Clinicopathological features of differentiated thyroid carcinoma as predictors of the effects of radioactive iodine therapy

甲状腺癌 医学 内科学 甲状腺癌 肿瘤科 逻辑回归 癌症 甲状腺
作者
Wen Liu,Beibei Jiang,Jingli Xue,Ruijing Liu,Yuqing Wei,Peifeng Li
出处
期刊:Annals of Diagnostic Pathology [Elsevier BV]
卷期号:69: 152243-152243 被引量:1
标识
DOI:10.1016/j.anndiagpath.2023.152243
摘要

Patients with differentiated thyroid cancer (DTC) usually have an excellent prognosis; however, 5 %–15 % develop radioactive iodine-refractory (RAIR) DTC (RAIR-DTC), which has a poor prognosis and limited treatment options. The aim of the present study was to investigate the clinicopathological characteristics of RAIR-DTC in order to provide clinical evidence for timely prediction of the effects of iodine therapy. Clinicopathological data for 44 patients with RAIR-DTC and 50 patients with radioiodine-avid DTC (RAIA-DTC) were retrospectively analyzed. The risk factors for RAIR-DTC were evaluated and a RAIR-DTC prediction model was established. RAIR-DTC showed unique clinicopathological features that differed from those of RAIA-DTC; these included age >55 years, a high-risk histological subtype, a large tumor size, a late TNM stage, calcification, distant metastasis, and more than six metastatic lymph nodes. Patients with RAIR-DTC also developed earlier tumor progression. Binary logistic regression analysis showed that distant metastasis, a high-risk histological subtype, and a maximum tumor diameter of ≥12.5 mm were independent risk factors for RAIR-DTC, and the specificity and sensitivity of a combination of these three parameters for the prediction of RAIR-DTC were 98.0 % and 56.8 %, respectively. Decision curve analysis and the calibration curve revealed that the combined prediction of these three parameters had good repeatability and accuracy. The clinicopathological features of DTC can effectively predict the effects of iodine therapy. A combination of distant metastasis, a high-risk histological subtype, and a maximum tumor diameter of ≥12.5 mm showed significantly higher prediction accuracy.
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