Department of Nuclear Medicine, Chonnam National University Hwasun Hospital.
Department of Nuclear Medicine, Chonnam National University Medical School.
Nucl Med Commun. 2020 Aug;41(8):733-739. doi: 10.1097/MNM.0000000000001214.
The aim of this study was to evaluate a prognostic value of the extent of metastatic lymph node combined with TSH-stimulated serum thyroglobulin (sTg) measured just before radioactive iodine (RAI) therapy in patients with papillary thyroid cancer (PTC).
The retrospective study included 468 patients with PTC who underwent total thyroidectomy with neck dissection and postoperative RAI therapy. The extent of metastatic lymph node was evaluated with the lymph node ratio (LNR) which was defined as the number of metastatic lymph nodes out of the number of total removed lymph nodes. We investigated which factors could significantly predict persistent or recurrent disease (PRD).
LNR ≥0.4 (P = 0.002) and sTg ≥6.0 ng/mL (P < 0.001) were associated with PRD in univariate analysis. In multivariate analysis, only male [hazard ratio: 2.35, 95% confidence interval (CI): 1.18-4.66, P = 0.014] and sTg (hazard ratio: 9.35, 95% CI: 4.44-19.67, P < 0.001) were associated with PRD prediction. When we divided patients into two groups (patients with sTg level < 6.0 ng/mL and those with sTg level ≥ 6.0 ng/mL), LNR (≥0.4) was a significant predictor of PRD in patients with sTg <6.0 ng/mL (hazard ratio: 4.38, 95% CI: 1.22-15.72, P = 0.024).
LNR ≥0.4 was a significant predictor of PRD when the sTg level was <6.0 ng/mL. LNR should be used in combination with a relatively low level of serum sTg to predict the prognosis of patients with PTC.
本研究旨在评估甲状腺乳头状癌（PTC）患者在放射性碘（RAI）治疗前测定的转移淋巴结数量与 TSH 刺激的血清甲状腺球蛋白（sTg）水平联合的程度对预后的预测价值。
本回顾性研究纳入了 468 例接受全甲状腺切除术和颈部淋巴结清扫术及术后 RAI 治疗的 PTC 患者。通过淋巴结比率（LNR）评估转移淋巴结的程度，LNR 定义为转移淋巴结数与切除的总淋巴结数之比。我们研究了哪些因素可以显著预测持续性或复发性疾病（PRD）。
单因素分析中，LNR≥0.4（P=0.002）和 sTg≥6.0ng/ml（P<0.001）与 PRD 相关。多因素分析中，仅男性[风险比：2.35，95%置信区间（CI）：1.18-4.66，P=0.014]和 sTg（风险比：9.35，95%CI：4.44-19.67，P<0.001）与 PRD 预测相关。当我们将患者分为两组（sTg 水平<6.0ng/ml 和 sTg 水平≥6.0ng/ml）时，LNR（≥0.4）是 sTg<6.0ng/ml 患者 PRD 的显著预测因素（风险比：4.38，95%CI：1.22-15.72，P=0.024）。
当 sTg 水平<6.0ng/ml 时，LNR≥0.4 是 PRD 的显著预测因素。LNR 应与相对较低的血清 sTg 水平联合使用，以预测 PTC 患者的预后。
