Puvvadi Suraj, Reddy Nisha, Jundi Rania, Chang Amber, Silberstein Peter T, Hsia Beau
College of Health Solutions, Arizona State University, Phoenix, USA.
College of Liberal Arts and Sciences, Arizona State University, Tempe, USA.
Cureus. 2024 Aug 15;16(8):e66913. doi: 10.7759/cureus.66913. eCollection 2024 Aug.
Objective The columnar cell variant of papillary thyroid carcinoma (PTC-CC) is a rare, malignant tumor of the thyroid gland. This study uses the National Cancer Database (NCDB) to analyze demographic and prognostic factors affecting the overall survival rates of PTC-CC. Methods From 2004 to 2020, 7,079 patients diagnosed with columnar cell papillary thyroid carcinoma were identified in the NCDB. Patient demographics were reviewed based on categories listed in the NCDB participant user file data dictionary. Kaplan-Meier curves, log-rank tests, and multivariable Cox hazard regression models were used to analyze the significance of demographic and prognostic factors on overall survival rates of PTC-CC. Results Multivariate analysis demonstrated each five-year increment in age was associated with a 30% increase in mortality (hazard ratio (HR) = 1.30, 95% confidence interval (CI): 1.25-1.36, P < 0.001). Charlson-Deyo scores displayed similar incremental increases, such that patients with a score ≥ 3 had a 154% increase in mortality risk relative to a score of 0 (HR = 2.54; 95% CI: 1.75-3.68, P < 0.001). Black individuals had a 70% increase in mortality compared to White individuals (HR = 1.70, 95% CI: 1.25-2.30, P < 0.001), while all Other races had the highest 10-year survival rate of 92.7%. Females had a significant 37% decrease in mortality compared to males (HR = 0.63, 95% CI: 0.54-0.73, P < 0.001). Patients in the lowest income quartiles were found to have a significant increase in mortality compared to the highest income group (HR = 0.54; 95% CI: 0.41-0.71, P < 0.001). Survival rates were negatively correlated with NCDB Analytic Staging increases. Conclusion In general, age, sex, race, education, income, comorbidities, and cancer staging were found to be predictive factors of overall survival rates of PTC-CC. However, insurance status and education levels did not result in significant differences.
目的 甲状腺乳头状癌柱状细胞变异型（PTC-CC）是一种罕见的甲状腺恶性肿瘤。本研究利用国家癌症数据库（NCDB）分析影响PTC-CC总生存率的人口统计学和预后因素。方法 2004年至2020年期间，在NCDB中识别出7079例诊断为柱状细胞型甲状腺乳头状癌的患者。根据NCDB参与者用户文件数据字典中列出的类别对患者人口统计学进行回顾。采用Kaplan-Meier曲线、对数秩检验和多变量Cox风险回归模型分析人口统计学和预后因素对PTC-CC总生存率的意义。结果 多变量分析表明，年龄每增加5岁，死亡率增加30%（风险比（HR）=1.30，95%置信区间（CI）：1.25-1.36，P<0.001）。Charlson-Deyo评分显示出类似的递增增加，因此评分≥3分的患者相对于评分为0分的患者死亡风险增加154%（HR=2.54；95%CI：1.75-3.68，P<0.001）。黑人个体的死亡率比白人个体高70%（HR=1.70，95%CI：1.25-2.30，P<0.001），而所有其他种族的10年生存率最高，为92.7%。女性的死亡率比男性显著降低37%（HR=0.63，95%CI：0.54-0.73，P<0.001）。发现收入最低四分位数的患者与最高收入组相比死亡率显著增加（HR=0.54；95%CI：0.41-0.71，P<0.001）。生存率与NCDB分析分期增加呈负相关。结论 总体而言，年龄、性别、种族、教育程度、收入、合并症和癌症分期被发现是PTC-CC总生存率的预测因素。然而，保险状况和教育水平并未导致显著差异。
