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对差分化甲状腺癌开发新的TNM分期系统:多中心队列研究

Yu Guo ^1,2,3,4, Qianyi Zhong ^5,6, Liangen Xie ^1,2,3

¹Department of General Surgery (Thyroid Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
²Department of Otorhinolaryngology Head and Neck Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
³Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
⁴Department of Thyroid Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
⁵The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China.
⁶Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou Twelfth People's Hospital (The Affiliated Twelfth People's Hospital of Guangzhou Medical University), Guangzhou Medical University, Guangzhou, China.
⁷Department of Maxillofacial and Otorhinolaryngological Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Basic and Translational Medicine on Head & Neck Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin, China.
⁸Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
⁹Department of Otolaryngology Head and Neck (Thyroid) Surgery, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, China.
¹⁰Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
¹¹State Key Laboratory of Oncology in South China, Guangzhou, China.

⁰Department of General Surgery (Thyroid Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Frontiers in Endocrinology +

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2025年九月4日

在PubMed上查看摘要

概括

对差分化甲状腺癌 (PDTC) 的新TNM分期系统提供了更好的预后. 这种系统比目前的AJCC系统更好地分层患者,有助于对这种罕见的癌症进行临床治疗.

科学领域

癌症学
内分泌学
癌症的发展阶段

背景情况

差分化甲状腺癌 (PDTC) 是一种罕见的恶性瘤,预后不佳.
现有的分期系统,包括AJCC TNM,无法充分捕捉PDTC的异质性和预后变化.
需要一个量身定制的分期系统来指导PDTC患者的治疗和改善结果.

研究的目的

专门针对差异化甲状腺癌 (PDTC) 的新型TNM分期系统的开发和验证.
提高PDTC预后和临床管理的准确性.
将新分期系统的性能与现有的AJCC TNM系统进行比较.

主要方法

使用美国SEER数据库 (2004-2016) 和来自中国机构的外部数据设计和验证了新的TNM分阶段系统.
考克斯回归分析确定了影响癌症特异性存活率 (CSS) 的预后因素.
根据调整的危险比率,患者被分为五个阶段,结果通过5年CSS率进行评估.

主要成果

与AJCC第八版TNM系统相比,新的TNM分期系统在内部和外部验证队列中显示出更高的差别和预测准确性.
新阶段I-IVB的5年CSS率在96.3%到22.3%之间,显示出明显的预后分层.
通过依赖时间的ROC曲线,C指数和校准图表来确认系统的性能.

结论

目前的AJCC分期系统不足以准确预测差分化甲状腺癌的预后.
新开发的TNM分期系统为PDTC提供了更好的分层和预后.
这种新型分期系统有可能显著提高PDTC的临床决策和患者管理.

关键词:

调整的危险比率癌症特异性生存率新的TNM阶段差分化的甲状腺癌预后预测