小乳头状癌（PTMC）中的预后作用。
方法
我们纳入了2930例在峨山医学中心接受PTC手术的患者。比较了男性和女性PTC患者病历中的临床病理特征。在倾向得分匹配分析后，评估了PTC和PTMC复发的独立预后因素。中位随访期为82个月。
结果
PTC男性患者的复发和死亡比女性患者更常见（分别为12.6%对9.6%，p = 0.03；2.2%对0.6%，p < 0.001）。然而，PTMC男性和女性患者的无病生存率没有差异（p = 0.57）。倾向得分匹配后的多变量分析显示，男性不是PTMC复发的独立预后因素（风险比[HR] 1.5，95%置信区间0.75 - 5.33，p = 0.17），但在直径>1 cm的PTC中是独立预后因素（HR = 3.06，95%置信区间1.34 - 6.98，p = 0.008）。
结论
男性是直径>1 cm的PTC复发的独立预后因素，但不是PTMC的预后因素。
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