淋巴结转移率对甲状腺乳头状癌术后131I治疗临床转归的预测价值

目的 分析淋巴结转移率对甲状腺乳头状癌(PTC)患者手术后碘131(131I)清除残留甲状腺组织(清甲)治疗临床转归的预测价值.方法 采用回顾性研究方法,收集2015 年1 月至2017 年6 月收治的95 例PTC 患者的临床资料,手术后均行131I清甲治疗.依据患者淋巴结转移率的不同,分为A组(转移率≤10％)14...

Predictive value of lymph node metastasis rate for clinical outcome of postoperative 131I treatment in patients with thyroid papillary carcinoma

Objective To analyze the predictive value of lymph node metastasis rate for the clinical outcome of patients with thyroid papillary carcinoma(PTC)treated after 131 I ablation of residual thyroid tissue treatment.Methods The clinical data of 95 PTC patients treated with 131 I ablation of residual tissue after operation from January 2015 to June 2017 were collected to analyze retrospectively.According to the different lymph node metastasis rate,the patients were divided into group A(metastasis rate≤10%,n=14),group B(metastasis rate>10%and≤25%,n=36),group C(metastasis rate>25%and≤50%,n=33),group D(metastasis rate>50%,n=12).During a median follow-up of 20 months(range 9 to 27 months),the clinical outcome of the patients after treatment(satisfaction,uncertainty,poor response)was observed and compared among these groups.ROC curve was drawed and used to evaluate the best diagnostic threshold and diagnostic efficacy of lymph node metastasis rate for predicting the clinical outcome,and multivariate logistic regression analysis was used to analyze the independent influencing factor for predicting the clinical outcome of PTC patients.Results There were no significant differences in gender,tumor stage,tumor site and tumor diameter(all P>0.05),but there were significant differences in ages,number of tumor lesions and extraglandular invasion(all P<0.01)and in the clinical outcomes among four groups(P<0.01).As the optimal diagnostic threshold of lymph node metastasis rate was 52.30%,the sensitivity,specificity and area under ROC curve were 53.57%,94.87%and 0.76,respectively.The ages,multiple foci,extraglandular invasion and lymph node metastasis rate were the independent factors influencing the clinical outcome(P<0.05,P<0.01).Conclusions The lymph node metastasis rate is closely related to the clinical outcome of PTC patients with 131 I ablation of residual thyroid tissue after surgery.The increase of lymph node metastasis rate is often associated with poor clinical outcome.The optimal diagnostic threshold of lymph node metastasis rate is 52.30%,which can be used as an independent and specific index to predict the clinical outcome of PTC patients.