Liu Yan, Liu Zeming, Zhao Qiuyang, Hua Teng, Chi Shuqi, Huang Tao, Wang Hongbo
Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Oncotarget. 2017 Oct 11;8(60):101623-101633. doi: 10.18632/oncotarget.21826. eCollection 2017 Nov 24.
Insular thyroid carcinoma (ITC) is an uncommon thyroid malignancy with an unclear prognosis. The aim of this study was to determine the prognoses of patients with ITC. We investigated a large cohort of patients with differentiated thyroid cancer from the Surveillance, Epidemiology, and End Results (SEER) database who were registered between 2004 and 2013, and compared the prognosis of patients with ITC to those with classic papillary thyroid cancer (CPTC) and follicular thyroid cancer (FTC). Patient mortality was determined using Kaplan-Meier analyses with log-rank tests, as well as Cox proportional hazards regression analyses. The study cohort comprised of 165 patients with ITC, 5419 patients with FTC, and 60739 patients with CPTC. The rate of cancer-specific mortality per 1000 person-years for ITC was higher than that for CPTC or FTC. According to multivariate Cox regression analysis, however, the cancer-specific and all-cause mortality rates of ITC were similar to those of CPTC and FTC. The cancer-specific survival rate in patients with ITC was higher than that in patients with CPTC, but similar to that in patients with FTC, after adjusting for potentially influencing factors using propensity score matching analysis. These findings, which contrast with previously published data, provide new implications for the treatment of patients with ITC.
甲状腺内癌（ITC）是一种预后不明的罕见甲状腺恶性肿瘤。本研究的目的是确定ITC患者的预后情况。我们调查了监测、流行病学和最终结果（SEER）数据库中一大群2004年至2013年间登记的分化型甲状腺癌患者，并将ITC患者的预后与经典乳头状甲状腺癌（CPTC）和滤泡状甲状腺癌（FTC）患者的预后进行比较。使用Kaplan-Meier分析和对数秩检验以及Cox比例风险回归分析来确定患者死亡率。研究队列包括165例ITC患者、5419例FTC患者和60739例CPTC患者。ITC每1000人年的癌症特异性死亡率高于CPTC或FTC。然而，根据多变量Cox回归分析，ITC的癌症特异性死亡率和全因死亡率与CPTC和FTC相似。在使用倾向评分匹配分析调整潜在影响因素后，ITC患者的癌症特异性生存率高于CPTC患者，但与FTC患者相似。这些与先前发表的数据形成对比的发现，为ITC患者的治疗提供了新的启示。
