Hematological Indexes Can Be Used to Predict the Incidence of Hypothyroidism in Nasopharyngeal Carcinoma Patients after Radiotherapy
Hematological Indexes Can Be Used to Predict the Incidence of Hypothyroidism in Nasopharyngeal Carcinoma Patients after Radiotherapy
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血液学指标可预测鼻咽癌放疗后甲状腺功能减退症的发生率
DOI：
10.1155/2020/3860936
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发表时间：
2020-05
影响因子：
--
通讯作者：
Chen Yuan-Yuan
中科院分区：
文献类型：
--
作者：
Zhou Ling;Chen Jia;Tao Chang-Juan;Huang Shuang;Zhang Jiang;Shen Wei;Zhu Chao-Nan;Chen Ming;Yu Zhong-Hua;Chen Yuan-Yuan
背景本研究旨在探讨甲状腺相关抗体、免疫细胞与甲状腺功能减退的关系，以建立鼻咽癌患者放疗后甲状腺功能减退发生率的预测模型。方法选取2015年1月至2018年8月在中国科学院大学附属肿瘤医院接受治疗的鼻咽癌患者170例。放疗前对患者的全血细胞计数、生化指标、凝血功能、免疫细胞和甲状腺相关抗体进行评估。Logistic回归模型进行，以阐明血液学指标与甲状腺功能减退症的发展。建立了甲减发病率的预测模型。使用十重交叉验证方法对多因素模型进行内部验证。结果单因素分析显示，甲减组与非甲减组的免疫细胞差异无统计学意义。性别、N分期、抗甲状腺过氧化物酶抗体（TPO-Ab）、抗甲状腺球蛋白抗体（TG-Ab）、甲状腺球蛋白（TG）和纤维蛋白原（Fb）与甲减相关。男性和早期N期是甲状腺功能的保护因素，而TPO-Ab，TG-Ab，TG和Fb计数的增加与甲状腺功能减退症发病率的增加有关。多因素分析显示TPO-Ab、TG-Ab、TG和Fb是甲减的独立预测因子。TPO-Ab、TG-Ab、TG和Fb计数的显著性模型的综合效应代表了预测放射性甲减发生率的最佳方法（AUC = 0.796）。采用十重交叉验证方法进行内部验证。训练集和测试集的AUC分别为0.792和0.798。结论TPO-Ab、TG-Ab、TG、Fb联合模型可用于放射治疗后甲减高危人群的筛查。
Background This study explored the relationship between thyroid-associated antibodies, immune cells, and hypothyroidism to establish a predictive model for the incidence of hypothyroidism in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods A total of 170 patients with NPC treated at the Cancer Hospital of University of Chinese Academy of Sciences between January 2015 and August 2018 were included. The complete blood count, biochemical, coagulation function, immune cells, and thyroid-associated antibodies tested before radiotherapy were evaluated. A logistic regression model was performed to elucidate which hematological indexes were related to hypothyroidism development. A predictive model for the incidence of hypothyroidism was established. Internal verification of the multifactor model was performed using the tenfold cross-validation method. Results The univariate analysis showed that immune cells had no statistically significant differences among the patients with and without hypothyroidism. Sex, N-stage, antithyroid peroxidase antibody (TPO-Ab), antithyroglobulin antibody (TG-Ab), thyroglobulin (TG), and fibrinogen (Fb) were associated with hypothyroidism. Males and early N-stage were protective factors of thyroid function, whereas increases in TPO-Ab, TG-Ab, TG, and Fb counts were associated with an increased rate of hypothyroidism incidence. The multivariate analysis showed that TPO-Ab, TG-Ab, TG, and Fb were independent predictors of hypothyroidism. The comprehensive effect of the significant model, including TPO-Ab, TG-Ab, TG, and Fb counts, represented the optimal method of predicting the incidence of radiation-induced hypothyroidism (AUC = 0.796). Tenfold cross-validation methods were applied for internal validation. The AUCs of the training and testing sets were 0.792 and 0.798, respectively. Conclusion A model combining TPO-Ab, TG-Ab, TG, and Fb can be used to screen populations at a high risk of developing hypothyroidism after radiotherapy.
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