基于倾向性得分匹配评价甲状腺乳头状癌右侧病灶大小与右侧喉返神经后方淋巴结转移的关系  

Relationship between right tumor size and metastasis of lymph node posterior to right recurrent laryngeal nerve in papillary thyroid carcinoma based on propensity score matching

作　　者：丁金旺 时晶晶 彭友 郑卫军[3] 周天晗 潘钢[2] DING Jinwang;SHI Jingjing;PENG You;ZHENG Weijun;ZHOU Tianhan;PAN Gang(Department of Head and Neck Surgery,Cancer Hospital of University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province,Hangzhou,Zhejiang,310022,China;Department of Oncological Surgery,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang,310006,China;School of Public Health,Zhejiang Chinese Medical University,Hangzhou,Zhejiang,310053,China)

机构地区：[1]中国科学院大学附属肿瘤医院(浙江省肿瘤医院)头颈外科,浙江省头颈肿瘤转化医学研究重点实验室,浙江杭州310022 [2]浙江大学医学院附属杭州市第一人民医院肿瘤外科,浙江杭州310006 [3]浙江中医药大学公共卫生学院,浙江杭州310053

出　　处：《中国耳鼻咽喉头颈外科》2021年第9期529-533,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：浙江省公益技术应用研究项目(2017C33180,LGF20H160003);浙江省医药卫生科技计划项目(2018KY576);杭州市卫生科技计划项目(0020190151、0020191087)。

摘　　要：目的基于倾向性得分匹配(propensity score matching,PSM)探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)右侧病灶大小与右侧喉返神经后方淋巴结(lymph node posterior to right recurrent laryngeal nerve,LN-prRLN)转移的关系。方法连续收集2014年3月~2019年7月在杭州市第一人民医院肿瘤外科收治的907例PTC,通过PSM分析匹配前后右侧病灶大小与LN-prRLN转移的相关性,制作受试者工作特征曲线评价预测效能。结果单因素和多因素分析结果均显示匹配前后右侧病灶大小是LN-prRLN转移的危险因素(P<0.05)。匹配前后右侧病灶大小均与LN-prRLN转移个数正相关(P<0.001)。右侧病灶大小预测LN-prRLN转移的曲线下面积为0.744,当取0.85 cm为界值时,敏感性为64.00%,特异性为72.00%。结论右侧病灶大小是预测PTC患者LN-prRLN转移的独立危险因素,当右侧病灶>0.85 cm时,建议行LN-prRLN清扫。OBJECTIVE To investigate the relationship between the right tumor size and the metastasis of lymph node posterior to right recurrent laryngeal nerve(LN-prRLN)in papillary thyroid carcinoma(PTC)based on propensity score matching(PSM).METHODS 907 consecutive patients with PTC who received surgical treatment in Department of Oncological Surgery of Hangzhou First People’s Hospital were enrolled in this study from March 2014 to July 2019.The correlation between the right tumor size and the metastasis of LN-prRLN before and after PSM was analyzed.Receiver operating characteristic curve was made to evaluate the clinical efficacy of right tumor size in predicting the metastasis of LN-prRLN.RESULTS Univariate analysis and multivariate logistic regression analysis showed that LN-prRLN metastases was closely related to the right tumor size before and after PSM(P<0.005).Furthermore,spearman correlation test showed that there was a positive correlation between the right tumor size and the number of LN-prRLN metastases(P<0.001).The area under the curve of the right tumor size in predicting the LN-prRLN metastases was 0.744.When 0.85 cm was taken as the threshold,the sensitivity and specificity of prediction were 64.00%and 72.00%,respectively.CONCLUSIONS The right tumor size was an independent risk factor for LN-prRLN metastases.LN-prRLN dissection is recommended when the right tumor size is>0.85 cm.

关 键 词：甲状腺肿瘤 倾向性得分匹配 病灶大小 右侧喉返神经后方淋巴结 

分 类 号：R736.1[医药卫生—肿瘤]