血液学指标可用于预测鼻咽癌患者放疗后发生甲状腺功能减退症的概率。

Hematological Indexes Can Be Used to Predict the Incidence of Hypothyroidism in Nasopharyngeal Carcinoma Patients after Radiotherapy.

机构信息

Institute of Cancer and Basic Medical (ICBM), Chinese Academy of Sciences, Hangzhou, China.

Department of Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences, Hangzhou, China.

出版信息

Biomed Res Int. 2020 May 11;2020:3860936. doi: 10.1155/2020/3860936. eCollection 2020.

DOI:10.1155/2020/3860936

PMID:32461982

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7243020/

Abstract

BACKGROUND

This study explored the relationship between thyroid-associated antibodies, immune cells, and hypothyroidism to establish a predictive model for the incidence of hypothyroidism in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.

METHODS

A total of 170 patients with NPC treated at the Cancer Hospital of University of Chinese Academy of Sciences between January 2015 and August 2018 were included. The complete blood count, biochemical, coagulation function, immune cells, and thyroid-associated antibodies tested before radiotherapy were evaluated. A logistic regression model was performed to elucidate which hematological indexes were related to hypothyroidism development. A predictive model for the incidence of hypothyroidism was established. Internal verification of the multifactor model was performed using the tenfold cross-validation method.

RESULTS

The univariate analysis showed that immune cells had no statistically significant differences among the patients with and without hypothyroidism. Sex, N-stage, antithyroid peroxidase antibody (TPO-Ab), antithyroglobulin antibody (TG-Ab), thyroglobulin (TG), and fibrinogen (Fb) were associated with hypothyroidism. Males and early N-stage were protective factors of thyroid function, whereas increases in TPO-Ab, TG-Ab, TG, and Fb counts were associated with an increased rate of hypothyroidism incidence. The multivariate analysis showed that TPO-Ab, TG-Ab, TG, and Fb were independent predictors of hypothyroidism. The comprehensive effect of the significant model, including TPO-Ab, TG-Ab, TG, and Fb counts, represented the optimal method of predicting the incidence of radiation-induced hypothyroidism (AUC = 0.796). Tenfold cross-validation methods were applied for internal validation. The AUCs of the training and testing sets were 0.792 and 0.798, respectively.

CONCLUSION

A model combining TPO-Ab, TG-Ab, TG, and Fb can be used to screen populations at a high risk of developing hypothyroidism after radiotherapy.

摘要

背景

本研究旨在探讨甲状腺相关抗体、免疫细胞与甲状腺功能减退症之间的关系，以期建立预测鼻咽癌（NPC）患者放疗后甲状腺功能减退症发生的模型。

方法

选取 2015 年 1 月至 2018 年 8 月在中国科学院大学附属肿瘤医院接受治疗的 170 例 NPC 患者，评估其放疗前全血细胞计数、生化、凝血功能、免疫细胞和甲状腺相关抗体。采用 logistic 回归模型阐明与甲状腺功能减退症发生相关的血液学指标。建立甲状腺功能减退症发生的预测模型，并采用 10 折交叉验证方法对多因素模型进行内部验证。

结果

单因素分析显示，甲状腺功能减退症患者与无甲状腺功能减退症患者之间的免疫细胞无统计学差异。性别、N 分期、抗甲状腺过氧化物酶抗体（TPO-Ab）、抗甲状腺球蛋白抗体（TG-Ab）、甲状腺球蛋白（TG）和纤维蛋白原（Fb）与甲状腺功能减退症相关。男性和早期 N 期是甲状腺功能的保护因素，而 TPO-Ab、TG-Ab、TG 和 Fb 计数的增加与甲状腺功能减退症发生率的增加相关。多因素分析显示，TPO-Ab、TG-Ab、TG 和 Fb 是甲状腺功能减退症的独立预测因子。包括 TPO-Ab、TG-Ab、TG 和 Fb 计数在内的显著模型的综合效应代表了预测放射性甲状腺功能减退症发生的最佳方法（AUC=0.796）。采用 10 折交叉验证方法进行内部验证。训练集和测试集的 AUC 分别为 0.792 和 0.798。