Journal of Multidisciplinary Healthcare (Feb 2023)
Blood Profiles in the Prediction of Radioiodine Refractory Papillary Thyroid Cancer: A Case–Control Study
Abstract
Hanqing Liu,1,* Qian Chen,2,* Bohao Liu,3 Jiaxi Wang,1 Chuang Chen,1 Shengrong Sun1 1Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 2Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 3Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chuang Chen; Shengrong Sun, Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan University at Jiefang Road 238, Wuhan, 430060, People’s Republic of China, Tel +86 27 88041911, Fax +86 27 88041911, Email [email protected]; [email protected]: Although most patients with papillary thyroid cancer can be cured by surgery and I-131 ablation, a small proportion will progress to radioactive iodine refractory (RAIR) thyroid cancer. The prediction of RAIR in its early stages can improve patient prognosis. The aim of this article is to evaluate the blood biomarkers in patients with RAIR and to establish a prediction model.Patients and Methods: Data collected from patients with thyroid cancer that were enrolled from Jan. 2017 to Dec. 2021 were screened. RAIR was defined based on the criteria in the 2015 American Thyroid Association guidelines. The blood biomarkers from the study participants at three admissions timepoints (surgery and first and secondary I-131 ablations) were compared using both parametric and nonparametric tests to identify predictive factors for RAIR. Binary logistic regression analysis was used to construct a prediction model using parameters associated with surgical procedure decision. The model was then assessed with receiver operating characteristic curves.Results: Thirty-six patients were included in the data analysis. Sixteen blood variables, including the low density lipoprotein-cholesterol-total cholesterol ratio, neutrophils, thyroglobulins, thyroglobulin antibody, thyroid peroxidase antibody, anion gap, etc., were revealed to be predictors for RAIR. The prediction model, which incorporated two parameters, reached an area under the curve of 0.861 (p< 0.001).Conclusion: Conventional blood biomarkers can be used in the prediction of early-stage RAIR. In addition, a prediction model incorporating multiple biomarkers can improve the predictive accuracy.Keywords: thyroid carcinoma, radioiodine refractoriness, scoring system, multivariable, PTC
