Using a nomogram based on preoperative serum fibrinogen levels to predict recurrence of papillary thyroid carcinoma.
Using a nomogram based on preoperative serum fibrinogen levels to predict recurrence of papillary thyroid carcinoma.
复制标题
使用基于术前血清纤维蛋白原水平的列线图来预测甲状腺乳头状癌的复发。
DOI：
10.1186/s12885-018-4296-7
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发表时间：
2018-04-05
期刊：
影响因子：
3.8
通讯作者：
Jingqiang Z
中科院分区：
文献类型：
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作者：
Jianyong L;Zhihui L;Rixiang G;Jingqiang Z
高纤维蛋白原血症日益被认为是影响肿瘤分期、发展和预后的重要危险因素。我们评估了术前血清纤维蛋白原水平是否能预测乳头状甲状腺癌(PTC)的复发。我们回顾收集了从2014年8月到2016年8月在我们机构接受手术的1023名PTC患者的数据。共有414名患者(2014年8月至2015年12月)作为训练集来构建模型，609名患者(从2016年1月至2016年8月)作为测试集来验证模型。在训练组中，血清纤维蛋白原水平高的PTC患者更有可能患有多发性PTC(P = 0.001)，并表现出周围组织或器官的侵犯(P <； 0.01)。此外，血清纤维蛋白原水平高的PTC患者的肿瘤分期(T，P = 0.001)和远处转移(P <； 0.001)的可能性也更大，且这些患者的术后复发率显著高于其他患者(P = 0.002)。所有这些发现都在测试集中得到了验证。单因素和多因素分析结果显示，高纤维蛋白原血症是PTC复发的危险因素。识别的危险因素被合并到诺模图中，并使用测试集进行验证(C指数 = 0.811，95%CI：0.762-0.871)。伴有高纤维蛋白原血症的PTC患者更有可能具有晚期的TNM分期和更高的PTC复发率。我们的诺模图可以用来客观和准确地预测PTC在临床上的复发。
Hyperfibrinogenemia is increasingly being recognized as an important risk factor related to cancer stage, development and outcomes. We evaluated whether preoperative serum fibrinogen levels predict recurrence of papillary thyroid carcinoma (PTC). We retrospectively collected data for 1023 PTC patients who underwent surgery at our institution from Aug 2014 to Aug 2016. In total, 414 patients (from Aug 2014 to Dec 2015) were used as the training set to build the model, and 609 patients (from Jan 2016 to Aug 2016) were used as the testing set to validate the model. In the training set, PTC cases with high serum fibrinogen levels were more likely to have multiple PTCs (P = 0.001) and to exhibit surrounding tissue or organ invasion (both P < 0.01). Moreover, PTC patients with higher serum fibrinogen levels were also more likely to have an advanced tumor stage (T, P = 0.001) and distance metastasis (P < 0.001), and these patients had a significantly higher rate of postoperative PTC recurrence (P = 0.002). All of these findings were validated in the testing set. The results of univariate and multivariate analyses indicated that hyperfibrinogenemia was a risk factor for PTC recurrence. The identified risk factors were incorporated into a nomogram and validated using the testing set (C-index = 0.811, 95% CI: 0.762–0.871). PTC cases with hyperfibrinogenemia are more likely to have an advanced TNM stage and have a higher rate of PTC recurrence. Our nomogram could be used to objectively and accurately predict PTC recurrence in a clinical setting.