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甲状腺乳头状癌患者治疗反应的血液预后预测因子。

Blood prognostic predictors of treatment response for patients with papillary thyroid cancer.

机构信息

Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.

Department of Nuclear Medicine, Sir Run Run Shaw Hospital Affiliated to School of Medicine, Zhejiang Universtity, Hangzhou, Zhejiang, P.R. China.

出版信息

Biosci Rep. 2020 Oct 30;40(10). doi: 10.1042/BSR20202544.

Abstract

BACKGROUND

Papillary thyroid cancer (PTC) is a very common malignant disease with high morbidity. We needed some pretreatment indicators to help us predict prognosis and guide treatment. We conducted a study about some pretreatment prognostic indicators.

METHODS

This clinical study recruited 705 postoperative PTC patients (211 males, 494 females). Clinical data before radioactive iodine (RAI) treatment were collected. Patients' response to therapy were classified into two categories: 'Good Prognosis Group' (GPG) and 'Poor Prognosis Group' (PPG), according to '2015 American Thyroid Association Guidelines'. Differences of indicators between different prognosis groups were compared. Odds ratios (ORs) were calculated by univariate/multiple binary logistic regression models. Difference of body mass index (BMI) changes before and after RAI treatment between different prognosis groups was also compared.

RESULTS

A total of 546 (77.45%) belonged to GPG, and 159 (22.55%) belonged to PPG. Platelet (PLT), neutrophil (NEUT), PLT subgroups, and combination of red blood cell distribution width (RDW) and BMI (COR-BMI) were different between two prognosis groups. The significance of the difference between the two groups of BMI disappeared after the Bonferroni correction. PLT and PLT subgroups had detrimental effects on the risk of PPG; T stage had a positive effect on the risk of PPG. PLT subgroup showed a detrimental effect on the risk of PPG when we included additional covariates.

CONCLUSIONS

We found that lower pretreatment PLT levels may indicate a poor prognosis for PTC. The relationship between platelet-derived growth factor (PDGF) and radiation sensitivity may be the key to this association.

摘要

背景

甲状腺乳头状癌(PTC)是一种发病率很高的常见恶性疾病。我们需要一些治疗前的指标来帮助我们预测预后并指导治疗。我们进行了一项关于一些治疗前预后指标的研究。

方法

本临床研究纳入了 705 例术后 PTC 患者(211 例男性,494 例女性)。收集了放射性碘(RAI)治疗前的临床资料。根据“2015 年美国甲状腺协会指南”,将患者的治疗反应分为“预后良好组”(GPG)和“预后不良组”(PPG)。比较不同预后组之间指标的差异。采用单因素/多因素二项逻辑回归模型计算比值比(OR)。比较不同预后组之间 RAI 治疗前后体重指数(BMI)变化的差异。

结果

共有 546 例(77.45%)属于 GPG,159 例(22.55%)属于 PPG。两组间血小板(PLT)、中性粒细胞(NEUT)、PLT 亚群以及红细胞分布宽度(RDW)和 BMI 的组合(COR-BMI)存在差异。两组间 BMI 差异在 Bonferroni 校正后无统计学意义。PLT 和 PLT 亚群对 PPG 的发病风险有不利影响;T 分期对 PPG 的发病风险有正向影响。当我们纳入更多的协变量时,PLT 亚群对 PPG 的发病风险有不利影响。

结论

我们发现,较低的治疗前 PLT 水平可能预示着 PTC 的预后不良。血小板衍生生长因子(PDGF)与辐射敏感性之间的关系可能是这种关联的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abfc/7578621/65b702ef94e1/bsr-40-bsr20202544-g1.jpg

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