淋巴结比率与甲状腺乳头状癌术后甲状腺球蛋白水平独立相关。

Lymph node ratio independently associated with postoperative thyroglobulin levels in papillary thyroid cancer.

机构信息

Department of Thyroid and Neck, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China.

Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Oral Oncol. 2023 Nov;146:106563. doi: 10.1016/j.oraloncology.2023.106563. Epub 2023 Sep 9.

DOI:10.1016/j.oraloncology.2023.106563

PMID:37690364

Abstract

OBJECTIVES

To investigate the impact of the lymph node ratio (LNR) on postoperative thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC).

PATIENTS AND METHODS

This was a retrospective, cohort study. The association between clinicopathological variables and postoperative unstimulated Tg (uTg) levels, preablative-stimulated Tg (sTg) levels, and postablative unstimulated Tg levels was analysed.

RESULTS

A total of 300 patients with PTC were identified. Multivariate logistic analysis showed that M classification (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.62-3.34), and postoperative thyroid-stimulating hormone levels (OR, 1.01; 95% CI, 1.01-1.02) were independently associated with postoperative uTg levels. One hundred and sixteen patients underwent radioactive iodine (RAI) therapy. Multivariate analysis showed that LNR in the central neck (OR, 1.24; 95% CI, 1.02-1.51), LNR in the lateral neck (OR, 1.73; 95% CI, 1.09-2.77), RAI dose (OR, 1.43; 95% CI, 1.21-1.69), and M classification (OR, 1.79; 95% CI, 1.22-2.61) were independently associated with preablative sTg levels. Tumour size (OR, 1.01; 95% CI, 1.00-1.01), LNR in the central neck (OR, 1.28; 95% CI, 1.08-1.51), LNR in the lateral neck (OR, 1.66; 95% CI, 1.10-2.49), RAI dose (OR, 1.54; 95% CI, 1.34-1.79), and M classification (OR, 1.56; 95% CI, 1.12-2.19) were also independently associated with postablative uTg levels.

CONCLUSION

LNR was independently associated with postoperative Tg levels in patients with PTC. Patients with high LNR were more likely to have incomplete biochemical responses after surgery.

摘要

目的

探讨淋巴结比率（LNR）对甲状腺乳头状癌（PTC）患者术后甲状腺球蛋白（Tg）水平的影响。

方法

这是一项回顾性队列研究。分析了临床病理变量与术后未刺激 Tg（uTg）水平、术前刺激 Tg（sTg）水平和术后未刺激 Tg 水平之间的关系。

结果

共纳入 300 例 PTC 患者。多变量逻辑分析显示，M 分类（比值比 [OR]，2.33；95%置信区间 [CI]，1.62-3.34）和术后甲状腺刺激激素水平（OR，1.01；95%CI，1.01-1.02）与术后 uTg 水平独立相关。116 例患者接受放射性碘（RAI）治疗。多变量分析显示，中央颈部 LNR（OR，1.24；95%CI，1.02-1.51）、侧颈部 LNR（OR，1.73；95%CI，1.09-2.77）、RAI 剂量（OR，1.43；95%CI，1.21-1.69）和 M 分类（OR，1.79；95%CI，1.22-2.61）与术前 sTg 水平独立相关。肿瘤大小（OR，1.01；95%CI，1.00-1.01）、中央颈部 LNR（OR，1.28；95%CI，1.08-1.51）、侧颈部 LNR（OR，1.66；95%CI，1.10-2.49）、RAI 剂量（OR，1.54；95%CI，1.34-1.79）和 M 分类（OR，1.56；95%CI，1.12-2.19）也与术后 uTg 水平独立相关。