Primary thyroid lymphoma: survival analysis of SEER database (1995–2016)

Abstract Background: Primary thyroid lymphoma (PTL) is a rare thyroid malignancy, there are few large sample studies on PTL and no standardized treatment regimen has been established due to the rarity. Objective: The aims of this study were to explore the incidence and prognostic factors of PTL and construct visual prognostic prediction models for post-chemotherapy and postoperative patients.Methods: The incidence of PTL in 1975-2017 was extracted from the US Surveillance, Epidemiology, and End Results (SEER) database, then assessed using joinpoint regression software. A total of 1,616 eligible PTL patients diagnosed in 1998-2016 were brought into prognostic analysis. Multivariate Cox regression analyses were carried out to reveal independent prognostic elements for overall survival (OS) and cancer-specific survival (CSS).Results: PTL incidence showed a relatively steady increase in 1975-1994, which annual percent change (APC) was 4.0%, and steady decreasing in 1994-2017(APC -2.4%). Age, marital status, lymphoma Ann Arbor stage, histological subtypes, surgery, chemotherapy, and radiation were significantly correlated to OS and CSS. The combination of radiotherapy with chemotherapy or surgery was beneficial to the prognosis of patients. Nomograms were constructed to predict OS and CSS in post-chemotherapy and postoperative PTL patients separately, and were verified to have good reliability.Conclusions: The incidence of PTL increased and subsequently decreased. We revealed the prognostic implications and constructed reliable nomograms for post-chemotherapy and postoperative PTL patients.

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Multi-modal Ultrasonic Diagnosis and Prognosis for Primary Thyroid Lymphoma Invasiveness

10.21203/rs.3.rs-629680/v1 ◽

2021 ◽

Author(s):

Chenjuan Peng ◽

Chen Yang ◽

Jincao Yao ◽

LingYan Zhou ◽

Jingjing Xu ◽

...

Keyword(s):

Poor Prognosis ◽

Survival Rates ◽

Diagnostic Value ◽

Thyroid Lymphoma ◽

Diagnosis And Prognosis ◽

Kaplan Meier ◽

Primary Thyroid Lymphoma ◽

Ultrasonic Images ◽

Mixed Types ◽

Thyroid Capsule

Abstract Objective Sixty-nine patients with primary thyroid lymphoma (PTL) were evaluated for diagnostic value and prognosis for PTL invasiveness. Methods We retrospectively (2008–2019) analyzed multi-modal ultrasonic images and clinical characteristics from pathologically confirmed PTL patients. These patients were divided into aggressive PTL(n=46) and indolent PTL(n=23). Results Age(>70 years old) and elevated LDH (lactase dehydrogenase) were statistically different clinical features between aggressive and indolent PTL. From ultrasonic images, 34 cases were nodular, 11 diffused, and 24 mixed. Mixed types displayed high invasiveness (45.7%) while diffuse types displayed higher inertness (39.1%), and differences were statistically significant (P = 0.000). Elastography, invaded thyroid capsule and increased chaotic vascularity also showed significant differences between aggressive and indolent PTL. We observed statistical difference in OS(overall survival rates) between aggressive and indolent PTL(p=0.032). Single factor Kaplan-Meier (K-M) analysis showed that: age > 70 years old, aggressive pathology, Ki67>30%, elastography scored >3 were positively correlated with the risk of poor prognosis of PTL (P < 0.05).Conclusions Multi-modal ultrasound provides accurate ultrasonographic information, e.g., ultrasound patterns, elastography, invaded thyroid capsules, and hypervascularity, which facilitates PTL invasiveness diagnostics for improved clinical treatment. In addition, PTL patients with age > 70 years old, aggressive pathology, Ki67>30%, elastography scored >3 are more likely to have poor prognosis.

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Contrast-Enhanced Ultrasound in the Differential Diagnosis of Primary Thyroid Lymphoma and Nodular Hashimoto’s Thyroiditis in a Background of Heterogeneous Parenchyma

Frontiers in Oncology ◽

10.3389/fonc.2020.597975 ◽

2021 ◽

Vol 10 ◽

Author(s):

Lulu Yang ◽

Haina Zhao ◽

Yushuang He ◽

Xianglan Zhu ◽

Can Yue ◽

...

Keyword(s):

Differential Diagnosis ◽

Hashimoto’S Thyroiditis ◽

Diagnostic Performance ◽

Roc Curves ◽

Hashimoto's Thyroiditis ◽

Imaging Features ◽

Contrast Enhanced Ultrasound ◽

Thyroid Lymphoma ◽

Contrast Enhanced ◽

Primary Thyroid Lymphoma

ObjectiveTo investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the differentiation of primary thyroid lymphoma (PTL) and nodular Hashimoto’s thyroiditis (NHT) in patients with background of heterogeneous diffuse Hashimoto’s thyroiditis (HT).MethodsSixty HT patients with 64 thyroid nodules (31 PTL and 33 NHT) who had undergone CEUS examination were included in this study. With histopathological results as the reference, we evaluated the imaging features of each nodule on both conventional ultrasonography (US) and CEUS. Quantitative CEUS parameters including peak intensity (PI), time to peak (TTP), and area under the time–intensity curve (AUC) were gathered in the nodule and background parenchyma. The ratio indexes of theses parameters were calculated by the ratio of the lesion and the corresponding thyroid parenchyma. Logistic regression and receiver operating characteristic (ROC) curves analyses of valuable US indicators were further preformed to evaluate the diagnostic capability of CEUS in discrimination of PTL and NHT.ResultsAmong all the observed US imaging features and CEUS parameters, 10 indicators showed significant differences between PTL and NHT (all P < 0.05). All the significant indicators were ranked according to the odds ratios (ORs). Eight of them were CEUS associated including imaging features of enhancement pattern, degree, homogeneity, and quantification parameters of PI, AUC, ratios of PI, AUC, and TTP, while indicators on conventional US, including vascularity and size ranked the last two with ORs less than 3. The five single CEUS parameters showed good diagnostic performance in diagnosis of PTL with areas under ROC curves of 0.72–0.83 and accuracies of 70.3–75.0%. The combination of CEUS imaging features and the ratios of PI, AUC, and TTP demonstrated excellent diagnostic efficiency and achieved area under ROC curve of 0.92, which was significantly higher than any of the five single parameters (all P < 0.05), with a sensitivity of 83.9%, specificity of 87.9%, and accuracy of 85.9%.ConclusionsCEUS is an efficient diagnostic tool in the differential diagnosis of PTL and NHT for patients with diffuse HT. Conjoint analysis of CEUS imaging features and quantification parameters could improve the diagnostic values.

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