Background
Methods
Study design
Inclusion and exclusion criteria
Serum fibrinogen measurement
Univariate and multivariate analysis of PTC recurrence
Statistical analysis
Results
Patient characteristics and PTC features
Training set | Testing set | P Value | |||
---|---|---|---|---|---|
Patients | Patients | ||||
Factor | No. | % | No. | % | |
All patients | 414 | 100 | 609 | 100 | |
Age (years) | 0.639 | ||||
≤45 | 242 | 58.5 | 347 | 57.0 | |
>45 | 172 | 41.5 | 262 | 43.0 | |
Age (years) | 0.079 | ||||
≤55 | 357 | 86.2 | 500 | 84.0 | |
>55 | 57 | 13.8 | 109 | 16.0 | |
Gender | 0.196 | ||||
Female | 305 | 73.7 | 426 | 82.1 | |
Male | 109 | 26.3 | 183 | 17.9 | |
Postoperative RAI | 0.655 | ||||
Yes | 228 | 55.1 | 344 | 56.5 | |
No | 186 | 44.9 | 265 | 43.5 | |
Race | 0.971 | ||||
Han | 403 | 97.3 | 593 | 97.4 | |
Tibetan | 3 | 0.7 | 6 | 1.0 | |
Other† | 8 | 1.9 | 10 | 1.6 | |
Smoking | 0.603 | ||||
Never | 352 | 84.5 | 508 | 83.4 | |
Quit | 17 | 4.1 | 23 | 3.8 | |
Ongoing | 45 | 10.9 | 78 | 12.8 | |
Alcohol use | 0.027 | ||||
Never | 358 | 86.0 | 490 | 80.5 | |
Quit | 3 | 0.7 | 14 | 2.3 | |
Ongoing | 53 | 12.8 | 105 | 17.2 | |
BRAF mutation | 0.030 | ||||
Positive | 51 | 12.3 | 128 | 21.0 | |
Negative | 77 | 18.6 | 88 | 14.4 | |
Unknown | 286 | 68.6 | 393 | 64.5 | |
T classification | 0.016 | ||||
T1 | 160 | 38.6 | 197 | 32.3 | |
T2 | 11 | 2.7 | 13 | 2.1 | |
T3 | 188 | 45.4 | 294 | 48.3 | |
T4 | 55 | 13.3 | 105 | 17.2 | |
N classification | 0.605 | ||||
N0 | 196 | 47.3 | 293 | 48.1 | |
N1a | 156 | 37.7 | 197 | 32.3 | |
N1b | 62 | 15.0 | 119 | 19.5 | |
Distant metastasis | 0.361 | ||||
No | 410 | 99.0 | 599 | 98.4 | |
Yes | 4 | 1.0 | 10 | 1.6 | |
PTC number | 0.135 | ||||
Single | 355 | 85.7 | 536 | 88.0 | |
Multiple | 59 | 14.3 | 73 | 12.0 | |
Bilateral lobe PTC | 0.010 | ||||
Yes | 47 | 11.4 | 41 | 6.7 | |
No | 367 | 88.6 | 568 | 93.3 |
Associations between serum fibrinogen levels and clinicopathological features
Training set | Testing set | |||||
---|---|---|---|---|---|---|
Serum fibrinogen level | Serum fibrinogen level | |||||
Factor | Low | High |
p
| Low | High |
p
|
All patients | 402 | 12 | 575 | 34 | ||
Age (years) | 0.017 | 0.693 | ||||
≤45 | 239 | 3 | 328 | 18 | ||
>45 | 163 | 9 | 247 | 16 | ||
Age (years) | 0.046 | 0.378 | ||||
≤55 | 349 | 8 | 474 | 26 | ||
>55 | 53 | 4 | 101 | 8 | ||
Gender | 0.441 | 0.394 | ||||
Female | 295 | 10 | 400 | 26 | ||
Male | 107 | 2 | 175 | 8 | ||
Postoperative RAI | 0.683 | 0.884 | ||||
Yes | 221 | 7 | 324 | 20 | ||
No | 181 | 5 | 251 | 14 | ||
Race | 0.215 | 0.906 | ||||
Han | 392 | 11 | 560 | 33 | ||
Other | 10 | 1 | 15 | 1 | ||
BRAF mutation | 0.642 | 0.073 | ||||
Positive | 49 | 2 | 125 | 3 | ||
Negative | 74 | 3 | 84 | 4 | ||
Unknown | 279 | 7 | 366 | 27 | ||
T classification |
0.001
|
0.001
| ||||
T1 | 160 | 0 | 189 | 8 | ||
T2 | 8 | 3 | 12 | 1 | ||
T3 | 181 | 5 | 279 | 15 | ||
T4 | 53 | 4 | 95 | 10 | ||
PTC nodule number |
0.001
|
<0.001
| ||||
Single | 345 | 6 | 509 | 22 | ||
Multiple | 57 | 6 | 66 | 12 | ||
Capsule invasion | 0.068 |
0.036
| ||||
Presence | 194 | 10 | 266 | 22 | ||
Absence | 208 | 2 | 309 | 12 | ||
Strap muscles invasion |
<0.001
|
0.013
| ||||
