CN114927223A - Evaluation model and method for differentiated thyroid cancer after total resection - Google Patents

Abstract

The invention discloses a full-resection postoperative evaluation model and method for differentiated thyroid cancer, wherein the model comprises the following steps: a data module for storing patient information, the patient information comprising: pathology information, serum data, and image data; a death risk assessment module for assessing a death risk based on the pathological information; a recurrence risk assessment module for assessing a recurrence risk based on the pathology information, the serum data, and the image data; the evaluation module before the postoperative iodine treatment is used for judging the curative effect of the operation based on the serum data and the image data; a real-time dynamic assessment module for assessing a patient treatment efficacy based on the pathology information, the serum data, and the image data. The model of the invention can definitely judge the operation curative effect and the treatment curative effect, and gives a patient and a definite judgment standard so as to ensure the patient to definitely determine the self condition and be convenient for a doctor to pertinently select a treatment scheme to treat the patient.

Description

Translated fromChinese

一种分化型甲状腺癌的全切术后评估模型和方法Postoperative evaluation model and method for differentiated thyroid cancer after total resection

技术领域technical field

本发明涉及医学领域，特别涉及一种分化型甲状腺癌的全切术后评估模型和方法。The invention relates to the field of medicine, in particular to a post-resection evaluation model and method for differentiated thyroid cancer.

背景技术Background technique

甲状腺癌以其发病率逐年增高日益引人关注，根据2018年国际癌症研究机构(International Agency for Research on Cancer，IARC)的数据估计，全球甲状腺癌发病率约为6.7/10万，我国每年新增病例达19万。分化型甲状腺癌(differentiated thyroidcancer，DTC)起源于甲状腺滤泡细胞，是甲状腺癌中最为常见的类型，主要包括乳头状癌、滤泡癌、Hu··rthle细胞癌和低分化甲状腺癌，占甲状腺癌总体的95％以上。目前甲状腺癌的治疗方法有很多，但是如何进行判断手术疗效和治疗疗效并没有很清楚的指导。Thyroid cancer is attracting more and more attention due to its increasing incidence year by year. According to the data of the International Agency for Research on Cancer (IARC) in 2018, the global incidence of thyroid cancer is about 6.7/100,000. The number of cases reached 190,000. Differentiated thyroid cancer (DTC) originates from thyroid follicular cells and is the most common type of thyroid cancer, including papillary carcinoma, follicular carcinoma, Hu··rthle cell carcinoma and poorly differentiated thyroid carcinoma, accounting for more than 95% of the cancer population. At present, there are many treatment methods for thyroid cancer, but there is no clear guidance on how to judge the efficacy of surgery and treatment.

发明内容SUMMARY OF THE INVENTION

(一)发明目的(1) Purpose of the invention

本发明的目的是提供一种可明确判断手术疗效和治疗疗效的分化型甲状腺癌的全切术后评估模型和方法。The purpose of the present invention is to provide a post-total resection evaluation model and method for differentiated thyroid cancer that can clearly determine the surgical efficacy and therapeutic efficacy.

(二)技术方案(2) Technical solutions

为解决上述问题，本发明的第一方面提供了一种分化型甲状腺癌的全切术后评估模型，包括：数据模块，用于存储患者的信息，所述患者的信息包括：病理信息、血清数据和影像数据；死亡风险评估模块，用于获取所述病理信息，并基于所述病理信息评估死亡风险；复发风险评估模块，用于获取所述病理信息、所述血清数据和所述影像数据，并基于所述病理信息、所述血清数据和所述影像数据评估复发风险；术后碘治疗前评估模块，用于获取所述血清数据和所述影像数据，并基于所述血清数据和所述影像数据判定手术疗效；实时动态评估模块，用于基于获取所述病理信息、所述血清数据和所述影像数据，并基于所述病理信息、所述血清数据和所述影像数据评估患者治疗疗效。In order to solve the above problems, a first aspect of the present invention provides a post-total resection evaluation model for differentiated thyroid cancer, including: a data module for storing patient information, the patient information including: pathological information, serum data and image data; a death risk assessment module for obtaining the pathological information and assessing the risk of death based on the pathological information; a recurrence risk assessment module for obtaining the pathological information, the serum data and the image data , and evaluate the risk of recurrence based on the pathological information, the serum data and the image data; an evaluation module before postoperative iodine treatment is used to obtain the serum data and the image data, and based on the serum data and the image data The image data is used to determine the surgical curative effect; the real-time dynamic evaluation module is used to obtain the pathological information, the serum data and the image data, and evaluate the patient treatment based on the pathological information, the serum data and the image data. curative effect.

进一步地，上述分化型甲状腺癌的全切术后评估模型还包括：随访时长模块，用于获取所述患者的信息，并基于患者的信息的得出治疗后随访时长。Further, the above-mentioned post-total resection evaluation model for differentiated thyroid cancer further includes: a follow-up duration module for acquiring the patient's information, and obtaining the post-treatment follow-up duration based on the patient's information.

进一步地，所述血清数据包括：Tg、TSH、TgAb和sTg数据。Further, the serum data includes: Tg, TSH, TgAb and sTg data.

进一步地，所述影像数据，包括：超声数据、CT数据、DxWBS数据、RxWBS数据和骨显像数据。Further, the image data includes: ultrasound data, CT data, DxWBS data, RxWBS data and bone imaging data.

进一步地，所述术后碘治疗前评估模块，包括：第一判定单元，用于基于所述血清数据，得出第一判定条件；第一评估模块，基于所述第一判定条件和所述影像数据评估手术疗效；其中，所述血清数据包括：第一次抽血数据为TgAb1、Tg1、sTg1和TSH1；第二次抽血数据为TgAb2、Tg2、sTg2和TSH2；Further, the pre-postoperative iodine treatment evaluation module includes: a first determination unit for obtaining a first determination condition based on the serum data; a first evaluation module based on the first determination condition and the Image data to evaluate surgical efficacy; wherein, the serum data includes: the first blood draw data are TgAb1, Tg1, sTg1 and TSH1; the second blood draw data are TgAb2, Tg2, sTg2 and TSH2;

所述第一判定条件，包括以下A、B和C：The first judgment condition includes the following A, B and C:

A：在TgAb2<115IU/mL的条件下，再满足下述两个条件之一：A: Under the condition of TgAb2<115IU/mL, one of the following two conditions is satisfied:

A1：TSH2<＝2ng/mL且Tg0<0.2ng/ml；A1: TSH2<=2ng/mL and Tg0<0.2ng/ml;

A2：TSH2>30ng/mL且Tg2<1.0ng/ml；A2: TSH2>30ng/mL and Tg2<1.0ng/ml;

B：满足下述两个条件之一：B: One of the following two conditions is met:

B1.在TgAb1<115IU/mL且TgAb2<115IU/mL的条件下，再满足下述两个条件之一：B1. Under the conditions of TgAb1<115IU/mL and TgAb2<115IU/mL, one of the following two conditions shall be satisfied:

