Number of tumor foci predicts prognosis in papillary thyroid cancer.
Number of tumor foci predicts prognosis in papillary thyroid cancer.
复制标题
肿瘤灶的数量可预测甲状腺乳头状癌的预后。
DOI：
10.1186/1471-2407-14-914
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发表时间：
2014-12-04
期刊：
影响因子：
3.8
通讯作者：
Li DS
中科院分区：
文献类型：
--
作者：
Qu N;Zhang L;Ji QH;Zhu YX;Wang ZY;Shen Q;Wang Y;Li DS
乳头状甲状腺癌（PTC）常表现为多灶性。然而，多灶性与不良预后的关系仍然存在争议。本回顾性研究的目的是确定多灶性PTC的特征，并评估多灶性PTC与预后的关系。我们回顾了496例因PTC而接受甲状腺全切除术的患者的医疗记录。患者分为G1（1个肿瘤灶）、G2（2个肿瘤灶）和G3（3个及以上肿瘤灶）。我们分析了每个分类的临床病理特征和临床结果。采用Cox回归模型评估多灶性与复发或癌症死亡率之间的关系。G1组287例，G2组141例，G3组68例。G1组平均年龄为47.1±16.1 yr， G2组平均年龄为41.1±18.4 yr， G3组平均年龄为35.5±15.9 yr，组间差异有统计学意义（p = 0.001）。G1 ~ G3组甲状腺外展、中央淋巴结转移（CLNM）、外侧淋巴结转移（LLNM）比例随肿瘤灶数的增加而增加。Kaplan-Meier曲线显示，G3组无复发生存期最短，3组间差异有统计学意义（p = 0.001， Log Rank检验）。此外，肿瘤特异性生存率随着肿瘤灶数量的增加而显著降低（p = 0.041）。多因素Cox分析显示，复发的独立预测因素包括bbbb3肿瘤灶[HR 2.60, 95%可信区间（CI） 1.53-4.39, p = 0.001]和甲状腺外扩张（HR 1.95, CI 1.12-3.38, p = 0.018）。肿瘤数量的增加与更具侵袭性特征的趋势相关，并预示着PTC的预后不良。
Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1 ± 16.1 yr in G1, 41.1 ± 18.4 yr in G2, and 35.5 ± 15.9 yr in G3 and differed significantly among the 3 groups (p = 0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan–Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p = 0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p = 0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p = 0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p = 0.018). An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.
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影响因子：
9
作者：
Moo, Tracy-Ann S.;Umunna, Ben;Fahey, Thomas J., III
通讯作者：
Fahey, Thomas J., III
影响因子：
5.9
作者：
MAZZAFERRI, EL;JHIANG, SM
通讯作者：
JHIANG, SM
甲状腺微小乳头状癌颈部淋巴结转移的危险因素：一项针对 1066 名患者的研究
影响因子：
5.8
作者：
Zhang, Ling;Wei, Wen-jun;Wu, Yi
通讯作者：
Wu, Yi
DOI：
10.1002/hed.23650
发表时间：
2015-05-01
影响因子：
2.9
作者：
Kim, Hye Jeong;Park, Hyeong Kyu;Chung, Jae Hoon
通讯作者：
Chung, Jae Hoon
影响因子：
1.9
作者：
DINSE, GE;LAGAKOS, SW
通讯作者：
LAGAKOS, SW