| 摘要: |
| ［摘要］ 目的 研究术后降钙素与术前降钙素比值（CR）作为预后标志物预测散发性甲状腺髓样癌（MTC）结构性复发的应用价值。方法 回顾性分析于中山大学肿瘤防治中心接受治疗的117例散发性MTC患者的临床资料。采用Kaplan-Meier方法和Cox回归分析CR对无复发生存期（RFS）的影响，并构建了基于CR的列线图模型。结果 预测疾病复发的CR的最佳截断值为0.124。CR≥0.124组患者的RFS显著短于CR<0.124组患者（P<0.001）。多因素Cox回归分析结果显示，CR、年龄、肿瘤直径、淋巴结转移数目是MTC结构性复发的独立影响因素，其中以CR影响作用最大［HR（95%CI）：5.09（2.34～11.06），P<0.001］。预测RFS的列线图模型的一致性指数（c-index）为0.837（95%CI：0.763～0.911），校准曲线显示基于CR的列线图校准度良好，具有较好的预测价值。结论 CR是预测散发性MTC患者结构性复发的有力指标，结合 CR的列线图可以精准计算散发性MTC患者术后结构性复发的风险，为个性化治疗提供参考。 |
| 关键词: 甲状腺髓样癌 预后 降钙素 术后降钙素与术前降钙素比值 复发 |
| DOI：10.3969/j.issn.1674-3806.2023.08.02 |
| 分类号:R 736.1 |
| 基金项目:广东省基础与应用基础研究基金项目（编号：2019A1515010150） |
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| Postoperative calcitonin-to-preoperative calcitonin ratio as a predictive marker for structural recurrence in sporadic medullary thyroid cancer: a retrospective study |
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JIAO Zan, JIANG Ming-jie, WU Tong, et al.
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Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
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| Abstract: |
| ［Abstract］ Objective To study the application value of postoperative calcitonin-to-preoperative calcitonin ratio(CR) as a predictive marker for structural recurrence in sporadic medullary thyroid cancer(MTC). Methods The clinical data of the MTC patients treated in Sun Yat-sen University Cancer Center were retrospectively analyzed. Kaplan-Meier method and Cox regression analysis were used to investigate the impact of CR on recurrence-free survival(RFS) and a nomogram based on CR was constructed. Results The optimal cut-off value of CR for predicting disease recurrence was 0.124. The RFS of the patients in the CR≥0.124 group was significantly lower than that of the patients in the CR<0.124 group(P<0.001). The results of multivariate Cox regression analysis showed that CR, age, tumor diameter and the number of lymph node metastasis were the independent influence factors of structural recurrence in MTC, among which CR was the strongest independent predictor［HR(95%CI): 5.09(2.34-11.06), P<0.001］. The consistency index(c-index) of the nomogram model for predicting RFS was 0.837(95%CI: 0.763-0.911). Moreover, the calibration curves showed that the nomogram based on CR had relatively good calibration and predictive value. Conclusion CR is a strong prognostic marker to predict structural recurrence in patients with sporadic MTC. Under the condition of CR combined with the nomogram, the risk of postoperative structural recurrence in patients with sporadic MTC can be accurately calculated to provide individualized treatment. |
Key words: Medullary thyroid cancer Prognosis Calcitonin Postoperative calcitonin-to-preoperative
?calcitonin ratio(CR) Recurrence |
