摘要
目的分析影响非远处转移性甲状腺乳头状癌^(131)I治疗疗效的危险因素,构建疗效预测模型。方法回顾性分析我院2016年1月—2020年12月期间行甲状腺癌切除术和^(131)I治疗的422例患者临床资料,采用多因素logistic回归分析筛选影响^(131)I治疗疗效的独立危险因素,构建疗效预测模型,并对模型进行评价和验证。结果选取75%的患者作为训练集(n=319),25%的患者作为验证集(n=103),训练集经多因素logistic回归分析后,非远处转移性甲状腺乳头状癌^(131)I治疗疗效不满意的独立危险因素为BRAF^(V600E)突变阳性、sTg/TSH≥0.05 ng/μIU、sTg/TgAb≥0.60 ng/IU、病灶最大径≥1.05 cm、淋巴结分期N1b、淋巴结转移率≥34.58%(P<0.05)。构建诺莫图模型,其在训练集和验证集中的ROC曲线下面积分别为0.90(95%CI0.87~0.94,P<0.001)和0.86(95%CI0.78~0.94,P<0.001)。结论本研究基于非远处转移性甲状腺乳头状癌^(131)I治疗疗效不满意的危险因素构建的疗效预测模型具有良好的预测效能。
Objective The objective of this study was to analyze the risk factors affecting the curative effect of ^(131)I treatment for non-distant metastatic papillary thyroid carcinoma(PTC),and construct a predictive model for curative effect.Methods The clinical data of 422 patients who underwent thyroid cancer resection and ^(131)I treatment in our hospital from January 2016 to December 2020 were retrospectively analyzed.Multivariate logistic regression analysis was used to screen independent risk factors affecting the efficacy of ^(131)I treatment,and the efficacy predictive model was constructed as well as its evaluation and validation.Results Selecting 75%patients as training set(n=319),25%patients as validation set(n=103).After multivariate logistic regression analysis in the training set,the independent risk factors of unsatisfactory ^(131)I treatment for non-distant metastatic PTC were positive BRAF^(V600E) mutation,sTg/TSH≥0.05 ng/μIU,sTg/TgAb≥0.60 ng/IU,the largest diameter of lesions≥1.05 cm,the lymph node staging N1b and the lymphatic metastasis rate≥34.58%(P<0.05).A nomogram model was constructed,and the areas under the ROC curve in the training set and validation set were 0.90(95%CI0.87-0.94,P<0.001)and 0.86(95%CI0.78-0.94,P<0.001),respectively.Conclusion The efficacy predictive model constructed in this study based on the risk factors of unsatisfactory ^(131)I treatment efficacy in non-distant metastatic PTC has good predictive performance.
作者
梁洁
王新华
王健
夏欢
LIANG Jie;WANG Xinhua;WANG Jian;XIA Huan(Department of Nuclear Medicine,The Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《实用肿瘤学杂志》
CAS
2022年第3期220-225,共6页
Practical Oncology Journal
基金
新疆维吾尔自治区自然科学基金(编号:2021D01C409)。