B11：TSH1<＝2ng/mL且0.2ng/ml<＝Tg1<＝1ng/ml；B11: TSH1<=2ng/mL and 0.2ng/ml<=Tg1<=1ng/ml;

B12：TSH2>30ng/mL且1ng/ml<＝Tg2<＝10ng/ml；B12: TSH2>30ng/mL and 1ng/ml<=Tg2<=10ng/ml;

B2：在TgAb1>＝115IU/mL或TgAb2>＝115IU/mL的条件下，满足TgAb2<TgAb1*(1+20％)；B2: Under the condition of TgAb1>=115IU/mL or TgAb2>=115IU/mL, TgAb2<TgAb1*(1+20%);

C：满足下述两个条件之一：C: One of the following two conditions is met:

C1：在TgAb1<115IU/mL且TgAb2<115IU/mL的条件下，再满足下述两个条件之一：C1: Under the conditions of TgAb1<115IU/mL and TgAb2<115IU/mL, one of the following two conditions is satisfied:

C11：TSH2<＝2ng/mL且Tg2>1.0ng/ml；C11: TSH2<=2ng/mL and Tg2>1.0ng/ml;

C12：TSH2>30ng/mL且Tg2>10ng/ml；C12: TSH2>30ng/mL and Tg2>10ng/ml;

C2：在TgAb1>＝115IU/mL或TgAb2>＝115IU/mL的条件下，满足TgAb2<TgAb1*(1+20％)。C2: Under the condition of TgAb1>=115IU/mL or TgAb2>=115IU/mL, TgAb2<TgAb1*(1+20%) is satisfied.

进一步地，所述第一评估模块用于：基于所述第一判定条件为A且影像学-则判定疗效满意；基于所述第一判定条件为B且影像学-则判定疗效不确切；基于所述第一判定条件为C且影像学-则判定生化疗效不佳；基于所述影像数据表示复发或转移，则判定结构性疗效不佳。。Further, the first evaluation module is used to: judge that the curative effect is satisfactory based on the first judgment condition being A and imaging-based; judge that the curative effect is inaccurate based on the first judgment condition being B and imaging-based The first determination condition is C and imaging - means that the biochemical efficacy is not good; based on the imaging data indicating recurrence or metastasis, it is determined that the structural efficacy is not good. .

进一步地，所述实时动态评估模块，包括：第二判定单元，用于基于所述血清数据和所述影像数据，得出第二判定条件；第二评估模块，用于基于所述第二判定条件评估患者治疗疗效；Further, the real-time dynamic evaluation module includes: a second determination unit for obtaining a second determination condition based on the serum data and the image data; a second evaluation module for based on the second determination Conditional assessment of patient treatment efficacy;

所述第二判定条件，包括以下A至E：The second judgment condition includes the following A to E:

A，血清数据满足以下两个条件之一，且影像学-；A, Serum data meet one of the following two conditions, and imaging -;

A1：TgAb<115IU/mL，且TSH<＝2ng/mL且Tg<0.2ng/ml；A1: TgAb<115IU/mL, and TSH<=2ng/mL and Tg<0.2ng/ml;

A2：TgAb<115IU/mL，且TSH>30ng/mL且Tg<1.0ng/ml；A2: TgAb<115IU/mL, and TSH>30ng/mL and Tg<1.0ng/ml;

B，满足以下两个条件之一；B, one of the following two conditions is met;

B1，满足TgAb<115IU/mL，且影像学-，且满足以下条件之一，则满足条件B1：B1, satisfy TgAb<115IU/mL, and imaging -, and satisfy one of the following conditions, then satisfy condition B1:

B11:TSH<＝2ng/mL且0.2ng/ml<＝Tg<1ng/ml；B11: TSH<=2ng/mL and 0.2ng/ml<=Tg<1ng/ml;

B12:TSH>30ng/mL且1ng/ml<＝Tg<10ng/ml；B12: TSH>30ng/mL and 1ng/ml<=Tg<10ng/ml;

B2，满足TgAb>＝115IU/mL，且TgAb2<TgAb1*(1+20％)且影像学-；B2, TgAb>=115IU/mL, and TgAb2<TgAb1*(1+20%) and imaging -;

C，满足以下两个条件之一；C, one of the following two conditions is met;

C1，满足TgAb<115IU/mL，且影像学-，且满足以下条件之一，则满足条件C1：C1, satisfy TgAb<115IU/mL, and imaging -, and satisfy one of the following conditions, then satisfy condition C1:

C11：TSH<＝2ng/mL且Tg>＝1.0ng/ml；C11: TSH<=2ng/mL and Tg>=1.0ng/ml;

C12：TSH>30ng/mL且Tg>＝10ng/ml；C12: TSH>30ng/mL and Tg>=10ng/ml;

C2:TgAb>＝115IU/mL，且TgAb2>＝TgAb1*(1+20％)且影像学-；C2: TgAb>=115IU/mL, and TgAb2>=TgAb1*(1+20%) and imaging -;

D，血清学呈任何水平；影像学证实疾病存在；D. Serology at any level; imaging confirms the presence of disease;

E，影像学结果不明确。E, Imaging findings are inconclusive.

进一步地，所述第二评估模块用于：基于所述第二判定条件为A，则判定疗效满意；基于所述第二判定条件为B，则判定疗效不确切；基于所述第二判定条件为C，则判定生化疗效不佳；基于所述第二判定条件为D，则判定结构性疗效不佳；基于所述第二判定条件为E，则判定影像学不明确。Further, the second evaluation module is used to: based on the second judgment condition being A, then judging that the curative effect is satisfactory; based on the second judgment condition being B, then judging that the curative effect is not exact; based on the second judgment condition If it is C, it is determined that the biochemical effect is not good; based on the second determination condition of D, it is determined that the structural effect is not good; based on the second determination condition of E, it is determined that the imaging is unclear.

