与ATA风险系统集成的动态风险分层用于预测乳腺甲状腺癌的长期结果
Laura Valerio1, Cristina Dalmiglio1, Fabio Maino1
1Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy.
Cancers
|September 28, 2023
概括
将初始治疗反应与美国甲状腺协会 (ATA) 风险类整合起来,可以改善差异化甲状腺癌管理. 这种方法为长期的患者随访提供了更精确,个性化的风险评估.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 对于治疗甲状腺癌的个性化风险评估重新产生了兴趣.
- 根据患者的风险,需要量身定制的治疗和随访策略.
- 探索初始治疗反应与已确定的风险类别的整合.
研究的目的:
- 评估是否与美国甲状腺协会 (ATA) 风险类整合初始治疗反应,可以改善差异化甲状腺癌 (DTC) 患者的长期随访.
- 增强皮质甲状腺癌 (PTC) 风险适应的管理策略.
主要方法:
- 低风险和中等风险的乳头甲状腺癌 (PTC) 患者的回顾性研究.
- 随访时间中位数为8年.
- 根据对初始治疗的反应进行分类 (治疗后6-12个月).
主要成果:
- 最初的优异反应子组:中等风险与低风险PTC中的复发率更高 (6.9%与1.2%).
- 初始生化不完整响应子组:在低风险与中等风险PTC中更高的优异响应 (58.0%与33.3%对比).
- 综合的ATA风险和初始反应显示出与单独的ATA风险 (AUC: 0.69) 或动态风险分层 (AUC: 0.86) 相比,更好的预后性能 (AUC: 0.89).
结论:
- 最初的ATA风险标准对于完善PTC患者的风险调整管理是有价值的.
- 将初始治疗反应与ATA风险类整合起来,可以提高预后准确性.
- 这种综合方法支持更精确的,个性化的甲状腺癌随访.
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