Logistic regression analysis of repeated radioiodine therapy treatments for papillary thyroid carcinoma patients
NUCLEAR MEDICINE COMMUNICATIONS
Authors: Soliman, Khaled; Albander, Hasna; Alenezi, Ahmed
Abstract
Purpose Radioiodine ablation treatment (RAT) is administered to papillary thyroid carcinoma patients post thyroidectomy. Multivariable logistic regression analysis can be applied to predict treatment failure. In this study, we propose a logistic regression model (LRM) to estimate the probability of repeating the treatment more than one time. Materials and methods A retrospective review of the last 5 years of RAT data revealed that 30 patients had received the RAT more than one time. Various factors including age, sex, pretreatment serum thyroglobulin (Tg), thyroid-stimulating hormone (TSH) and administered activity were analyzed to predict RAT failure and therefore the necessity to repeat the treatment by administering additional doses of radioiodine. Results The administered activity, the patient age, the presence of distant lymph nodes on the whole-body radioiodine scan (WBS) and the level of Tg before the treatment were found to be the predictive variables. The following LRM is proposed: Y = 7.8295 - 0.0012 [Activity in (MBq) - 0.0541 (Age) - 34.3 (Lymph Nodes) - 0.0042 (Tg)]. The prediction accuracy of the LRM was assessed using receiver operating characteristic (ROC) curve by calculating the area under the curve (AUC). We found the AUC = 0.8972. Conclusion Patients who are older in age, who receive higher administered radioiodine activity, have higher serum thyroglobulin levels and have lymph node uptake reported in their post-ablation WBS are more likely to have unsuccessful treatment outcome and will repeat the treatment. This LRM could help in adjusting RAT options in order to reduce the repeat rate.
Thyroid cancer and thyroid autoimmune disease: A review of molecular aspects and clinical outcomes
PATHOLOGY RESEARCH AND PRACTICE
Authors: Dias Lopes, Natalia Medeiros; Mendonca Lens, Hannah Hamada; Armani, Andre; Marinello, Poliana Camila; Cecchini, Alessandra Lourenco
Abstract
Thyroid cancer (TC) is the most prevalent malignant neoplasm that affects the endocrine system. Hashimoto's thyroiditis (HT), also known as chronic lymphocytic thyroiditis, is the most common autoimmune thyroid ease (AITD) that, together with Graves' disease (GD), represent the main autoimmune diseases that affect thyroid gland. Some studies suggest a greater risk of AITD and the development of TC, while others, investigate its relationship with TC progression and patient prognosis. In this review, we have analyzed published data the molecular aspects related to the association between AITD and TC, addressing their influence on TC gression, diagnosis, and prognosis of the patients. MEDLINE database (PubMed) platform was used as a search engine and the original articles related to the topic were selected using the keywords combination "thyroid cancer and Hashimoto thyroiditis" or "thyroid carcinoma and thyroid autoimmune disease". After the selection, we categorized the main findings of the papers into four topics: antitumor immunity, tumor progression, agnosis, and prognosis. Although most of the studies have pointed out the presence of AITD as a factor increases the risk of TC, few molecular mechanisms to support this conclusion have been described. Additionally, little information is available to explain, pathophysiologically, the effects of autoimmunity in TC diagnosis, progression, and prognosis.