Research On Risk Factors Of Postoperative Recurrence Of Differentiated Thyroid Carcinoma

Objective To analyze the the possible risk factors for postoperative recurrence of differentiated thyroid cancer to provide clinical reference for postoperative follow-up.Methods A total of 899 patients with differentiated thyroid cancer（DTC）admitted to the Department of Oncology of Ningxia Medical University General Hospital from January2014 to January 2016 who underwent thyroid surgery for the first time were collected.Follow-up showed that 62 patients had recurrence,and they were divided into two groups according to recurrence（n=62）and non-recurrence（n=837）.Compared two groups of patients with clinical characteristics,tumor pathology,such as general situation（gender,age）,pathological type,the number of cancer,cancer,diameter,capsule invasion,lymph node metastasis（central,their neck area）,molecular pathology（presence of BRAFV600E expression）,immunohistochemical pathology（Ki67 level）,the presence of merger hashimoto thyroiditis,whether with nodular goiter,operation way（total thyroidectomy or other）,postoperative presence of indexes of ¹³¹I treatment.The effects of different factors on DTC recurrence were compared and analyzed.Results There were 62（6.8%）patients with DTC recurrence after the first surgical resection in our hospital,the mean time of recurrence was 24 months,and 91.9%of the patients recurred within 5 years.The analysis showed that gender and age were not related to recurrence（Table 1）.Pathological type（P>0.5）,surgical method（P=0.331）,postoperative131I treatment（P=0.333）,presence of Hashimoto’s thyroiditis（P=0.968）,nodular goiter（P=0.157）and BRAFV600E gene expression（P=0.646）were not risk factors for tumor recurrence（Table 2）.Ki67 levels（P=0.092）were not associated with recurrence（Table3）.Univariate analysis showed that multifocal,tumor diameter,capsule invasion,lymph node metastasis,central region metastasis,and lateral cervical region metastasis were all associated with DTC recurrence（P<0.05）（see Table 4）.Logistic regression analysis showed that multifocal（P=0.030,OR=1.831）,tumor diameter>2cm（P<0.009,OR=2.261）,lymph node metastasis（P=0.039,OR）were independent risk factors for recurrence after DTC（see Table5）.Conclusion There are three independent risk factors for postoperative recurrence of DTC,which are multifocal,tumor diameter and lymph node metastasis,respectively,suggesting that postoperative management should be individualized,and DTC patients with high risk of recurrence should receive active follow-up and treatment after surgery.