摘要
目的分析甲状腺癌根治术后1年内复发的危险因素。方法选取2021年1月至2023年2月于济源市第二人民医院行根治术的甲状腺癌患者70例为研究对象,根据术后1年内复发情况分为复发组(n=17)和无复发组(n=53)。收集两组患者临床资料,分析甲状腺癌患者行根治术后1年内复发的影响因素。结果复发组术后未行131I治疗、肿瘤直径≥5cm、术前淋巴结转移、未分化癌、TNM分期为Ⅲ+Ⅳ期、腺体包膜浸润患者占比及甲状腺球蛋白(Tg)、甲状腺球蛋白抗体(TgAb)水平均高于无复发组,微RNA(miRNA)-335水平低于无复发组(P<0.05)。多因素Logistic回归分析显示:术后未行131I治疗、肿瘤直径、术前淋巴结转移、未分化癌、TNM分期、腺体包膜浸润、miRNA-335、Tg、TgAb均是影响甲状腺癌根治术后1年内复发的危险因素(P<0.05)。受试者操作特征(ROC)曲线分析显示:血清miRNA-335、Tg、TgAb预测甲状腺癌根治术后1年内复发的曲线下面积分别为0.818、0.821、0.852;敏感度分别为0.706、0.824、0.824;特异度分别为0.906、0.811、0.925。结论影响甲状腺癌根治术后1年内复发的因素包括术后未行131I治疗、肿瘤直径≥5cm、有术前淋巴结转移、未分化癌、TNM分期Ⅲ+Ⅳ、有腺体包膜浸润、miRNA-335高表达、Tg高水平及TgAb高水平等,临床随访时可对上述指标进行监测,继而及时实施干预措施。
【Objective】To analyze the risk factors for recurrence within one year after radical surgery for thyroid cancer.【Methods】Seventy patients with thyroid cancer who underwent radical surgery in at Jiyuan Second People's Hospital from January 2021 to February 2023 were selected.They were divided into a recurrence group(n=17)and a non-recurrence group(n=53)based on whether recurrence occurred within one year after surgery.Clinical data of the two groups were collected and analyzed to identify the influencing factors for recurrence within one year after radical surgery for thyroid cancer.【Results】The recurrence group had a significantly higher proportion of patients with the following characteristics compared with the non-recurrence group(P<0.05):no postoperative 131I therapy,tumor diameter≥5 cm,preoperative lymph node metastasis,undifferentiated carcinoma,TNM stage III+IV,and glandular capsule infiltration.Furthermore,levels of thyroglobulin(Tg)and thyroglobulin antibody(TgAb)were higher,while the level of microRNA(miRNA)-335 was lower in the recurrence group.Multivariate logistic regression analysis showed that absence of postoperative 131I therapy,tumor diameter,preoperative lymph node metastasis,undifferentiated carcinoma,TNM stage,glandular capsule infiltration,miRNA-335 expression,and levels of Tg and TgAb were independent risk factors for recurrence within one year(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under the curve of serum miRNA-335,Tg,and TgAb for predicting recurrence of thyroid cancer within one year after radical surgery were 0.818,0.821,and 0.852,respectively;the sensitivity values were 0.706,0.824,and 0.824 and the specificity values were 0.906,0.811,and 0.925,respectively.【Conclusion】Factors that affect the recurrence of thyroid cancer within one year after radical surgery include postoperative 131I treatment,tumor diameter,preoperative lymph node metastasis,undifferentiated cancer,TNM staging,glandular capsule infiltration,miRNA-335,Tg,TgAb,etc.Monitoring these indicators during follow-up could facilitate timely intervention.
作者
程娟
任联胜
李彩霞
CHENG Juan;REN Liansheng;LI Caixia(Department of Thyroid and Breast Surgery,Jiyuan Second People's Hospital,Jiyuan,Henan 459000,China)
出处
《中国医学工程》
2025年第8期56-60,共5页
China Medical Engineering
关键词
甲状腺肿瘤
甲状腺癌根治术
术后复发
影响因素
甲状腺球蛋白
thyroid tumors
radical thyroidectomy
postoperative recurrence
influencing factors
thyroglobulin
