Ultrasonography Combined with Antibody Status for Predicting ATA Recurrence Risk Stratification of Papillary Thyroid Carcinoma in the Context of Hashimoto's Background
10.3969/j.issn.1005-5185.2024.09.005
- VernacularTitle:超声联合抗体状态预测桥本甲状腺炎背景下甲状腺乳头状癌的ATA复发风险分层
- Author:
Naiqiao GE
1
,
2
;
Yuexiang WANG
;
Yu LAN
;
Bo JIANG
;
Molin LI
;
Guanghui XING
;
Yukun LUO
Author Information
1. 解放军医学院,北京 100853
2. 中国人民武装警察部队吉林省总队医院医学影像科,吉林长春 130051
- Keywords:
Hashimoto disease;
Thyroid cancer,papillary;
Ultrasonography;
Antibodies;
Recurrence;
Risk;
Forecasting
- From:
Chinese Journal of Medical Imaging
2024;32(9):891-896
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To predict the 2015 American thyroid association(ATA)recurrence risk stratification based on ultrasonographic features and Hashimoto's thyroiditis(HT)-specific antibody status of papillary thyroid carcinoma(PTC)in the context of HT.Materials and Methods A retrospective analysis was conducted on the ultrasonographic and clinical data of 479 patients with coexisting PTC and HT,who underwent their first thyroid surgery at the First Medical Center of Chinese PLA General Hospital from January 2017 to December 2019.All patients were divided in chronological order into a training group(n=327)and a validation group(n=152).Multivariate Logistic regression analysis was utilized to identify independent factors associated with high recurrence risk stratification according to the ATA guidelines.Predictive models were constructed and screened,and the efficacy of these models was evaluated using the area under the curve,calibration curves and Brier scores.Results Multivariate Logistic regression analysis identified the following as independent predictive factors for high recurrence risk stratification:multifocal malignancy of nodules(OR=3.812,95％CI 1.275-11.397,P=0.017),nodule contact with the capsule(OR=8.012,95％CI 1.647-38.972,P=0.010),microcalcifications(OR=4.220,95％CI 1.302-13.678,P=0.016),an aspect ratio＞1(OR=4.017,95％CI 1.286-12.548,P=0.017),abundant nodule vascularity(OR=6.120,95％CI 2.225-16.832,P＜0.001),maximum nodule diameter ≥1 cm(OR=4.784,95％CI 1.360-16.833,P=0.015),a glandular echo characteristic of typical HT(OR=0.114,95％CI 0.039-0.330,P＜0.001),and anti-thyroid peroxidase antibody monopositivity(OR=0.088,95％CI 0.006-1.299,P=0.077).The predictive model demonstrated strong performance,as evidenced by the area under the curve of 0.942(95％CI 0.911-0.972)in the training set and 0.933(95％CI 0.878-0.990)in the validation set.Both groups exhibited well-fitting calibration curves.The Brier scores were 0.054 and 0.058 for the training and validation sets,respectively,indicating excellent predictive efficacy of the model.Conclusion The preoperative prediction model,based on ultrasonographic features combined with antibody status,demonstrates good efficacy in assessing ATA recurrence risk stratification for coexisting PTC and HT patients,which can assist clinicians in formulating treatment plans.