Presence | 40 | 6 | 68 | 9 | ||
Absence | 362 | 6 | 507 | 25 | ||
RLN invasion |
<0.001
|
0.001
| ||||
Presence | 9 | 2 | 44 | 8 | ||
Absence | 393 | 10 | 531 | 26 | ||
Esophagus invasion |
<0.001
|
0.009
| ||||
Presence | 6 | 2 | 18 | 4 | ||
Absence | 396 | 10 | 557 | 30 | ||
Trachea invasion |
<0.001
|
<0.001
| ||||
Presence | 3 | 3 | 11 | 5 | ||
Absence | 399 | 9 | 564 | 29 | ||
N classification | 0.186 | 0.604 | ||||
N0 | 193 | 3 | 279 | 14 | ||
N1a | 149 | 7 | 183 | 14 | ||
N1b | 60 | 2 | 113 | 6 | ||
M classification |
<0.001
|
<0.001
| ||||
M0 | 400 | 10 | 569 | 30 | ||
M1 | 2 | 2 | 6 | 4 | ||
PTC recurrence |
0.002
|
0.002
| ||||
No | 373 | 8 | 547 | 28 | ||
Yes | 29 | 4 | 28 | 6 | ||
AJCC stage |
0.004
|
0.047
| ||||
I | 268 | 4 | 392 | 20 | ||
II | 62 | 2 | 100 | 3 | ||
III | 70 | 4 | 77 | 7 | ||
IV | 2 | 2 | 6 | 4 |
The correlation between serum fibrinogen levels and prognosis in PTC patients
Univariate and multivariate analyses of PTC recurrence
Training set | Testing set | |||
---|---|---|---|---|
Factor | HR(95% CI) |
p
| HR(95% CI) |
p
|
All patients | 414 | 609 | ||
Age (years) | 0.622 | 0.753 | ||
≤45 | 1 (reference) | 1 (reference) | ||
>45 | 0.982 (0.457 to 1.452) | 0.872(0.562 to 1.654) | ||
Age (years) | 0.672 | 0.261 | ||
≤55 | 1 (reference) | 1 (reference) | ||
>55 | 1.524 (0.782 to 2.281) | 1.622 (0.891 to 2.462) | ||
Gender | 0.321 | 0.271 | ||
Female | 1 (reference) | 1 (reference) | ||
Male | 1.451 (0.661 to 2.992) | 1.652 (0.842 to 2.721) | ||
Postoperative RAI | 0.172 | 0.283 | ||
Yes | 1 (reference) | 1 (reference) | ||
No | 0.872 (0.521 to 1.726) | 0.982 (0.475 to 2.228) | ||
Race | 0.372 | 0.208 | ||
Han | 1 (reference) | 1 (reference) | ||
Other | 1.211 (0.872 to 1.872) | 1.253 (0.772 to 2.011) | ||
BRAF mutation | 0.382 | 0.229 | ||
Positive | 1 (reference) | 1 (reference) | ||
Negative | 0.871 (0.622 to 1.263) | 0.982 (0.821 to 1.461) | ||
T classification |
0.021
|
0.008
| ||
T1-2 | 1 (reference) | 1 (reference) | ||
T3-4 | 3.261 (1.271 to 5.653) | 3.876 (1.532 to 6.211) | ||
PTC nodule number | 0.152 | 0.102 | ||
Single | 1 (reference) | 1 (reference) | ||
Multiple | 1.933 (0.891 to 2.901) | 2.011 (0.902 to 3.110) | ||
N classification |
0.048
|
0.041
| ||
N0 | 1 (reference) | 1 (reference) | ||
N1 | 1.502 (1.029 to 2.893) | 1.462 (1.081 to 3.011) | ||
M classification |
<0.001
|
<0.001
| ||
M0 | 1 (reference) | 1 (reference) | ||
M1 | 8.662 (3.092 to 16.223) | 9.920 (3.825 to 21.273) | ||
Serum fibrinogen levels |
0.012
|
0.007
| ||
Low | 1 (reference) | 1 (reference) | ||
High | 3.457 (2.203 to 6.782) | 4.228(2.102 to 7.541) |
Variables | Odds ratio | 95% CI | P value |
---|---|---|---|
Training set (n=414) | |||
Serum fibrinogen levels (high vs low) | 3.152 | 1.781-5.882 | 0.002 |
T classification | 4.117 | 1.340-9.831 | <0.001 |
N classification | 1.682 | 1.132-2.862 | 0.046 |
M classification | 11.681 | 5.684-32.391 | <0.001 |
Testing set (n=609) | |||
Serum fibrinogen levels (high vs low) | 2.891 | 1.201-4.874 | 0.032 |
T classification | 3.872 | 1.227-10.862 | 0.001 |
N classification | 1.621 | 1.201-2.984 | 0.042 |
M classification | 13.772 | 4.823-28.910 | <0.001 |