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一项前性多中心研究检查了甲状腺癌治疗结果与自身免疫性甲状腺炎存在之间的关系
Simone De Leo1, Silvia D'Elia2, Giorgio Grani3
1Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Thyroid : official journal of the American Thyroid Association
|September 19, 2023
概括
在差异化甲状腺癌 (DTC) 患者的自身免疫甲状腺炎 (AT) 与生化复发的可能性更高,但在一年内没有结构性复发. 需要进一步的研究来理解这种关联.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 自免疫过程与差异化甲状腺癌 (DTC) 结局之间的关系受到争论,但从回顾性研究中获得的证据有限.
- 自身免疫性甲状腺炎 (AT) 是一种常见的疾病,可能会影响DTC的行为和治疗反应.
研究的目的:
- 在差异化甲状腺癌 (DTC) 患者中调查自身免疫甲状腺炎 (AT) 存在与1年治疗结果之间的关联.
- 使用前性收集的数据,比较DTC患者与无相关的AT之间的临床病理特征和治疗反应.
主要方法:
- 一项大型的多中心研究利用了来自意大利甲状腺癌观测中心 (ITCO) 数据库的前性收集数据,包括4233名DTC患者.
- 患者被分为具有 (AT) 或没有 (noAT) 相关的自身免疫甲状腺炎的组.
- 倾向性得分匹配用于比较AT和noAT组之间的临床特征和1年结果.
主要成果:
- 在倾向得分匹配后,与没有AT的患者相比,具有AT的患者表现出更高的生物化学不完整反应发生率 (7.3%与4.5%,P=.001).
- 在有AT和没有AT的患者之间没有观察到疾病结构性持续性的统计学上显著差异 (3.4%对2.7%,P=.35).
- 患有AT的患者年轻,具有较小的双边瘤,并且更频繁地被归类为美国甲状腺协会 (ATA) 的较低风险类别.
结论:
- 在这项前性研究中,自身免疫性甲状腺炎 (AT) 与差异化甲状腺癌 (DTC) 患者在1年随访后的生化持续率较高有关.
- 甲状腺的存在与DTC的结构性持久性没有显著关联,这表明剩余的甲状腺组织可能起作用.
- 在诊断时,与ATA中级和高风险类别相关的确定的更高风险,无论AT状态如何,仍然显著.
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