进一步地，所述复发风险包括高危、中危和低危；Further, the recurrence risk includes high risk, intermediate risk and low risk;

其中，符合以下任何条件之一，即为高危：Among them, any one of the following conditions is met, that is, high risk:

肉眼可见肿瘤侵犯周围组织或器官；Macroscopic tumor invasion into surrounding tissues or organs;

肿瘤未能完全切除；The tumor was not completely removed;

影像数据显示有远处转移；Imaging data showing distant metastasis;

血清数据显示有远处转移；Serum data showing distant metastasis;

FTC伴有广泛血管侵犯；FTC with extensive vascular invasion;

符合以下任何条件之一，即为中危；Any one of the following conditions is met, which is medium risk;

镜下发现肿瘤有甲状腺周围软组织侵犯；Microscopically, the tumor was found to have perithyroid soft tissue invasion;

初次碘131治疗后RxWBS发现有颈部甲状腺床外转移灶摄碘；After initial iodine-131 treatment, RxWBS found that there was iodine uptake in cervical metastases outside the thyroid bed;

肿瘤为侵袭性组织学亚型；The tumor is of an aggressive histological subtype;

PTC伴有血管侵犯；PTC with vascular invasion;

临床发现淋巴结转移或病理检查发现＞5个淋巴结转移；Lymph node metastasis was found clinically or >5 lymph node metastasis was found by pathological examination;

符合以下A、B、C和D任一一条者为低危：Low-risk individuals who meet any of the following A, B, C, and D:

A,病理类型＝1且符合以下全部条件A1-A7的PTC为低危：A, PTC with pathological type=1 and meeting all the following conditions A1-A7 is low risk:

A1：无局部或远处转移；A1: No local or distant metastasis;

A2：所有肉眼可见的肿瘤均被彻底切除；A2: All macroscopic tumors were completely removed;

A3：肿瘤没有侵犯周围组织；A3: The tumor does not invade surrounding tissues;

A4：肿瘤不是侵袭性组织学亚型；A4: The tumor is not an aggressive histological subtype;

A5:若行碘131治疗，则首次RxWBS显示甲状腺床外无异常放射性碘摄取灶；A5: If iodine-131 treatment is performed, the first RxWBS shows that there is no abnormal radioactive iodine uptake outside the thyroid bed;

A6：无血管侵犯；A6: No vascular invasion;

A7：临床未发现有淋巴结转移，或病理检查发现≤5个淋巴结微转移A7: No lymph node metastasis was found clinically, or ≤5 lymph node micrometastases were found by pathological examination

B,局限于甲状腺内的FV-PTC；B, FV-PTC confined to the thyroid;

C,局限于甲状腺内、伴有包膜侵犯的高分化FTC，无血管侵犯或仅有微血管侵犯(＜4个病灶)；C, Well-differentiated FTC confined to the thyroid gland with capsular invasion, no vascular invasion or only microvascular invasion (<4 lesions);

D，局限于甲状腺内、单灶或多灶的PTMC。D, PTMC confined to the thyroid gland, unifocal or multifocal.

进一步地，随访时长模块包括：第一时长单元，用于在已做首次碘131治疗的时候判定随访时长；第二时长单元，用于在已做未做碘131治疗的时候判定随访时长。Further, the follow-up duration module includes: a first duration unit, used to determine the follow-up duration when the first iodine-131 treatment has been performed;

本发明的第二方面提供了一种分化型甲状腺癌的全切术后评估方法，包括：获取患者的信息，所述患者的信息包括：病理信息、血清数据和影像数据；基于所述病理信息评估死亡风险；基于所述病理信息、所述血清数据和所述影像数据评估复发风险；基于血清数据和影像数据判定手术疗效；基于所述病理信息、所述血清数据和所述影像数据评估患者治疗疗效。。A second aspect of the present invention provides a post-total resection evaluation method for differentiated thyroid cancer, comprising: acquiring patient information, where the patient information includes: pathological information, serum data and image data; based on the pathological information assessing the risk of death; assessing the risk of recurrence based on the pathological information, the serum data and the imaging data; determining the surgical efficacy based on the serum data and the imaging data; evaluating the patient based on the pathological information, the serum data and the imaging data therapeutic efficacy. .

(三)有益效果(3) Beneficial effects

本发明的上述技术方案具有如下有益的技术效果：The above-mentioned technical scheme of the present invention has the following beneficial technical effects:

本发明的评估模型通过数据模块，死亡风险评估模块、复发风险评估模块、术后碘治疗前评估模块、实时动态评估模块，可明确判断手术疗效和治疗疗效，给患者和明确一个明确的判定标准，以便患者明确自身状况，并且便于医生有针对性的选择治疗方案对患者进行治疗。The evaluation model of the present invention can clearly judge the surgical curative effect and the therapeutic curative effect through the data module, the death risk assessment module, the recurrence risk assessment module, the post-operative iodine treatment pre-assessment module, and the real-time dynamic assessment module, and provide patients with a clear judgment standard. , so that patients can clarify their own conditions, and it is convenient for doctors to choose a treatment plan for the patients in a targeted manner.

附图说明Description of drawings

图1是本发明第一实施方式的分化型甲状腺癌的全切术后评估模型的结构示意图；1 is a schematic structural diagram of a post-total resection evaluation model for differentiated thyroid cancer according to the first embodiment of the present invention;

图2是本发明第二实施方式的分化型甲状腺癌的全切术后评估方法的流程图。2 is a flowchart of a method for evaluating differentiated thyroid cancer after total resection according to the second embodiment of the present invention.

附图标记reference number

100：数据模块；200：死亡风险评估模块；300：复发风险评估模块；400：术后碘治疗前评估模块；500：实时动态评估模块；600：随访时长模块。100: data module; 200: death risk assessment module; 300: recurrence risk assessment module; 400: post-operative iodine treatment pre-assessment module; 500: real-time dynamic assessment module; 600: follow-up duration module.

具体实施方式Detailed ways

为使本发明的目的、技术方案和优点更加清楚明了，下面结合具体实施方式并参照附图，对本发明进一步详细说明。应该理解，这些描述只是示例性的，而并非要限制本发明的范围。此外，在以下说明中，省略了对公知结构和技术的描述，以避免不必要地混淆本发明的概念。In order to make the objectives, technical solutions and advantages of the present invention clearer, the present invention will be further described in detail below with reference to the specific embodiments and the accompanying drawings. It should be understood that these descriptions are exemplary only and are not intended to limit the scope of the invention. Also, in the following description, descriptions of well-known structures and techniques are omitted to avoid unnecessarily obscuring the concepts of the present invention.

首先对一些英文缩写进行释义：First, some English abbreviations are explained:

TgAb：表示抗甲状腺球蛋白抗体；TgAb: means anti-thyroglobulin antibody;

Tg：表示甲状腺球蛋白抗体；Tg: indicates thyroglobulin antibody;

sTg：表示刺激性甲状腺球蛋白抗体；即TSH>30ng/mL时Tg的值。sTg: Indicates stimulating thyroglobulin antibody; that is, the value of Tg when TSH>30ng/mL.

TSH：表示促甲状腺激素。TSH: stands for Thyroid Stimulating Hormone.

第一实施方式first embodiment

图1是本发明第一实施方式的分化型甲状腺癌的全切术后评估模型的结构示意图。FIG. 1 is a schematic structural diagram of a post-total resection evaluation model for differentiated thyroid cancer according to the first embodiment of the present invention.

