建造一种新工具，用于预测未接受手术的乳头状甲状腺癌患者的癌症特异性生存率
Construction of a new tool for predicting cancer-specific survival in papillary thyroid cancer patients who have not received surgery
影响因子:4.60000
分区:医学3区 / 内分泌学与代谢3区
发表日期:2024
作者:
Sanjun Chen, Yanmei Tan, Xinping Huang, Yanfei Tan
摘要
乳头状甲状腺癌的患病率正在逐渐增加，年轻人的趋势显而易见。由于身体或财务原因，一些患者可能无法接受手术，这是治疗的主要手术。因此，在非手术甲状腺癌患者中预测癌症特异性生存期（CSS）是必要的。病人的人口统计学和临床信息是从监测，流行病学和最终结果数据库中提取的。 SPSS软件用于执行COX回归分析以及倾向得分匹配分析。 R软件用于构建和验证列图。 X-tile软件用于选择患者风险分层的最佳截止点。这项回顾性研究总共包括1319名患者。经过COX回归分析后，使用年龄，年级，T期，M级，放疗和化学疗法来构建符号图。 C-索引，校准曲线和接收器操作特征曲线均验证了该图的高预测精度。决策曲线分析表明，患者可以从这种预测模型中获得临床益处。倾向匹配后的生存曲线分析证明了放射疗法对非手术患者的CSS的积极作用。您的回顾性研究成功地建立了一个nom图，可以准确预测非手术乳头状甲状腺甲状腺癌患者的CSS，并证明对手术患者的放射治疗仍然可以帮助改善预后。这些发现可以帮助临床医生做出更好的选择。
Abstract
The prevalence of papillary thyroid cancer is gradually increasing and the trend of youthfulness is obvious. Some patients may not be able to undergo surgery, which is the mainstay of treatment, due to physical or financial reasons. Therefore, the prediction of cancer-specific survival (CSS) in patients with non-operated papillary thyroid cancer is necessary.Patients' demographic and clinical information was extracted from the Surveillance, Epidemiology, and End Results database. SPSS software was used to perform Cox regression analyses as well as propensity score matching analyses. R software was used to construct and validate the nomogram. X-tile software was used to select the best cutoff point for patient risk stratification.A total of 1319 patients were included in this retrospective study. After Cox regression analysis, age, grade, T stage, M stage, radiotherapy, and chemotherapy were used to construct the nomogram. C-index, calibration curves, and receiver operating characteristic curves all verified the high predictive accuracy of the nomogram. The decision curve analysis demonstrated that patients could gain clinical benefit from this predictive model. Survival curve analysis after propensity score matching demonstrated the positive effects of radiotherapy on CSS in non-operated patients.Our retrospective study successfully established a nomogram that accurately predicts CSS in patients with non-operated papillary thyroid cancer and demonstrated that radiotherapy for operated patients can still help improve prognosis. These findings can help clinicians make better choices.