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- 저자 : 강상율(Sang Yull Kang) (검색결과 3 건)
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갑상선 유두암에서 전이 림프절 비율의 예후 인자적 가치
강상율(Sang Yull Kang),김선광(Seon Kwang Kim),윤현조(Hyun Jo Youn),정성후(Sung Hoo Jung) 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.3
Purpose: Metastatic lymph node ratio (MLNR) is known as an important prognostic factor in many solid carcinomas; however, the role of MLNR in papillary thyroid carcinoma (PTC) is unclear. The purpose of this study was to determine whether MLNR has prognostic significance for recurrence in patients with pathological N1a PTC. Methods: A retrospective analysis was conducted of 1,198 patients with PTC who underwent total thyroidectomy with central neck dissection between 2006 and 2011. Only patients with central lymph node metastasis were included in this study. Patients with lateral neck lymph node metastasis or extrathyroidal involvement were excluded. Finally, this study included 282 patients with N1a patients. MLNR was defined as the number of metastatic lymph nodes divided by the number of removed lymph nodes. Results: Median age was 47.3 years (17∼73 years). There were 209 female patients and 41 male patients, respectively. Median follow-up period was 53 months (36∼114 months). Median value of MLNR was 0.36 (0.04∼1.000). Of 250 patients, 20 patients (8.0%) developed recurrent disease. MLNR independently predicted PTC recurrence (odds ratio [OR], 6.385; 95% confidence interval [CI], 2.523-16.158; P < 0.001). In receiver operating characteristic curve analysis, 0.47 was significantly meaningful for recurrence when three or more lymph nodes were collected. Conclusion: MLNR is an independent predictor of PTC recurrence in patients with pathological N1a PTC. Therefore, N1a patients with MLNR > 0.47 should be monitored closely for recurrence.
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나안수,강상율,김선광,윤현조,정성후,Ahn Soo Na,Sang Yull Kang,Seon Kwang Kim,Hyun Jo Youn,Sung Hoo Jung 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4
Purpose: Obesity is a known risk factor for several cancers, including breast, colon, esophagus, kidney, uterus, and thyroid. Recent studies have reported that higher body mass index (BMI) is also associated with more advanced stage. The aim of this study was to investigate the clinicopathological relevance between BMI and papillary thyroid carcinoma (PTC). Methods: A total of 798 patients surgically treated for PTC from January 2006 to June 2010 were included in this study. Medical records and pathologic reports were reviewed retrospectively. According to BMI, patients were divided into four groups: underweight (3.1%), normal (57.3%), overweight (31.6%), and obese (8.0%). Clinicopathological factors were analyzed and compared between normal and other groups. Results: According to the results, 709 patients were women (89.0%) and mean age was 48.5 years; mean follow-up period was 1,721±464.2 days. In comparison between the normal and underweight groups, there was significantly more extra-thyroidal invasion [Odds ratio (OR) 3.923, P=0.006] in the underweight group. In the obese group, tumor size was significantly larger (OR 1.794, P=0.007). However, there was no significant difference between the normal and overweight group. Conclusion: In the obese group, tumor size was the only clinical significant factor between high BMI and PTC. Interestingly, more extra-thyroidal invasion was seen in the underweight group. To confirm this result, further studies with long-term follow-up and more patients are required.
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갑상선 유두암 재발의 예측 인자로서 혈중 호중구-림프구 비율의 임상적 유용성
한세웅,강상율,김선광,윤현조,정성후,Se Woong Han,Sang Yull Kang,Seon Kwang Kim,Hyun Jo Youn,Sung Hoo Jung 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4
Purpose: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of poor prognosis in patients with various types of cancer. To date, the utility of NLR for prediction of prognosis in thyroid cancer patients has not been studied. Therefore, the aim of our study was to determine whether NLR is associated with other prognostic factors of papillary thyroid carcinoma and predictive of recurrence. Methods: We conducted a retrospective review of 367 patients who underwent thyroidectomy for papillary thyroid carcinoma from January 2005 to December 2007. We measured the white blood cell count including neutrophil and lymphocyte within one month preoperatively. The NLR was defined as the absolute neutrophil count divided by absolute lymphocyte count. Logistic regression analysis was applied for comparison of NLR with other prognostic factors, including tumor size, lymph node metastasis, multiplicity, extrathyroidal invasion, and TNM stage. We also determined the cut-off value of NLR with a prediction for recurrence. Results: Median age of patients was 47 years (16∼86 years) and the rate of papillary thyroid microcarcinoma was 65.7% (241/367 cases). Median follow-up period was 1,841 days (506∼3,135 days). The median value of NLR was 1.68 (0.66∼6.36). NLR was not related to any other prognostic factors of papillary thyroid carcinoma. The cut-off value of NLR for prediction of recurrence was 1.73, where the sensitivity was 66.7% and specificity was 69.8%. Conclusion: Patients with NLR equal to or higher than 1.73 showed significantly higher recurrence of papillary thyroid carcinoma. Further validation study should be conducted for clinical use of NLR as a prognostic marker.
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