Zheng Danni, Yang Jiawen, Qian Jiali, Jin Lingli, Huang Guanli
Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Cancer Manag Res. 2022 Dec 20;14:3493-3505. doi: 10.2147/CMAR.S366270. eCollection 2022.
Many patients have a higher risk of thyroid cancer if they have both papillary thyroid carcinoma (PTC) and Type 2 diabetes mellitus (T2DM). Meanwhile, the primary reason for local PTC recurrence is cervical lymph node metastasis. Therefore, the prognosis of patients affects how cervical lymph nodes are managed during surgery. Due to surgical complications such as laryngeal nerve palsy and hypocalcemia, it is still debatable whether to prevent central lymph node dissection (CLND). Predicting central lymph node metastasis (CLNM) is crucial to direct CLND. It is unclear how important the fibrinogen-to-neutrophil ratio (FNR) is in thyroid cancer, so we looked into how it might help patients with PTC and T2DM predict CLNM.
Wenzhou Medical University's First Affiliated Hospital provided us with 413 patients with PTC and T2DM, randomly divided into a training set (N = 292) and a validation set (N = 121). Univariate and multivariate logistic regression analyses were used to identify independent risk factors. After constructing a nomogram, the validity of the model was evaluated.
The maximum tumor diameter, high-density lipoprotein, thyroxine, triglyceride, lymphocyte, and FNR were all identified as independent risk factors by multivariate logistic regression analysis. The C index of the training set was 0.775, and the validation set was 0.654.
In patients with PTC and T2DM, preoperative FNR was an independent risk factor for CLNM.
许多同时患有甲状腺乳头状癌（PTC）和2型糖尿病（T2DM）的患者患甲状腺癌的风险更高。同时，PTC局部复发的主要原因是颈部淋巴结转移。因此，患者的预后会影响手术中颈部淋巴结的处理方式。由于存在喉返神经麻痹和低钙血症等手术并发症，对于是否进行中央区淋巴结清扫（CLND）仍存在争议。预测中央区淋巴结转移（CLNM）对于指导CLND至关重要。目前尚不清楚纤维蛋白原与中性粒细胞比值（FNR）在甲状腺癌中的重要性如何，因此我们研究了它如何帮助PTC和T2DM患者预测CLNM。
温州医科大学附属第一医院为我们提供了413例PTC和T2DM患者，随机分为训练集（N = 292）和验证集（N = 121）。采用单因素和多因素逻辑回归分析确定独立危险因素。构建列线图后，评估模型的有效性。
多因素逻辑回归分析确定最大肿瘤直径、高密度脂蛋白、甲状腺素、甘油三酯、淋巴细胞和FNR均为独立危险因素。训练集的C指数为0.775，验证集为0.654。
在PTC和T2DM患者中，术前FNR是CLNM的独立危险因素。
