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侵袭性包膜滤泡型和经典型乳头状甲状腺癌的预后:一项使用监测、流行病学和最终结果(SEER)数据库的倾向评分匹配研究

Prognosis of invasive encapsulated follicular variant and classical papillary thyroid carcinoma: a propensity score-matched study using the SEER database.

作者信息

Jin Shuai, Xie Lang, Zhang Gongyou, Liu Lei, Xia Kaide, Liu Hongzhou, Zhang Haiwang, Li Peng

机构信息

School of Biology and Engineering (School of Health Medicine Modern Industry), Guizhou Medical University, Guiyang, China.

Department of Hospital Infection Management and Preventive Health Care, Zhejiang Provincial People's Hospital Bijie Hospital, Bijie, China.

出版信息

Sci Rep. 2025 Jan 2;15(1):413. doi: 10.1038/s41598-024-84425-w.

Abstract

The latest World Health Organization Classification of Tumors, Fifth Edition, recognizes the invasive encapsulated follicular variant of papillary thyroid carcinoma (IEFVPTC) as a distinct malignant entity rather than a subtype of papillary thyroid carcinoma (PTC). This reclassification highlights the need to explore potential prognostic differences between IEFVPTC and classic PTC. This study utilized the Surveillance, Epidemiology, and End Results (SEER) database to compare prognoses of patients diagnosed with IEFVPTC and classic PTC between 2004 and 2019. Propensity score matching (PSM) was employed to adjust for confounding variables and reduce selection bias. Kaplan-Meier survival curves and Cox regression models were used to evaluate overall survival (OS) between the two groups. A total of 1,530 IEFVPTC and 81,508 classic PTC patients were analyzed. Before PSM, significant differences were noted in race, T-stage, N-stage, M-stage, laterality, radiotherapy, surgical modality, tumor size, and income. Post-PSM, these differences were not statistically significant (p > 0.05). Kaplan-Meier curves and Cox regression models showed no significant differences in OS between IEFVPTC and classic PTC both before and after PSM. This PSM analysis revealed no significant differences in overall survival between patients with IEFVPTC and classic PTC, suggesting that the reclassification of IEFVPTC does not translate into distinct prognostic outcomes.

摘要

世界卫生组织最新的《肿瘤分类》第五版将侵袭性包膜型甲状腺乳头状癌(IEFVPTC)认定为一种独特的恶性实体,而非甲状腺乳头状癌(PTC)的一个亚型。这一重新分类凸显了探索IEFVPTC与经典PTC之间潜在预后差异的必要性。本研究利用监测、流行病学和最终结果(SEER)数据库,比较了2004年至2019年间诊断为IEFVPTC和经典PTC的患者的预后。采用倾向评分匹配(PSM)来调整混杂变量并减少选择偏倚。使用Kaplan-Meier生存曲线和Cox回归模型评估两组之间的总生存期(OS)。共分析了1530例IEFVPTC患者和81508例经典PTC患者。在PSM之前,在种族、T分期、N分期、M分期、病变侧别、放疗、手术方式、肿瘤大小和收入方面存在显著差异。PSM之后,这些差异无统计学意义(p>0.05)。Kaplan-Meier曲线和Cox回归模型显示,在PSM前后,IEFVPTC和经典PTC患者的OS均无显著差异。这项PSM分析显示,IEFVPTC患者和经典PTC患者的总生存期无显著差异,这表明IEFVPTC的重新分类并未转化为明显不同的预后结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5463/11696095/9ef79ac4c64a/41598_2024_84425_Fig1_HTML.jpg

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