中国低风险乳头甲状腺小癌的积极监测:关于进展,影响因素和成本效益的前性研究
Yuxin Ge1, Bin Zheng2, Cheng Li2
1Department of General Practice, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
World journal of surgery
|March 27, 2025
概括
针对乳头甲状腺微癌 (PTMC) 的积极监测 (AS) 在中国是可行的,也是具有成本效益的. 这种利用高分辨率超声波的方法可以帮助避免过度治疗,并降低低风险患者的医疗费用.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 状甲状腺微癌 (PTMC) 的检测率不断上升,需要采取战略来防止过度治疗.
- 主动监控 (AS) 是一个潜在的管理解决方案,但其在中国的成本效益需要评估.
- 本研究评估了AS对中国PTMC患者的可行性和经济效益.
研究的目的:
- 评估在中国队列中对乳头甲状腺微癌 (PTMC) 的积极监测 (AS) 的可行性和成本效益.
- 在AS下确定与PTMC进展相关的风险因素.
- 为了比较AS的5年医疗成本与即时手术 (IS).
主要方法:
- 在上海瑞金医院对145名PTMC患者进行前性研究.
- 分析进展风险因素和5年医疗费用,比较AS和IS.
- 使用SPSS 26和R.进行了Kaplan-Meier和COX生存分析.
主要成果:
- 在35个月的时间里,在105个完成者中观察到13%的累积进展率.
- 疾病进展与更高的淋巴结转移率 (61.5%与7.7%) 相关.
- 发现主动监测 (AS) 在5年内比立即手术 (IS) 有成本效益大约6倍.
结论:
- 积极监测 (AS) 是一种成本效益高的战略,用于在中国管理低风险的PTMC.
- 高分辨率超声波是有效的检测疾病的进展.
- 进展风险因素包括40岁以下的年龄,微化和瘤大小>7mm;需要进一步验证.
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