桥本氏甲状腺炎对放射性碘治疗后甲状腺乳头状癌临床结果的影响:倾向得分匹配研究。

IF 3.7 3区 医学 Q2 Medicine Endocrine Pub Date : 2025-01-01 Epub Date: 2024-07-26 DOI:10.1007/s12020-024-03973-3
Jingjia Cao, Yaru Sun, Yang Liu, Yunfei Xu, Xiao Li, Wei Zhang, Ximing Wang
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引用次数: 0

摘要

目的:多年来,人们从不同角度研究了桥本氏甲状腺炎(HT)与甲状腺乳头状癌(PTC)之间的潜在关联。本研究旨在评估桥本氏甲状腺炎对接受放射性碘(RAI)治疗的 PTC 患者临床预后的影响:我们对 2017 年 4 月至 2020 年 5 月接受 RAI 治疗的连续 PTC 患者进行了一项回顾性研究。HT的诊断基于病理检查,患者被分为HT组和非HT组。观察了年龄、性别、超声特征、乳头状变异、甲状腺外扩展和其他组织病理学特征的分布。采用倾向得分匹配法(PSM)比较两组患者在1年和3年随访时的临床特征和预后:共有 782 名 PTC 患者(570 名女性,212 名男性)入组。130例(16.6%)患者出现高热,发病时年龄较小、原发肿瘤较小、甲状腺外扩展较少、淋巴结转移较少。在复查图像时,只有钙化和血流分布在美国特征中存在显著差异(P 结论:钙化和血流分布在美国特征中存在显著差异:有 HT 的 PTC 患者发病时的侵袭性特征较低。重要的是,HT 的存在不仅与预后密切相关,而且对复发风险具有保护作用。
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The impact of Hashimoto's thyroiditis on the clinical outcome of papillary thyroid cancer after radioactive iodine therapy: a propensity score matching study.

Objective: The potential association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) has been studied from different perspectives for many years. This study was aimed to evaluate the impact of HT on the clinical outcomes of PTC patients after radioactive iodine (RAI) therapy.

Material and methods: We conducted a retrospective study on consecutive patients with PTC who underwent RAI therapy from April 2017 to May 2020. The diagnosis of HT was based on pathological examination, and patients were divided into the HT and non-HT group. Distributions of age, gender, ultrasound features, papillary variants, extrathyroidal extension, and other histopathological characteristics were observed. Propensity score matching (PSM) was used to compare the clinical features and outcomes between the two groups at 1 and 3-year follow-up.

Results: In total, 782 patients with PTC were enrolled (570 women, 212 men). HT was presented in 130 (16.6%) patients, and was associated with younger age, smaller primary tumors, less extrathyroidal extension, and less lymph node metastasis at presentation. On review of the images, only calcification and blood flow distribution were significantly different among the US features (P < 0.05). At the end of follow-up (three years), the responses to RAI therapy were significantly different between the two groups (ER: 76.9% vs 64.9%; IDR:11.5% vs 17.2%; BIR: 4.6% vs 10.7%; SIR: 6.9% vs 7.2%, P = 0.03). Patients with HT had less frequently evidence of disease (11.6% vs 17.9%). When compared with the matched groups, 123 pairs of patients were successfully matched, PTC patients with HT were found to have a better response to RAI therapy.

Conclusions: PTC patients with HT had less aggressive characteristics at presentation. Importantly, the presence of HT not only had a significant association with the outcome, but was also protective from the risk of recurrence.

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来源期刊
Endocrine
Endocrine 医学-内分泌学与代谢
CiteScore
6.40
自引率
5.40%
发文量
0
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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