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Predictive Risk-scoring Model For Central Lymph Node Metastasis and Predictors of Recurrence in Papillary Thyroid Carcinoma.
Scientific Reports ( IF 3.8 ) Pub Date : 2020-01-20 , DOI: 10.1038/s41598-019-55991-1
Lie-Hao Jiang 1 , Ke-Xin Yin 2 , Qing-Liang Wen 3 , Chao Chen 3 , Ming-Hua Ge 1 , Zhuo Tan 1
Affiliation  

There are about half of papillary thyroid carcinoma (PTC) patients with the experience of central lymph node metastasis (CLNM), while the model to predict high-risk groups of CLNM from PTC patients is uncertain. The aim of this study was to evaluate candidate risk factors of CLNM and identify risk factors of recurrence to guide the postoperative therapeutic decision and follow-up for physicians and patients.A total of 4107 patients(4884 lesions) who underwent lymph node dissection in two hospitals from 2005 to 2014 were evaluated. CLNM risk was stratified and a risk-scoring model was developed on the basis of the identified independent risk factors for CLNM. Cox's proportional hazards regression model was used to investigate the risk factors for recurrence.CLNM was proved in 37.96% (1559/4107) of patients and 33.96% (1659/4884) of lesions. In the multivariate analysis, Male, Age ≤35 years, Tumor size >0.5 cm,Lobe dissemination (+), Psammoma body (+), Multifocality and Capsule invasion (+) were independent risk predictors of CLNM (P  < 0.01). A 14-point risk-scoring model was built to predict the stratified CLNM in PTC patients and the area under receiver operating characteristic curve of the model for the prediction of CLNM was 0.672 (95% CI: 0.656-0.688) (P < 0.01). COX regression model showed that Tumor size >0.5 cm, Lobe dissemination (+), Multifocality and CLNM were significant risk factors associated with poor outcomes. The research suggested that prophylactic CLN dissection could be performed in patients with total score ≥4 according to the risk-scoring model, and more aggressive treatment and more frequent follow-up should be considered for patients with Tumor size >0.5 cm, Lobe dissemination (+), Multifocality and CLNM.

中文翻译:

乳头状甲状腺癌中央淋巴结转移的预测风险评分模型和复发预测因子。

大约有一半的乳头状甲状腺癌(PTC)患者经历过中央淋巴结转移(CLNM),而从PTC患者中预测CLNM高危人群的模型尚不确定。这项研究的目的是评估CLNM的候选危险因素,并确定复发的危险因素,以指导医生和患者的术后治疗决策和随访。共有4107例患者(4884个病变)接受了两次淋巴结清扫术对2005年至2014年的医院进行了评估。对CLNM风险进行分层,并在已确定的CLNM独立风险因素的基础上建立风险评分模型。使用Cox比例风险回归模型研究复发的危险因素.CLNM在37.96%(1559/4107)的患者和33.96%(1659/4884)的病变中得到证实。在多变量分析中,男性,年龄≤35岁,肿瘤大小> 0.5 cm,血肿散布(+),肺淋巴瘤(+),多灶性和胶囊浸润(+)是CLNM的独立危险因素(P <0.01)。建立了一个14点风险评分模型来预测PTC患者的分层CLNM,并且该模型的受试者工作特征曲线下的面积用于预测CLNM为0.672(95%CI:0.656-0.688)(P <0.01) 。COX回归模型显示,肿瘤大小> 0.5 cm,肺叶扩散(+),多灶性和CLNM是与不良预后相关的重要危险因素。研究表明,根据风险评分模型,总分≥4的患者可以进行预防性CLN夹层,
更新日期:2020-01-21
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