如图1所示，本实施方式提供了一种分化型甲状腺癌的全切术后评估模型，包括：数据模块100，用于存储患者的信息，所述患者的信息包括：病理信息、血清数据和影像数据；死亡风险评估模块200，用于基于所述病理信息评估死亡风险；复发风险评估模块300，用于基于所述病理信息、所述血清数据和所述影像数据评估复发风险；术后碘治疗前评估模块400，用于基于血清数据和影像数据；实时动态评估模块500，用于在碘治疗后，基于所述病理信息、所述血清数据和所述影像数据评估。本实施方式的评估模型通过数据模块100，死亡风险评估模块200、复发风险评估模块300、术后碘治疗前评估模块400、实时动态评估模块500，可明确判断手术疗效和治疗疗效，给患者和明确一个明确的判定标准，以便患者明确自身状况，并且便于医生有针对性的选择治疗方案对患者进行治疗。As shown in FIG. 1 , this embodiment provides a post-total resection evaluation model for differentiated thyroid cancer, including: a data module 100 for storing patient information, where the patient information includes: pathological information, serum data and image data; the death risk assessment module 200 is used to assess the death risk based on the pathological information; the recurrence risk assessment module 300 is used to assess the recurrence risk based on the pathological information, the serum data and the image data; The pre-iodine treatment evaluation module 400 is used for evaluating based on serum data and image data; the real-time dynamic evaluation module 500 is used for evaluating based on the pathological information, the serum data and the image data after the iodine treatment. Through the data module 100, the death risk assessment module 200, the recurrence risk assessment module 300, the pre-postoperative iodine treatment assessment module 400, and the real-time dynamic assessment module 500, the assessment model of this embodiment can clearly determine the surgical efficacy and treatment efficacy, and provide patients and patients with A clear judgment standard is defined, so that patients can identify their own conditions, and it is convenient for doctors to choose treatment plans for patients in a targeted manner.

所述血清数据至少包括：Tg、TSH、TgAb和sTg数据。The serum data includes at least: Tg, TSH, TgAb and sTg data.

所述影像数据至少包括：超声数据、CT数据和DxWBS数据。The image data at least includes: ultrasound data, CT data and DxWBS data.

病理信息至少包括：病灶和残甲数量。Pathological information includes at least: lesions and number of residual nails.

所述血清数据具体包括术后停左甲状腺素片的血清数据，包括：Tg0、TSH0、TgAb0和sTg0数据；和，两次碘-131治疗前的抽血的血清数据，包括：Tg1、TSH1、TgAb1和sTg1数据和Tg2、TSH2、TgAb2和sTg2数据。The serum data specifically includes serum data of levothyroxine tablets after surgery, including: Tg0, TSH0, TgAb0, and sTg0 data; and, serum data of blood drawn before two iodine-131 treatments, including: Tg1, TSH1, TgAb1 and sTg1 data and Tg2, TSH2, TgAb2 and sTg2 data.

其中，按照治疗的顺序，患者的信息可以包括：Among them, in the order of treatment, the patient's information can include:

基本信息，包括：患者的ID号、姓名、性别、确诊年龄和出生日期；Basic information, including: patient's ID number, name, gender, age at diagnosis and date of birth;

首次手术前甲功，包括：患者的ID号、姓名、手术次数、时间、促甲状腺激素(TSH：单位：uIU/ml)、甲状腺球蛋白(Tg：单位：ng/ML、甲状腺球蛋白抗体(TgAb：单位：IU/ml)、促甲状腺激素受体抗体(TRAb：单位：IU/L)、抗甲状腺过氧化物酶抗体(A-TPO：单位：IU/ml)，这个首次手术，即分化型甲状腺癌全切手术；Thyroid function before the first operation, including: patient's ID number, name, number of operations, time, thyroid stimulating hormone (TSH: unit: uIU/ml), thyroglobulin (Tg: unit: ng/ML, thyroglobulin antibody ( TgAb: unit: IU/ml), thyrotropin receptor antibody (TRAb: unit: IU/L), anti-thyroid peroxidase antibody (A-TPO: unit: IU/ml), this first operation, that is, differentiation type thyroid cancer total resection;

病理信息，包括：患者的ID号、姓名、手术次数、手术时间、手术方式、手术切缘、病理类型、病理亚型、分化程度、术后病理是否提示桥本氏甲状腺炎或其他甲状腺炎原发肿瘤单双侧、原发灶最大径、是否累及被膜、是否侵犯血管、侵犯血管灶数、最远倾及范围周围侵犯明显度、多灶性、多灶数量、是否淋巴结清扫、淋巴结清扫数、淋巴清扫数量合计、淋巴结转移数、淋巴结转移数量合计转移淋巴结最大径、远处转移部位、远处转移描述、免疫组化Ki-67(单位：％)、免疫组化VEGF、TERT突变、Braf突变、K-ras突变、H-ras突变、N-ras突变、TP 53突变、RET和免疫组化EGFR；Pathological information, including: patient's ID number, name, number of operations, operation time, operation method, surgical margin, pathological type, pathological subtype, degree of differentiation, and whether postoperative pathology suggests Hashimoto's thyroiditis or other thyroiditis Unilateral and bilateral tumor, the largest diameter of the primary tumor, whether it involves the capsule, whether it invades the blood vessels, the number of vascular lesions, the most distant and surrounding extent of invasion, multifocality, the number of multifocal lesions, whether lymph node dissection, and the number of lymph node dissections , Total number of lymph node dissections, number of lymph node metastases, total number of lymph node metastases, maximum diameter of metastatic lymph nodes, distant metastasis site, description of distant metastasis, immunohistochemical Ki-67 (unit: %), immunohistochemical VEGF, TERT mutation, Braf Mutation, K-ras mutation, H-ras mutation, N-ras mutation, TP 53 mutation, RET and immunohistochemical EGFR;

术后停L-T4前甲功，包括：ID号、姓名、手术次数、检测时间1、促甲状腺激素1(TSH：单位：uIU/ml)、甲状腺球蛋白1(Tg：单位：ng/Ml)、甲状腺球蛋白抗体1(TgAb：单位：IU/ml)、促甲状腺激素受体抗体1(TRAb：单位：IU/L)、检测时间2、促甲状腺激素2(TSH：单位：uIU/ml)、甲状腺球蛋白2(Tg：单位：ng/Ml)、甲状腺球蛋白抗体2(TgAb：单位：IU/ml)和促甲状腺激素受体抗体2(TRAb：单位：IU/L)。这里保留两次检测的血清数据或者更多；Postoperative thyroid function before stopping L-T4, including: ID number, name, number of operations, detection time 1, thyroid stimulating hormone 1 (TSH: unit: uIU/ml), thyroglobulin 1 (Tg: unit: ng/Ml) ), thyroglobulin antibody 1 (TgAb: unit: IU/ml), thyrotropin receptor antibody 1 (TRAb: unit: IU/L), detection time 2, thyrotropin 2 (TSH: unit: uIU/ml) ), thyroglobulin 2 (Tg: unit: ng/Ml), thyroglobulin antibody 2 (TgAb: unit: IU/ml), and thyrotropin receptor antibody 2 (TRAb: unit: IU/L). Serum data for two tests or more are retained here;

