基于年龄分层的乳头甲状腺癌患者侧面淋巴结转移的明显危险因素
Huizhu Cai1, Lingdun Zhuge1, Zehao Huang1
1Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMC surgery
|January 13, 2024
概括
年龄显著影响皮质甲状腺癌中的侧面淋巴结转移风险. 最佳的年龄切断点是30岁和45岁,指导皮毛甲状腺癌患者的量身定制的手术策略.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 在瘤学瘤学.
背景情况:
- 年龄是乳头甲状腺癌 (PTC) 侧面淋巴结转移 (LLNM) 的已知危险因素.
- 准确的LLNM风险预测模型需要精确的年龄分层.
- 了解特定年龄的风险因素对于定制的PTC管理至关重要.
研究的目的:
- 确定在PTC中预测LLNM的最佳年龄截止值.
- 在PTC患者的不同年龄组中分析LLNM的不同风险因素.
主要方法:
- 对499名经过甲状腺切除术和侧切割 (LND) 的PTC患者进行了回顾性分析.
- 使用LOWESS曲线和R中的"切换点"包来确定最佳的年龄截止值.
- 采用多变量逻辑回归来识别年龄层内的独立LLNM风险因素.
主要成果:
- 在PTC中,LLNM风险分层的最佳年龄截止值被确定为30岁和45岁.
- 中枢淋巴结转移 (CLNM) 是所有年龄组LLNM的重要预测因素.
- 年轻的 (<30岁) PTC 患者显示与性别,瘤大小和位置相关的LLNM风险增加.
- 年龄较大 (>45岁) 的PTC患者与瘤位置,甲状腺外延伸和结节外延伸相关的LLNM风险增加.
结论:
- 年龄特异性风险因素分析在PTC中改进了LLNM预测.
- 考虑年龄限制 (30岁和45岁) 可以指导PTC的手术管理决策.
- 在CLNM确认时建议使用活跃的LND;对于上叶瘤的年轻患者和额外甲状腺扩张的老年患者,建议对侧部进行积极的评估.
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