Hematological Indexes Can Be Used to Predict the Incidence of Hypothyroidism in Nasopharyngeal Carcinoma Patients after Radiotherapy

Abstract

Background. This study explored the relationship between thyroid-associated antibodies, immune cells, and hypothyroidism to establish a predictive model for the incidence of hypothyroidism in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods. A total of 170 patients with NPC treated at the Cancer Hospital of University of Chinese Academy of Sciences between January 2015 and August 2018 were included. The complete blood count, biochemical, coagulation function, immune cells, and thyroid-associated antibodies tested before radiotherapy were evaluated. A logistic regression model was performed to elucidate which hematological indexes were related to hypothyroidism development. A predictive model for the incidence of hypothyroidism was established. Internal verification of the multifactor model was performed using the tenfold cross-validation method. Results. The univariate analysis showed that immune cells had no statistically significant differences among the patients with and without hypothyroidism. Sex, N-stage, antithyroid peroxidase antibody (TPO-Ab), antithyroglobulin antibody (TG-Ab), thyroglobulin (TG), and fibrinogen (Fb) were associated with hypothyroidism. Males and early N-stage were protective factors of thyroid function, whereas increases in TPO-Ab, TG-Ab, TG, and Fb counts were associated with an increased rate of hypothyroidism incidence. The multivariate analysis showed that TPO-Ab, TG-Ab, TG, and Fb were independent predictors of hypothyroidism. The comprehensive effect of the significant model, including TPO-Ab, TG-Ab, TG, and Fb counts, represented the optimal method of predicting the incidence of radiation-induced hypothyroidism (AUC=0.796). Tenfold cross-validation methods were applied for internal validation. The AUCs of the training and testing sets were 0.792 and 0.798, respectively. Conclusion. A model combining TPO-Ab, TG-Ab, TG, and Fb can be used to screen populations at a high risk of developing hypothyroidism after radiotherapy.

Prognostic value of hypothyroidism in patients undergoing intensity‐modulated radiation therapy for nasopharyngeal carcinoma

“…Hypothyroidism is a common complication of radiotherapy for NPC. In the present study, we found that the incidence of hypothyroidism after radiotherapy for nasopharyngeal cancer was 38%, which was similar to that reported by other authors, 11 who reported a primary hypothyroidism incidence of 45.29% (77/170). After baseline matching, both disease‐free survival and recurrence‐free survival rates were higher in the hypothyroid group than in the group with normal thyroid function.…”

A new prognostic model for recurrent pregnancy loss: assessment of thyroid and thromboelastograph parameters

“…Additionally, thyroid autoantibodies, particularly TGAb, could be an expression of a more general maternal immune system abnormality leading to RPL (45). Research has shown that a positive TGAb and TPOAb expression is also associated with a higher incidence of hypothyroidism (46), with the presence of TPOAb being linked to RPL (47). Therefore, TAI and the thyroid function may have significant implications for the pathophysiology of RPL.…”

Establishment of a patient-derived organoid model and living biobank for nasopharyngeal carcinoma

“…NPC is causally linked to Epstein-Barr virus (EBV) infections ( 4 , 5 ). The 5-year overall survival rate for NPC is above 80% ( 6 , 7 ). However, recurrence occurs in 10% to 15% of patients with NPC, and the 5-year overall survival rate for patients with recurrent NPC is only 13.2% to 38% ( 8 , 9 ).…”