碘131治疗前评估，包括：ID号、姓名、手术次数、预行碘治疗次数、影像学检查、升高TSH的方式、停服L-T4时间、第1次抽血时间、促甲状腺激素1(TSH：单位：uIU/ml)、甲状腺球蛋白1(Tg：单位：ng/Ml)、甲状腺球蛋白抗体1(TgAb：单位：IU/ml)、促甲状腺激素受体抗体1(TRAb：单位：IU/L)、第2次抽血时间、促甲状腺激素2(TSH：单位：uIU/ml)、甲状腺球蛋白2(Tg：单位：ng/Ml)、甲状腺球蛋白抗体2(TgAb：单位：IU/ml)和促甲状腺激素受体抗体2(TRAb：单位：IU/L)。其中，影像学检查包括：颈部B超、胸部CT结果、其他检查(如PET/CT、MIBI等)、其他检查描述、诊断性碘-131全身显像(DxWBS)和诊断性碘-131全身显像其他转移描述；Evaluation before iodine 131 treatment, including: ID number, name, number of operations, number of pre-operative iodine treatment, imaging examination, way of increasing TSH, time of stopping L-T4, time of first blood draw, thyroid stimulating hormone1 (TSH: unit: uIU/ml), thyroglobulin 1 (Tg: unit: ng/Ml), thyroglobulin antibody 1 (TgAb: unit: IU/ml), thyrotropin receptor antibody 1 (TRAb: unit : IU/L), the second blood draw time, thyroid stimulating hormone 2 (TSH: unit: uIU/ml), thyroglobulin 2 (Tg: unit: ng/Ml), thyroglobulin antibody 2 (TgAb: unit : IU/ml) and thyroid stimulating hormone receptor antibody 2 (TRAb: unit: IU/L). Among them, imaging examinations include: neck B-ultrasound, chest CT results, other examinations (such as PET/CT, MIBI, etc.), other examination descriptions, diagnostic iodine-131 whole body imaging (DxWBS) and diagnostic iodine-131 whole body imaging imaging other metastatic descriptions;

碘131治疗，包括：患者的ID号、姓名、手术次数、碘治疗次数、治疗日期、治疗剂量、影像学检查-治疗后碘-131全身显像(RxWBS)和治疗后碘-131全身显像(RxWBS)其他转移描述；Iodine-131 treatment, including: patient's ID number, name, number of operations, number of iodine treatments, date of treatment, treatment dose, imaging tests - post-treatment iodine-131 whole-body imaging (RxWBS) and post-treatment iodine-131 whole-body imaging (RxWBS) other transfer descriptions;

碘131治疗后随诊，包括：患者的ID号、姓名、手术次数、碘治疗次数、随诊次数、抽血日期、促甲状腺激素(TSH：单位：uIU/ml)、甲状腺球蛋白(Tg：单位：ng/Ml)、甲状腺球蛋白抗体(TgAb：单位：IU/ml)、促甲状腺激素受体抗体(TRAb：单位：IU/L)和影像学检查。其中，影像学检查，包括：颈部B超、胸部CT、DxWBS、DxWBS其他转移描述、其他检查(如PET/CT、MIBI等)和影像学检查其他检查描述。Follow-up after iodine-131 treatment, including: patient's ID number, name, number of operations, number of iodine treatments, number of follow-up visits, date of blood draw, thyroid-stimulating hormone (TSH: unit: uIU/ml), thyroglobulin (Tg: Unit: ng/Ml), thyroglobulin antibody (TgAb: unit: IU/ml), thyrotropin receptor antibody (TRAb: unit: IU/L) and imaging examination. Among them, imaging examinations include: neck B-ultrasound, chest CT, DxWBS, other DxWBS metastasis descriptions, other examinations (such as PET/CT, MIBI, etc.) and imaging examinations and other examination descriptions.

结果，包括：患者的ID号、姓名、肿瘤TNM分期-T、肿瘤TNM分期-N、肿瘤TNM分期-M、STAGE(8TH)、复发风险分层、术后状态评估、实时动态评估和初始治疗后随访时长(月)。Results, including: patient's ID number, name, tumor TNM stage-T, tumor TNM stage-N, tumor TNM stage-M, STAGE (8TH), recurrence risk stratification, postoperative status assessment, real-time dynamic assessment and initial treatment Length of follow-up (months).

先对下述的取值进行说明：First, the following values are explained:

手术方式：＝0，表示未再行甲状腺局部手术(包括淋巴结清扫)Surgical method: = 0, indicating that no local thyroid surgery (including lymph node dissection) has been performed.

＝1，表示单侧切=1, which means unilateral cut

＝2，表示近/全切=2, means near/full cut

＝3，表示残余甲状腺切除术；=3, indicating residual thyroidectomy;

手术切缘：＝0，表示阴性Surgical margin: = 0, indicating negative

＝1，表示阳性；=1, indicating positive;

病理类型：＝0，表示无原发肿瘤证据Pathological type: = 0, indicating no evidence of primary tumor

＝1，表示PTC(乳头状癌)= 1, indicating PTC (papillary carcinoma)

＝2，表示FTC(滤泡癌)= 2, indicating FTC (follicular carcinoma)

＝3，表示MTC(髓样癌)=3, indicating MTC (medullary carcinoma)

＝4，表示ATC(未分化癌)；=4, indicating ATC (undifferentiated carcinoma);

病理亚型：＝1.1.，表示经典型Pathological subtype: = 1.1., indicating the classic type

＝1.2.，表示滤泡亚型= 1.2., indicating the follicular subtype

＝1.3，表示实体/梁状/岛状型=1.3, indicating solid/beam/island type

＝1.4，表示高细胞亚型= 1.4, indicating the high cellularity subtype

＝1.5，表示弥漫硬化亚型= 1.5, indicating diffuse sclerosis subtype

＝1.6，表示透明细胞型=1.6, indicating clear cell type

＝1.7，表示柱状细胞亚型=1.7, indicating the columnar cell subtype

＝1.8，表示包裹型=1.8, indicating wrapping

＝1.9，表示筛状桑葚型=1.9, indicating sieve mulberry type

＝1.10，表示鞋钉型(微乳头/失黏附)= 1.10, indicating stud type (micropapillary/loss of adhesion)

＝1.11，表示嗜酸细胞型= 1.11, indicating the eosinophilic type

＝1.12，表示梭形细胞型=1.12, indicating spindle cell type

＝1.13，表示结节性筋膜炎样型=1.13, indicating nodular fasciitis-like type

＝1.14，表示Warthin样型；=1.14, indicating the Warthin-like type;

颈部B超：＝0，表示阴性(无明显异常)Neck B-ultrasound: = 0, indicating negative (no obvious abnormality)

