Predictors For Early(Within 3 Years) Recurrence Of Papillary Thyroid Carcinoma

Background: Thyroid carcinoma is a kind of by far the most common endocrine tumor,among them,thyroid papillary carcinoma(papillary thyroid carcinoma,PTC)is the most common,more than about 90% of thyroid cancer,the prognosis is best in the four kinds of thyroid cancer.In spite of this,some patients still have PTC recurrence,metastasis and even death.Studies have shown that PTC recurrence within 3 years after the first operation is an important risk factor affecting the prognosis.The risk factors of PTC recurrence have been studied by domestic and foreign scholars,but most of them were followed up for long-term postoperative(more than 5 years)to analyze the recurrence factors of PTC,and few of them took short-term(within 3 years)recurrence of thyroid papillary cancer as a research topic.Objective: To study the first operation of PTC and its clinical and pathological characteristics,and to analyze the influence of these factors on early(within 3 years)recurrence of PTC,the predictors of recurrence may indicate poor prognosis,so as to provide reference for clinical treatment,surgical range and postoperative management to a certain extent.Methods: Retrospective study of thyroid surgery were followed up for inventory file,the first hospital,Jilin university on January 1,2015 to December 31,2015 for the first time in the center line between surgery,and postoperative pathology confirmed for 1792 patients with thyroid papillary carcinoma,its treatment and relapse of postoperative follow-up,using 20 IMB SPSS Statistics software for statistical analysis.Gender,age,family history,surgical method,maximum tumor diameter,multifocal,lymph node metastasis,lymphocytic thyroiditis,TNM stage,capsule invasion,body mass index and other items were considered as possible prognostic factors for univariate analysis.Mann-Whitney test,Chi-square test or Fisher's exact probability method were used to test whether there were differences between the comparison group data of each clinical factor.Kaplan-Meier(k-m)method was used to compare the differences between the groups in the subsequent survival analysis,and the recurrence-free survival curve was drawn under each factor.The bilateral test was considered statistically significant when P<0.05.Finally,COX regression analysis was conducted to study the influence of multiple factors on recurrence and determine the independent factors that ultimately affect the recurrence of PTC patients.Results: A total of 1792 eligible patients were included,958 of whom were followed up,and 28 of them relapsed within 3 years.Due to the large number of patients without recurrence,300 people were randomly selected as the control group and 28 patients with recurrence as the recurrence group.The results of univariate analysis showed that there were no significant differences in gender,age,body mass index,TNM stage,surgical method and whether PTC patients were combined with hashimoto between the relapse group and the control group(P>0.05).PTC recurrence was significantly affected by family history of PTC,tumor diameter 2cm,multifocal tumor,lymph node metastasis,number of metastases 5,lateral cervical lymph node metastasis,membrane invasion,especially gross invasion(P<0.05).COX regression analysis showed that lymph node metastasis,especially lateral cervical lymph node metastasis,and family history were independent risk factors for early(within 3 years)PTC recurrence(P<0.05).Conclusion: Patients' gender,age,body mass index,whether they were combined with hashimoto,first operation and TNM stage did not significantly affect the early postoperative recurrence of PTC.Tumor diameter 2cm,multiple lesions and membrane invasion can increase the risk of early postoperative recurrence of PTC,but they are not independent risk factors.Family history of PTC and lymph node metastasis,especially lateral cervical lymph node metastasis,may be independent risk factors for early recurrence of PTC after first surgery.