儿童和青少年甲状腺自身抗体与甲状腺乳头状癌复发的关系
Relationship Between Thyroid Autoantibodies and Recurrence of Papillary Thyroid Carcinoma in Children and Adolescents.
作者信息
Huang Dongmei, Zhi Jingtai, Zhang Jinming, Qin Xuan, Zhao Jingzhu, Zheng Xiangqian, Gao Ming
机构信息
Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Department of Thyroid and Breast Surgery, Tianjin Union Medical Center, Tianjin, China.
出版信息
Front Oncol. 2022 Jun 8;12:883591. doi: 10.3389/fonc.2022.883591. eCollection 2022.
BACKGROUND
Numerous studies reported connection between papillary thyroid carcinoma (PTC) and thyroid autoantibody in adults, but few of them have investigated whether there is a similar link in children and adolescents. The purpose of this research was to explore the relationship between clinicopathological features, prognosis and preoperative thyroid peroxidase antibody (TPOAb) as well as thyroglobulin antibody (TgAb) status in children and adolescents with PTC.
METHODS
This study retrospectively reviewed 179 patients of PTC who underwent a thyroidectomy from January 2000 to June 2021 at Tianjin Medical University Cancer Hospital. We compared preoperative TgAb and TPOAb status with the clinicopathological features and prognosis of children and adolescents with PTC in different age groups.
RESULTS
Patients with positive preoperative TPOAb and TgAb had lower recurrence rate in the younger group ( = 0.006, 0.047, respectively). Patients with positive TPOAb preoperatively had normal level of preoperative Tg and less cervical LNM than patients with negative TPOAb in children and adolescents (P < 0.05). Positive TPOAb preoperatively of PTC patients had a longer median DFS (113.4 months) than negative TPOAb (64.9 months) (P = 0.009, log-rank). Univariate analyses showed age, maximal tumor size, T stage, multifocality, lateral LNM and N staging were predictors for cancer recurrence in children and adolescents (P<0.05). Cox regression analysis found younger age (HR 0.224, P < 0.001), lateral LNM (HR 0.137, P = 0.010), N stage (HR 30.356, P < 0.001) were independent risk factors for recurrence.
CONCLUSIONS
Our study found that presence of preoperative TPOAb and TgAb could serve as novel prognostic factors for predicting recurrence of PTC in children.
背景
众多研究报道了成人甲状腺乳头状癌（PTC）与甲状腺自身抗体之间的联系，但很少有研究调查儿童和青少年中是否存在类似关联。本研究的目的是探讨儿童和青少年PTC患者的临床病理特征、预后与术前甲状腺过氧化物酶抗体（TPOAb）以及甲状腺球蛋白抗体（TgAb）状态之间的关系。
方法
本研究回顾性分析了2000年1月至2021年6月在天津医科大学肿瘤医院接受甲状腺切除术的179例PTC患者。我们比较了术前TgAb和TPOAb状态与不同年龄组儿童和青少年PTC患者的临床病理特征及预后。
结果
术前TPOAb和TgAb阳性的患者在较年轻组中的复发率较低（分别为 = 0.006，0.047）。儿童和青少年中，术前TPOAb阳性的患者术前Tg水平正常，颈部淋巴结转移（LNM）少于TPOAb阴性的患者（P < 0.05）。PTC患者术前TPOAb阳性的中位无病生存期（DFS）（113.4个月）长于TPOAb阴性的患者（64.9个月）（P = 0.009，对数秩检验）。单因素分析显示年龄、最大肿瘤大小、T分期、多灶性、侧方LNM和N分期是儿童和青少年癌症复发的预测因素（P<0.05）。Cox回归分析发现年龄较小（风险比[HR] 0.224，P < 0.001）、侧方LNM（HR 0.137，P = 0.010）、N分期（HR 30.356，P < 0.001）是复发的独立危险因素。
结论
我们的研究发现术前TPOAb和TgAb的存在可作为预测儿童PTC复发的新的预后因素。
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