＝1，表示残甲=1, indicating residual armor

＝2，表示残留病灶= 2, indicating residual disease

＝3，表示可疑转移淋巴结=3, indicating suspected metastatic lymph nodes

＝4，表示转移淋巴结=4, indicating metastatic lymph nodes

＝5，表示不能确定良恶性；= 5, indicating that benign and malignant cannot be determined;

胸部CT：＝0，表示未见特异性改变或良性病变Chest CT: = 0, indicating no specific changes or benign lesions

＝1，表示肺部转移，较前减少或缩小= 1, indicating lung metastases, reduced or reduced compared to the previous

＝2，表示肺部转移，较前无明显改变= 2, indicating lung metastasis, no significant change compared to before

＝3，表示肺部转移，较前增多或增大=3, indicating lung metastases, increased or enlarged than before

＝4，表示肺部病灶，良恶性不能确定；=4, indicating lung lesions, benign and malignant can not be determined;

其他检查(如PET/CT、MIBI等)：＝0，表示阴性(无明显转移征象)；Other examinations (such as PET/CT, MIBI, etc.): = 0, indicating negative (no obvious signs of metastasis);

＝1，表示残余甲状腺=1, indicating residual thyroid

＝2，表示淋巴结转移= 2, indicating lymph node metastasis

＝3，表示肺转移= 3, indicating lung metastases

＝4，表示骨转移=4, indicating bone metastasis

＝5，表示其他转移(其他请自行添加描述)；=5, indicating other transfers (for others, please add a description yourself);

诊断性碘-131全身显像(DxWBS)：＝0，表示未见残余甲状腺或转移灶(或极少量残余甲状腺)Diagnostic iodine-131 whole body imaging (DxWBS): = 0, indicating no residual thyroid or metastases (or very little residual thyroid)

＝1，表示仅有残余甲状腺= 1, indicating only residual thyroid

＝2，表示转移淋巴结= 2, indicating metastatic lymph nodes

＝3，表示肺转移= 3, indicating lung metastases

＝4，表示骨转移=4, indicating bone metastasis

＝5，表示(其他转移，如脑转移，肝转移等)；=5, indicating (other metastasis, such as brain metastasis, liver metastasis, etc.);

影像学检查-治疗后碘-131全身显像(RxWBS)：＝0，表示未见残余甲状腺或转移灶(极少量)Imaging examination-post-treatment iodine-131 whole body imaging (RxWBS): = 0, indicating no residual thyroid or metastases (very small amount)

＝1，表示仅有残余甲状腺= 1, indicating only residual thyroid

＝2，表示转移淋巴结= 2, indicating metastatic lymph nodes

＝3，表示肺转移= 3, indicating lung metastases

＝4，表示骨转移=4, indicating bone metastasis

＝5，表示其他；=5, indicating other;

值中会存在3+4，2+3类似的，约定使用“+”号分割；There will be 3+4, 2+3 similar in the value, and it is agreed to use the "+" sign to divide;

最远侵及范围：＝0，表示甲状腺内The farthest invasion and range: = 0, indicating that the thyroid

＝1，表示甲状腺被膜/被膜外纤维脂肪组织= 1, indicating thyroid capsule/extracapsular fibrous adipose tissue

＝2，表示带状肌= 2, indicating the ribbon muscle

＝3，表示皮下软组织、喉、气管、食管或喉返神经=3, indicating subcutaneous soft tissue, larynx, trachea, esophagus or recurrent laryngeal nerve

＝4，表示累及椎前筋膜，或包绕颈动脉或纵隔血管；=4, indicating involvement of the prevertebral fascia, or surrounding the carotid artery or mediastinal vessels;

是否侵犯血管：＝0，表示否Whether the blood vessel is violated: = 0, indicating no

＝1，表示是，如是标出有几灶侵犯血管=1, means yes, if yes, mark several foci invading blood vessels

分化程度：＝1，表示低分化Degree of differentiation: = 1, indicating low differentiation

＝2，表示中分化= 2, indicating moderate differentiation

＝3，表示高分化。=3, indicating high differentiation.

在描述具体每个模块的逻辑之前，先说明一下取值规则：Before describing the logic of each module, let's explain the value rules:

1、本发明的模型中，所有Tg、TSH、TgAb涉及的“＞”和“＜”在后台逻辑判断中可直接去除符号，使用数字进行判断。1. In the model of the present invention, all ">" and "<" involved in Tg, TSH, TgAb can directly remove the symbols in the background logic judgment, and use numbers to judge.

2、本发明的模型中，所有用到“手术及病理情况表”数据的，因手术存在多次情况，判断时根据以下规则取值(所有下述叠加取值规则仅用于手术方式＝2及其之前手术)：2. In the model of the present invention, all the data of the "surgery and pathological condition table" are used, because there are multiple situations in the operation, the value is determined according to the following rules (all the following superimposed value rules are only used for the operation method = 2 and previous surgery):

手术方式若有0+2类似数据，按“+”分割，分别进行判断；If the operation method has 0+2 similar data, press "+" to divide and judge separately;

(1)手术时间：设手术方式＝2的手术时间为A，取A；(1) Operation time: set the operation time of operation method=2 as A, take A;

(2)手术切缘、是否累及被膜、是否侵犯血管、多灶性、免疫组化VEGF、TERT突变、Braf突变：只要有＝1的，取值为1；(2) Surgical margin, whether the capsule is involved, whether the blood vessel is involved, multifocal, immunohistochemical VEGF, TERT mutation, Braf mutation: as long as there is = 1, the value is 1;

(3)病理类型：首先取所有数据，判断是否有非0数据；如果没有非0数据，判断是否有0，有则取0，没有则认为是数据缺失；如果有非0数据，则判断是否全部相同，如果全部相同，则取该值，如果有不相同的，则按不相同的相加；例如：有3条数据，空，0和0的，那就取0；有3条数据，空，1和1，就取1；有3条数据，0，1和2，就取1+2；后续逻辑中严格匹配，病理类型＝1的，如果是1+2则不符合。(3) Pathological type: First, take all data to determine whether there is non-zero data; if there is no non-zero data, determine whether there is 0, if there is, take 0, and if there is no data, it is considered that the data is missing; All are the same, if all are the same, take the value, if there are different, add them according to the difference; for example: if there are 3 pieces of data, empty, 0 and 0, then take 0; if there are 3 pieces of data, Empty, 1 and 1, take 1; if there are 3 pieces of data, 0, 1 and 2, take 1+2; follow-up logic is strictly matched, pathological type = 1, if it is 1+2, it does not match.

