The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
Wenzhou Medical University, Wenzhou, 325600, Zhejiang Province, China.
BMC Cancer. 2021 Apr 1;21(1):344. doi: 10.1186/s12885-021-07953-y.
To investigate the factors that affect postoperative recurrence in medullary thyroid carcinoma (MTC) patients, including preoperative ultrasonic characteristics and other factors.
A retrospective analysis of 7 MTC patients who underwent the first thyroid surgery from 2009 to 2018 and who had complete follow-up data was conducted. According to the follow-up results, these patients were divided into the recurrence group (17 cases) and non-recurrence group (57 cases). The preoperative ultrasound characteristics, preoperative and postoperative calcitonin levels, and general informations of the two groups were recorded, respectively. Univariate and multivariate analyses were performed.
Single factor Kaplan-Meier (K-M) analysis showed that: ① Preoperative ultrasonic characteristics including tumor size > 40.0 mm, capsular invasion, and metastatic cervical lymph nodes, as well as preoperative calcitonin level > 565.8 pg/ml, and postoperative calcitonin (within one week) level > 45.0 pg/ml were positively correlated with the risk of postoperative recurrence of MTC (P < 0.05); ② There was no evidence to show that sex and age had a statistically significant effect on postoperative recurrence of MTC (P > 0.05). Multivariate Cox regression analysis showed that metastatic lymph nodes shown by ultrasound (HR = 5.368, 95%CI 1.063-27.104, P = 0.042) was an independent risk factor for postoperative recurrence of MTC.
MTC patients with metastatic lymph nodes shown by ultrasound are prone to postoperative recurrence of MTC. In addition, MTC patients with a tumor > 40.0 mm, capsular invasion, preoperative calcitonin level > 565.8 pg/ml, and postoperative calcitonin level > 45.0 pg/ml are more likely to have postoperative recurrence.
为了研究影响甲状腺髓样癌（MTC）患者术后复发的因素，包括术前超声特征和其他因素。
回顾性分析 2009 年至 2018 年期间首次接受甲状腺手术的 7 例 MTC 患者，这些患者均有完整的随访资料。根据随访结果，将这些患者分为复发组（17 例）和非复发组（57 例）。记录两组患者的术前超声特征、术前和术后降钙素水平以及一般信息。分别进行单因素和多因素分析。
单因素 Kaplan-Meier（K-M）分析显示：①术前超声特征包括肿瘤大小>40.0mm、包膜侵犯和转移性颈部淋巴结，以及术前降钙素水平>565.8pg/ml 和术后降钙素（一周内）水平>45.0pg/ml，与 MTC 术后复发的风险呈正相关（P<0.05）；②性别和年龄与 MTC 术后复发无统计学显著影响（P>0.05）。多因素 Cox 回归分析显示，超声显示的转移性淋巴结（HR=5.368，95%CI 1.063-27.104，P=0.042）是 MTC 术后复发的独立危险因素。
超声显示有淋巴结转移的 MTC 患者易发生 MTC 术后复发。此外，肿瘤大小>40.0mm、包膜侵犯、术前降钙素水平>565.8pg/ml 和术后降钙素水平>45.0pg/ml 的 MTC 患者术后更易复发。
