检讨瘤大小与高度差异化的甲状腺癌风险之间的关系
Sara P Ginzberg1,2,3, James Sharpe1, Jesse E Passman1,3
1Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
概括
在分化良好的甲状腺癌中,巨大的瘤大小增加了风险,但高风险特征更为关键. 4厘米的切割距离并不是增加死亡风险的最显著指标.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 大型瘤与差异化甲状腺癌的较差结果有关.
- 瘤大小>4厘米的独立预后值,与其他侵略性标志物分开,需要澄清.
研究的目的:
- 评估瘤大小,高危组织病理特征和差异化甲状腺癌的存活率之间的关联.
- 为了确定4厘米的瘤大小切断线是否准确地反映了管理决策.
主要方法:
- 分析国家癌症数据库 (2010-2015) 和监测,流行病学和最终结果计划 (2008-2013) 对差异化良好的甲状腺癌患者的分析.
- 倾向性得分匹配和多变量Cox比例危险模型来评估瘤大小和存活率.
- 用于评估瘤大小和高风险特征对生存的综合影响的相互作用术语.
主要成果:
- 瘤大小>4厘米独立地与更差的存活率相关 (HR1.63,p < 0.001).
- 结合大的瘤大小和高风险特征导致的生存率比单独的任何一个因素都差.
- 死亡危险的最显著增加发生在2厘米和5厘米,而不是在4厘米的值.
结论:
- 同时的高风险特征对存活的影响比单独的大瘤大小更大.
- 4厘米的切断值不是确定高度差异化的甲状腺癌风险增加的最佳门.
- 建议采用更精细的瘤大小评估方法来管理已分化的甲状腺癌.
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