Iqbal Asif, Lee Kue T, Yasinzai Abdul Qahar Khan, Li Ziyang, Wali Agha, Tareen Bisma, Khan Israr, Khan Marjan, Ullah Asad
Medicine, Mercy Health, Ardmore, USA.
Otolaryngology, Augusta University Medical College of Georgia, Augusta, USA.
Cureus. 2024 Jun 27;16(6):e63326. doi: 10.7759/cureus.63326. eCollection 2024 Jun.
Introduction Squamous cell carcinoma of the thyroid (SCCT) is a rare, aggressive thyroid cancer distinguished by the emergence of squamous cells due to chronic inflammation or metaplasia. It poses diagnostic and therapeutic challenges, often identified at an advanced stage with a poor prognosis. The rarity of SCCT underscores the necessity for advanced research on effective treatments and diagnostic strategies. The current data utilized the Surveillance, Epidemiology, and End Results (SEER) database to determine the characteristics and outcomes of patients with primary SCCT. Methods De-identified data from patients with primary SCCT from 2000 to 2020 were collected using the SEER database. Demographic data, including age, sex, race, income, and housing, and clinical data including tumor size, tumor stage, nodal status, metastases, treatment modality, survival, and the patient's status, were extracted. Exclusion criteria were patients with unknown outcomes and missing death certificates. A detailed comparison of the two patient cohorts and univariate and multivariate Cox proportional hazard regression survival analyses were conducted. Results Among the 159 primary SCCT patients, the median age was 71 ± 21 years, with 83 females (52.2%) and 76 males (47.8%). The median overall follow-up was 6.0 years (4.41-7.59). The majority were White (108, 67.9%), followed by Hispanic (19, 11.9%). The five-year overall survival (OS) of the study group was 17.6% (95% CI = 14.5-20.7). The five-year disease-specific survival (DSS) was 37.6% (95% CI = 32.7-42.5). There was no significant difference based on surgery, chemotherapy, or radiation (p = 0.134). Age, tumor stage, nodal status, and distant metastases were negative prognostic factors. Sex, race, income, and housing were not predictive of survival. Conclusion The current study on SCCT highlights a low five-year OS rate of 17.6% and a DSS rate of 37.6%, with no significant difference in survival based on surgery, chemotherapy, or radiation. The negative prognostic factors included age, tumor stage, nodal status, and distant metastases, whereas sex, race, income, and housing did not significantly predict survival outcomes. These findings underscore the critical need for early detection and the development of more effective treatment strategies to manage SCCT.
引言 甲状腺鳞状细胞癌（SCCT）是一种罕见的侵袭性甲状腺癌，其特征是由于慢性炎症或化生而出现鳞状细胞。它带来了诊断和治疗方面的挑战，通常在晚期才被发现，预后较差。SCCT的罕见性凸显了对有效治疗方法和诊断策略进行深入研究的必要性。当前的数据利用监测、流行病学和最终结果（SEER）数据库来确定原发性SCCT患者的特征和预后。
方法 使用SEER数据库收集2000年至2020年原发性SCCT患者的去识别数据。提取人口统计学数据，包括年龄、性别、种族、收入和住房情况等，以及临床数据，包括肿瘤大小、肿瘤分期、淋巴结状态、转移情况、治疗方式、生存情况和患者状态等。排除标准为结局未知和缺少死亡证明的患者。对两组患者进行了详细比较，并进行了单因素和多因素Cox比例风险回归生存分析。
结果 在159例原发性SCCT患者中，中位年龄为71±21岁，女性83例（52.2%），男性76例（47.8%）。中位总随访时间为6.0年（4.41 - 7.59）。大多数为白人（108例，67.9%），其次是西班牙裔（19例，11.9%）。研究组的五年总生存率（OS）为17.6%（95%CI = 14.5 - 20.7）。五年疾病特异性生存率（DSS）为37.6%（95%CI = 32.7 - 42.5）。手术、化疗或放疗之间无显著差异（p = 0.134）。年龄、肿瘤分期、淋巴结状态和远处转移是负面预后因素。性别、种族、收入和住房情况不能预测生存情况。
结论 目前关于SCCT的研究突出显示五年总生存率低至17.6%，疾病特异性生存率为37.6%，手术、化疗或放疗对生存情况无显著差异。负面预后因素包括年龄、肿瘤分期、淋巴结状态和远处转移，而性别、种族、收入和住房情况对生存结局无显著预测作用。这些发现强调了早期检测以及开发更有效治疗策略来管理SCCT的迫切需求。
