Analysis Of Clinical Characteristics Of Low-risk Papillary Thyroid Microcarcinoma That Can Be Recommended For Active Surveillance

Objective:To explore the relevant clinical characteristics of low-risk PTMC that can be recommended for active surveillance,so as to provide clinical reference for PTMC patients to accept active surveillance.Methods:The clinical and postoperative pathological data of PTMC patients who underwent surgical treatment from January 2017 to December 2018 were reviewed.Patients with cancer metastasis found in PTMC postoperative pathology are classified as the group recommended for immediate surgery,while those without cancer metastasis are classified as the group recommended for active surveillance.ROC curve analysis was utilized to calculate the sensitivity,specificity and optimal diagnostic threshold for judging whether active surveillance can be recommended based on the age or tumor diameter of low-risk PTMC patients.?~2 test was used to compare whether there was a statistical difference among that patients can be recommended for active surveillance with different tumor diameter,gender,age,single focus or multiple foci.Logistic regression equation was utilized to analyze the relevant factors that low-risk PTMC patients can be recommended for active surveillance.Results:A total of 162 patients with low-risk PTMC were reflected in the present study.There were 30 males and 132 females;The age ranged from 24 years old to 68 years old and the average age was 44.51±10.31 years old;The tumor diameter ranged from 3 mm to 10 mm and the average tumor diameter was 7.04±2.22 mm;There were 112 cases PTMC that had single focal and 50 cases PTMC that had multiple foci;There were 52PTMC patients in the immediate surgery group and 110 PTMC patients in the active surveillance group.ROC curve analysis results showed that the optimal diagnostic threshold of age for judging whether low-risk PTMC patients could be recommended for active surveillance was 51.5 years old.Univariate analysis results showed that there was a statistical difference in low-risk PTMC's recommended management methods between the age<51.5 years old group and the age>51.5 years old group(P<0.05).While,there was no significant differences in low-risk PTMC's recommended management methods among different gender groups,tumor diameter groups,single focus group and multiple foci group(P>0.05).Multivariate analysis showed that age>51.5 years old was an important related factor to active surveillance for low-risk PTMC patients(P<0.05).Conclusions:Age is one of the important clinical characteristics related to whether low-risk PTMC patients can be recommended for active surveillance.PTMC elderly patients have a lower cancer metastasis rate than young and middle-aged patients.For low-risk PTMC patients over 51.5 years old and little psychological pressure,active surveillance can be recommended after combining risk assessment and repeated communication.This study provides reliable reference value for the feasibility of that patients can be recommended for active surveillance.In the future,a large number of prospective studies and related molecular biology studies will be still needed.