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Factores predictores de recurrencia en pacientes con cáncer de tiroides: un estudio transversal

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dc.contributor.advisorAlexandra, Porras
dc.contributor.authorLesmes Velasco, Dario Andres
dc.contributor.orcid1052384626
dc.date.accessioned2025-02-18T13:11:34Z
dc.date.available2025-02-18T13:11:34Z
dc.date.issued2025-02
dc.description.abstractIntroducción: el cáncer de tiroides es la neoplasia endocrina maligna más común globalmente, con una incidencia creciente. En Colombia, es el segundo en prevalencia, solo superado por Ecuador. Este estudio examina los factores de riesgo asociados con la recurrencia del carcinoma papilar de tiroides (CPT) en una cohorte de pacientes colombianos. Metodología: se realizó un estudio de corte transversal en una institución de tercer nivel en Bogotá, con 245 pacientes con CPT que recibieron terapia con yodo radiactivo. Se recopilaron datos clínicos y patológicos, y se realizó análisis estadístico con Stata para determinar las asociaciones entre variables y la recurrencia del cáncer. Análisis estadístico: se calculó la asociación de factores mediante odds ratios (OR) y se aplicó regresión logística multivariada. Se generó una curva ROC para evaluar la capacidad predictiva de la tiroglobulina en la recurrencia, se evaluó la interacción que tiene esta con otros factores. Resultados: los niveles elevados de tiroglobulina post-tiroidectomía (>2 ng/mL) se asociaron significativamente con un mayor riesgo de recaída (OR: 3, 07, IC 95%: 1, 21-8, 22, p=0.0082). Aunque el tamaño tumoral >2 cm mostró una tendencia hacia la recaída, no alcanzó significación estadística (p=0, 066). La terapia con yodo radiactivo y la presencia de anticuerpos anti-tiroglobulina indicaron posibles efectos protectores. El estado bioquímicamente incompleto según el sistema MSKCC también mostró una asociación significativa con la recaída (p=0.022, OR: 2.71). Conclusiones: la tiroglobulina post-quirúrgica es un predictor crucial de recurrencia del CPT. Aunque algunos factores como el tamaño tumoral y la invasión vascular no alcanzaron significancia estadística, podrían tener relevancia clínica. Estos hallazgos subrayan la importancia de un seguimiento intensivo en pacientes con niveles elevados de tiroglobulina y sugieren áreas para futuras investigacione
dc.description.abstractenglishIntroduction: Thyroid cancer is the most common endocrine malignancy globally, with an increasing incidence. In Colombia, it is the second most prevalent, only surpassed by Ecuador. This study examines the risk factors associated with the recurrence of papillary thyroid carcinoma (PTC) in a cohort of Colombian patients. Methodology: A cross-sectional study was conducted at a tertiary institution in Bogotá, with 245 patients with PTC who received radioactive iodine therapy. Clinical and pathological data were collected, and statistical analysis was performed with Stata to determine the associations between variables and cancer recurrence. Statistical analysis: The association of factors was calculated using odds ratios (OR) and multivariate logistic regression was applied. A ROC curve was generated to evaluate the predictive capacity of thyroglobulin in recurrence, and the interaction that it has with other factors was evaluated. Results: Elevated post-thyroidectomy thyroglobulin levels (>2 ng/mL) were significantly associated with an increased risk of relapse (OR: 3.07, 95% CI: 1.21-8.22, p=0.0082). Although tumor size >2 cm showed a trend toward relapse, it did not reach statistical significance (p=0.066). Radioactive iodine therapy and the presence of anti-thyroglobulin antibodies indicated possible protective effects. Biochemically incomplete status according to the MSKCC system also showed a significant association with relapse (p=0.022, OR: 2.71). Conclusions: Post-surgical thyroglobulin is a crucial predictor of PTC recurrence. Although some factors such as tumor size and vascular invasion did not reach statistical significance, they might have clinical relevance. These findings underscore the importance of intensive follow-up in patients with elevated thyroglobulin levels and suggest areas for future research.
dc.description.degreelevelMaestríaspa
dc.description.degreenameMagíster en Epidemiologíaspa
dc.description.sponsorshipCobos Medical Center
dc.format.mimetypeapplication/pdf
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/13986
dc.language.isoen_US
dc.publisher.facultyFacultad de Medicinaspa
dc.publisher.grantorUniversidad El Bosquespa
dc.publisher.programMaestría en Epidemiologíaspa
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dc.rightsAttribution-NonCommercial-ShareAlike 4.0 Internationalen
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf2
dc.rights.localAcceso abiertospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subjectNeoplasias de Tiroides
dc.subjectCáncer de Tiroides
dc.subjectCarcinoma Papilar de Tiroides
dc.subjectTiroglobulina
dc.subjectIsótopos Radioactivos
dc.subjectTerapia con Yodo Radioactivo
dc.subjectFactores de Riesgo
dc.subjectRecurrencia
dc.subjectTiroidectomía
dc.subjectBiomarcadores
dc.subjectEpidemiología
dc.subjectAnálisis Estadístico
dc.subjectAnálisis de Supervivencia
dc.subject.keywordsThyroid Neoplasms
dc.subject.keywordsThyroid Cancer
dc.subject.keywordsPapillary Thyroid Carcinoma
dc.subject.keywordsThyroglobulin
dc.subject.keywordsRadioactive Isotopes
dc.subject.keywordsRadioiodine Therapy
dc.subject.keywordsRisk Factors
dc.subject.keywordsRecurrence
dc.subject.keywordsThyroidectomy
dc.subject.keywordsBiomarkers
dc.subject.keywordsEpidemiology
dc.subject.keywordsStatistical Analysis
dc.subject.keywordsSurvival Analysis
dc.subject.nlmWA 105
dc.titleFactores predictores de recurrencia en pacientes con cáncer de tiroides: un estudio transversal
dc.title.translatedPredictive factors of recurrence in patients with thyroid cancer: a cross-sectional study
dc.type.coarhttps://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttps://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesis/Trabajo de grado - Monografía - Maestríaspa

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