(4)病理亚型：判断时，取到历次的值，根据1.1-1.15，后续按逻辑判断，是否存在或不存在任何一种；(4) Pathological subtype: when judging, the previous values are obtained, and according to 1.1-1.15, the subsequent logical judgment is whether there is any one or not;

(5)分化程度：判断时，根据1-3，取数字最小那次的值；(5) Degree of differentiation: when judging, according to 1-3, take the value of the smallest number;

(6)原发肿瘤单双侧：只要有＝2的，取值为2；(6) Unilateral and bilateral primary tumors: as long as there is = 2, the value is 2;

(7)原发灶最大径、侵犯血管灶数、最远倾及范围、周围侵犯明显度、多灶数量、免疫组化Ki-67：多次手术，取其中最大值；(7) The maximum diameter of the primary tumor, the number of invading vascular lesions, the most distant inclination and extent, the apparent degree of surrounding invasion, the number of multiple lesions, and immunohistochemical Ki-67: multiple operations, whichever is the largest;

(8)远处转移部位：按实际取值。＝0判断为M0，1、2、3判断为M1，多次按最严重取值，即0<1<2<3。如某人有2条数据，手术方式＝0的值为0，手术方式＝1的值为1，则取1；(8) Distant metastatic site: according to the actual value. =0 is judged as M0, 1, 2, and 3 are judged as M1, and the most severe value is taken multiple times, that is, 0<1<2<3. If someone has 2 pieces of data, the value of operation method=0 is 0, and the value of operation method=1 is 1, then take 1;

(9)淋巴结清扫数、清扫合计、转移数、转移合计：(9) Number of lymph node dissections, total number of dissections, number of metastases, and total number of metastases:

判断TNM分期中的N分期时，按每次手术数据，根据TNM分期规则，分别计算n分期，最后结果按严重的取值，严重比较规则：0<N1a<N1<N1b；例如，最终几次数据N结果有N1a和N1b，则取N1b。When judging the N staging in TNM staging, according to the data of each operation, according to the TNM staging rules, the n staging is calculated separately, and the final result is based on the serious value, the serious comparison rule: 0<N1a<N1<N1b; for example, the last several times The result of data N has N1a and N1b, then take N1b.

判断复发风险时，取手术方式＝2及2之前的所有多次手术相应值的总和。When judging the risk of recurrence, the sum of the corresponding values of all multiple surgeries before surgery mode=2 and 2 is taken.

在一个实施例中，本实施例具体描述术后碘治疗前评估模块400。In one embodiment, this embodiment specifically describes the post-operative iodine treatment pre-assessment module 400.

仅有残甲的可算作影像学阴性(即影像学-)。Only residual nails can be counted as negative imaging (ie, imaging -).

碘治疗前评估主要依靠影像学和血清学数据进行判断，所取数据为“碘131治疗前评估”或“术后停L-T4前甲功”部分数据，取值规则为：The evaluation before iodine treatment mainly relies on imaging and serological data for judgment. The data collected are part of the data of "evaluation before iodine 131 treatment" or "thyroid function before stopping L-T4 after surgery", and the value rules are as follows:

(1)若“碘131治疗前评估”和“术后停L-T4前甲功”部分都有数据，则取“碘131治疗前评估”部分数据；若其中一个部分无数据，则按有数据部分取值；若“两部分都无数据算数据缺失。(1) If there are data in both "Assessment before iodine 131 treatment" and "thyroid function before stopping L-T4 after surgery", the data in "Assessment before iodine 131 treatment" are taken; if there is no data in one of the parts, press The value of the data part; if "there is no data in both parts, it is considered that the data is missing.

(2)取“碘131治疗前评估”部分数据时，判断条件以sTg和TgAb为准；此部分中按“预行碘治疗次数”的值为0或1进行取值。(2) When taking the data of "Iodine-131 Pre-treatment Evaluation" part, the judgment conditions are based on sTg and TgAb; in this part, the value of "Pre-Iodine Treatment Times" is 0 or 1 to take the value.

(3)取“术后停L-T4前甲功”部分数据时，判断条件以Tg和TgAb为准，这里直接取值，理论上此部分只有一条数据。(3) When taking the part of the data of "postoperative thyroid function before stopping L-T4", the judgment condition is based on Tg and TgAb, and the value is directly taken here. In theory, there is only one data in this part.

(4)先判断TgAb趋势，不论取“碘131治疗前评估”或是“术后停L-T4前甲功”部分数据，TgAb时都取两次抽血时间的数据；趋势规则见下(4) First determine the trend of TgAb, regardless of whether the data of "evaluation before iodine 131 treatment" or "postoperative thyroid function before L-T4 stop" are taken, the data of two blood sampling times are taken for TgAb; the trend rules are as follows

(5)TgAb均阴性时判断sTg或Tg的条件，不论取“碘131治疗前评估”或是“全切术后停L-T4前甲功”部分数据，所需数据都只取第二次抽血时间的数据Tg2和TSH2。(5) The conditions for judging sTg or Tg when TgAb are all negative, no matter whether the data of "evaluation before iodine 131 treatment" or "thyroid function before L-T4 stop after total resection" are taken, the required data are only taken for the second time Blood draw time data Tg2 and TSH2.

判断TgAb趋势：仅需在TgAb阳性，即TgAb大于等于115IU/mL时判断，若小于115IU/mL，不需判断趋势。不论是“碘131治疗前评估”或是“术后停L-T4前甲功”部分第一次抽血和第二次抽血的数据都做判断，只要有一个大于等于115IU/mL，即判断为TgAb阳性。阳性时判断TgAb趋势。To judge the trend of TgAb: It only needs to be judged when TgAb is positive, that is, when TgAb is greater than or equal to 115 IU/mL, if it is less than 115 IU/mL, it is not necessary to judge the trend. Whether it is "evaluation before iodine 131 treatment" or "thyroid function before stopping L-T4 after surgery", the data of the first blood draw and the second blood draw shall be judged, as long as one is greater than or equal to 115IU/mL, that is Judged as TgAb positive. TgAb trend was judged when positive.

如果第一次抽血和第二次抽血都小于115IU/mL，则按以下判定条件进行判定。If both the first blood draw and the second blood draw are less than 115IU/mL, the following judgment conditions are used to judge.

其中，第一次抽血数据为TgAb1、Tg1、sTg1和TSH1。第二次抽血数据为TgAb2、Tg2、sTg2和TSH2。此外，TgAb稳定或下降的判定条件为TgAb2<TgAb1*(1+20％)；TgAb上升判定条件为TgAb2>＝TgAb1*(1+20％)。Among them, the data of the first blood draw were TgAb1, Tg1, sTg1 and TSH1. The second blood draw data were TgAb2, Tg2, sTg2 and TSH2. In addition, the condition for determining whether TgAb is stable or falling is TgAb2<TgAb1*(1+20%); the condition for determining TgAb rise is TgAb2>=TgAb1*(1+20%).

其中，影像学-表示：无影像学证实的或功能性疾病存在证据，就是影像报告没有病灶，判断所有影像学-。即胸部CT＝0，且颈部B超＝(0或1)且其他检查＝(0或1)且DxWBS＝(0或1或2或1+2)。Among them, imaging - means: there is no evidence of imaging confirmed or functional disease, that is, the imaging report has no lesions, and all imaging - is judged. That is, chest CT=0, and neck ultrasound=(0 or 1) and other examinations=(0 or 1) and DxWBS=(0 or 1 or 2 or 1+2).

