Department of Thyroid and Breast Surgery, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Blood Transfusion, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241254059. doi: 10.1177/15330338241254059.
Primary squamous cell thyroid carcinoma (PSCTC) is an extremely rare carcinoma, accounting for less than 1% of all thyroid carcinomas. However, the factors contributing to PSCTC outcomes remain unclear. This study aimed to identify the prognostic factors and develop a prognostic predictive model for patients with PSCTC. The analysis included patients diagnosed with thyroid carcinoma between 1975 and 2016 from the Surveillance, Epidemiology, and End Results database. Prognostic differences among the 5 pathological types of thyroid carcinomas were analyzed. To determine prognostic factors in PSCTC patients, the Cox regression model and Fine-Gray competing risk model were utilized. Based on the Fine-Gray competing risk model, a nomogram was established for predicting the prognosis of patients with PSCTC. A total of 198,757 thyroid carcinoma patients, including 218 PSCTC patients, were identified. We found that PSCTC and anaplastic thyroid cancer had the worst prognosis among the 5 pathological types of thyroid carcinoma ( < .001). According to univariate and multivariate Cox regression analyses, age (71-95 years) was an independent risk factor for poorer overall survival and disease-specific survival in PSCTC patients. Using Fine-Gray regression analysis, the total number of in situ/malignant tumors for patient (Number 1) (≥2) was identified as an independent protective factor for prognosis of PSCTC. The area under the curve, the concordance index (C-index), calibration curves and decision curve analysis revealed that the nomogram was capable of predicting the prognosis of PSCTC patients accurately. The competing risk nomogram is highly accurate in predicting prognosis for patients with PSCTC, which may help clinicians to optimize individualized treatment decisions.
原发性鳞状细胞甲状腺癌（PSCTC）是一种极为罕见的癌，占所有甲状腺癌的比例不足 1%。然而，导致 PSCTC 结局的因素尚不清楚。本研究旨在确定 PSCTC 患者的预后因素，并为其建立预后预测模型。
该分析纳入了 1975 年至 2016 年间来自监测、流行病学和最终结果（SEER）数据库的甲状腺癌患者。分析了 5 种甲状腺癌病理类型的预后差异。为了确定 PSCTC 患者的预后因素，使用了 Cox 回归模型和 Fine-Gray 竞争风险模型。基于 Fine-Gray 竞争风险模型，为预测 PSCTC 患者的预后建立了一个列线图。
共纳入 198757 例甲状腺癌患者，其中 218 例为 PSCTC 患者。我们发现，PSCTC 和间变性甲状腺癌在 5 种甲状腺癌病理类型中预后最差（<0.001）。根据单因素和多因素 Cox 回归分析，年龄（71-95 岁）是 PSCTC 患者总生存期和疾病特异性生存期较差的独立危险因素。使用 Fine-Gray 回归分析，患者（Number 1）原位/恶性肿瘤总数（≥2）被确定为 PSCTC 预后的独立保护因素。曲线下面积、一致性指数（C-index）、校准曲线和决策曲线分析表明，该列线图能够准确预测 PSCTC 患者的预后。
竞争风险列线图在预测 PSCTC 患者的预后方面具有很高的准确性，这可能有助于临床医生优化个体化治疗决策。
