淋巴结转移比值对淋巴结阳性甲状腺髓样癌患者预后的预测价值  

Predicting value of metastatic lymph node ratio in lymph node positive medullary thyroid carcinoma patients

作　　者：李铮[1] 卢秀波[1] LI Zheng;LU Xiubo(Department of Thyroid Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院甲状腺外科,郑州450052

出　　处：《郑州大学学报（医学版）》2022年第3期375-378,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划省部共建项目(SB201901023)。

摘　　要：目的:探究淋巴结转移比值(MLNR)对淋巴结阳性甲状腺髓样癌(MTC)患者术后预后的预测价值。方法:回顾性分析郑州大学第一附属医院初诊的87例淋巴结阳性MTC患者的临床病理资料,治疗方式均为全甲状腺切除并颈部淋巴结清扫术。应用Cox回归分析无进展生存、无局部复发生存和无远处转移生存的影响因素,采用ROC曲线计算MLNR的最佳截断值。结果:多因素分析结果显示高MLNR是患者无进展生存、无局部复发生存和无远处转移生存的不良影响因素[HR(95%CI)分别为1.552(1.051~2.292)、1.619(1.062~2.466)、1.712(1.028~2.739),P<0.05]。MLNR预测患者无进展生存的ROC曲线下面积为0.712,95%CI为0.567~0.857。根据ROC曲线,确定MLNR最佳截断值为0.52,并据此将患者分为低MLNR组(n=54)和高MLNR组(n=33)。高MLNR组较低MLNR组患者预后差(P<0.05)。结论:MLNR与淋巴结阳性MTC患者的预后有关,可作为评估该类患者术后预后的重要指标。Aim:To identify the predicting value of metastatic lymph node ratio(MLNR) in lymph node positive medullary thyroid carcinoma(MTC) patients.Methods:The clinicopathological and prognostic data of 87 MTC patients with positive lymph node that were admitted in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.Cox regression was used to analyze the influencing factors of disease-free survival(DFS),local-regional recurrence free survival(LRRFS) and distant metastases free survival(DMFS).ROC curve was used to calculate the cutoff value of MLNR.Results:Multivariate regression showed that high MLNR was an adverse factor in predicting postoperative prognosis of DFS,LRRFS and DMFS[HR(95%CI) were 1.552(1.051-2.292),1.619(1.062-2.466),1.712(1.028-2.739),P<0.05].The area under ROC curve for MLNR predicting DFS of patients was 0.712,95%CI was 0.567-0.857.According to the ROC curve,the optimal cutoff value of MLNR was 0.52,and patients were allocated into low MLNR group(n=54) and high MLNR group(n=33).The prognosis of the high MLNR group was poor compared with the low MLNR group(P<0.05).Conclusion:MLNR is associated with the prognosis of patients with lymph node positive MTC,and could be used as an important indicator to evaluate the postoperative prognosis.

关 键 词：甲状腺髓样癌 淋巴结转移比值 预后 

分 类 号：R736.1[医药卫生—肿瘤]