侵袭性甲状腺外延伸和乳头甲状腺癌的存活率之间的因果推断:倾向性得分匹配和权重分析
Ming Xu1, Zihan Xi1, Qiuyang Zhao1
1Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Frontiers in endocrinology
|June 9, 2023
概括
甲状腺外延伸到其他器官是乳头甲状腺癌存活率的高风险因素. 侵入带肌肉也会影响老年患者或那些有较大的瘤的患者的生存率.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
- 癌症预后 癌症预后
背景情况:
- 甲状腺外延伸 (ETE) 是已知的甲状腺 papillary 癌症 (PTC) 预后的风险因素.
- 不同程度的ETE对患者结果的影响仍在争论中.
- 这项研究研究了ETE程度和PTC预后之间的关系.
研究的目的:
- 为了澄清不同程度的甲状腺外延伸在乳头甲状腺癌的预后意义.
- 为了确定与较差的患者存活率相关的特定ETE范围.
- 分析影响ETE和PTC结果之间的关系的共变量.
主要方法:
- 对108,426名乳头甲状腺癌患者的回顾性分析.
- ETE的分类为没有,囊,皮带肌肉和其他器官.
- 应用治疗权重的逆概率,标准化死亡率权重和倾向性得分匹配以减少偏差.
- 卡普兰-梅尔和单变Cox回归分析用于生存评估.
主要成果:
- 在Kaplan-Meier分析中,ETE进入或超越皮带肌肉显著影响了整体生存率 (OS) 和甲状腺癌特异性生存率 (TCSS).
- 在考克斯回归分析中,ETE进入软组织或其他器官成为OS和TCSS的高风险因素.
- 敏感性分析确定年龄较大 (≥55) 和较大的瘤大小 (>2厘米) 是PTC中与ETE进入或超越皮带肌肉的较低OS相关的因素.
结论:
- 甲状腺外延伸到软组织或其他器官是所有乳头甲状腺癌患者的重要高风险因素.
- 虽然不是主要的不良预后标志物,但带肌中的ETE会对老年患者或患有较大的瘤的患者的生存系统产生负面影响.
- 需要进一步的研究来验证这些发现,并确定超出ETE的独立预后因素.
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