基于患者血清数据将判定条件分为以下A、B和C，3种情况：Based on patient serum data, the judgment conditions are divided into the following A, B and C, 3 cases:

A：在TgAb2<115IU/mL的条件下，再满足下述两个条件之一：A: Under the condition of TgAb2<115IU/mL, one of the following two conditions is satisfied:

(1)(TSH2<＝2ng/mL且Tg0<0.2ng/ml)(1) (TSH2<=2ng/mL and Tg0<0.2ng/ml)

(2)(TSH2>30ng/mL且Tg2<1.0ng/ml)。(2) (TSH2>30ng/mL and Tg2<1.0ng/ml).

B：满足下述两个(1或2)条件之一：B: One of the following two (1 or 2) conditions is met:

1.在TgAb1<115IU/mL且TgAb2<115IU/mL的条件下，再满足下述两个条件之一：1. Under the conditions of TgAb1<115IU/mL and TgAb2<115IU/mL, one of the following two conditions should be satisfied:

(1)TSH1<＝2ng/mL且0.2ng/ml<＝Tg1<＝1ng/ml；(1) TSH1<=2ng/mL and 0.2ng/ml<=Tg1<=1ng/ml;

(2)TSH2>30ng/mL且1ng/ml<＝Tg2<＝10ng/ml。(2) TSH2>30ng/mL and 1ng/ml<=Tg2<=10ng/ml.

2.在TgAb1>＝115IU/mL或TgAb2>＝115IU/mL的条件下，满足TgAb2<TgAb1*(1+20％)。2. Under the condition of TgAb1>=115IU/mL or TgAb2>=115IU/mL, TgAb2<TgAb1*(1+20%) is satisfied.

C：满足下述两个(1或2)条件之一：C: One of the following two (1 or 2) conditions is satisfied:

1.在TgAb1<115IU/mL且TgAb2<115IU/mL的条件下，再满足下述两个条件之一：1. Under the conditions of TgAb1<115IU/mL and TgAb2<115IU/mL, one of the following two conditions should be satisfied:

(1)TSH2<＝2ng/mL且Tg2>1.0ng/ml；(1) TSH2<=2ng/mL and Tg2>1.0ng/ml;

(2)TSH2>30ng/mL且Tg2>10ng/ml。(2) TSH2>30ng/mL and Tg2>10ng/ml.

2.在TgAb1>＝115IU/mL或TgAb2>＝115IU/mL的条件下，满足TgAb2<TgAb1*(1+20％)。2. Under the condition of TgAb1>=115IU/mL or TgAb2>=115IU/mL, TgAb2<TgAb1*(1+20%) is satisfied.

然后基于血清数据的判定情况并结合影像数据，判定手术疗效。Then, based on the determination of serum data and combined with image data, the surgical efficacy was determined.

疗效满意(以下简称P-ER)、疗效不确切(以下简称P-IDR)、生化疗效不佳(以下简称P-BIR)、结构性疗效不佳(以下简称P-SIR)或影像学不明确(以下简称P-UCC)：Satisfactory curative effect (hereinafter referred to as P-ER), indeterminate curative effect (hereinafter referred to as P-IDR), poor biochemical response (hereinafter referred to as P-BIR), poor structural response (hereinafter referred to as P-SIR) or unclear imaging (hereinafter referred to as P-UCC):

1.P-ER1. P-ER

满足上述A且影像学-则判定疗效满意。Satisfying the above A and imaging - means the curative effect is satisfactory.

2.P-IDR2. P-IDR

满足上述B且影像学-则判定疗效不确切。Satisfying the above B and imaging - the efficacy is not accurate.

3.P-BIR3. P-BIR

满足上述C且影像学-则判定生化疗效不佳。Satisfying the above C and imaging - means poor biochemical efficacy.

4.P-SIR4. P-SIR

血清学呈任何水平，影像学明确的复发或转移，则判定结构性疗效不佳；Any level of serology, clear recurrence or metastasis on imaging, it is judged that the structural curative effect is poor;

即影像数据满足以下任何一种情况：That is, the image data meets any of the following conditions:

(1)颈部B超结果为2或4；(1) The result of neck B-ultrasound is 2 or 4;

(2)胸部CT超结果为1-3任一；(2) The result of chest CT ultrasonography is any one of 1-3;

(3)其他检查结果为2-5任一；(3) Other inspection results are any of 2-5;

(4)DxWBS结果为3-5任一。(4) The DxWBS result is any of 3-5.

5.P-UCC5. P-UCC

影像数据满足以下任何一种情况则判定影像学不明确：Imaging data is determined to be unclear if the imaging data meets any of the following conditions:

(1)颈部B超结果为3或5；(1) The result of neck B-ultrasound is 3 or 5;

(2)胸部CT超结果为4；(2) The result of chest CT ultrasonography is 4;

(3)其他检查结果为6。(3) Other inspection results are 6.

在一个实施例中，本实施例详细描述实时动态评估模块500，其中，实时动态评估模块500，基于所述病理信息、所述血清数据和所述影像数据评估患者治疗疗效。In one embodiment, this embodiment describes the real-time dynamic evaluation module 500 in detail, wherein the real-time dynamic evaluation module 500 evaluates the therapeutic efficacy of the patient based on the pathological information, the serum data and the image data.

其中治疗疗效包括：疗效满意(以下简称ER)、疗效不确切(以下简称IDR)、生化疗效不佳(以下简称BIR)、结构性疗效不佳(以下简称SIR)或影像学不明确(以下简称UCC)。The therapeutic efficacy includes: satisfactory efficacy (hereinafter referred to as ER), indefinite efficacy (hereinafter referred to as IDR), poor biochemical response (hereinafter referred to as BIR), poor structural response (hereinafter referred to as SIR) or unclear imaging (hereinafter referred to as BIR) UCC).

本实施例的取值规则是：The value rule of this embodiment is:

根据“碘131治疗前评估”部分第二次抽血日期以及“碘31治疗后随诊”部分抽血日期，比较得出最近日期，最近日期如果是“碘131治疗后随诊”的抽血日期，取值就取“碘131治疗后随诊”中相关数据；如果是第二次抽血日期，取值就取“碘131治疗前评估”中相关数据。According to the date of the second blood draw in the "Assessment before iodine-131 treatment" and the date of blood draw in the "Follow-up after iodine-31 treatment" section, compare the latest date, if the latest date is the blood draw of "follow-up after iodine-131 treatment" If it is the date of the second blood draw, the value will be taken from the relevant data in "Assessment before Iodine 131 Treatment".

其中，若日期不全，则默认补全为1日或1月1日，如2020则默认为：2020-01-01，如2020-08则默认为：2020-08-01，若出现相同日期数据，按录入先后顺序，后记录为最新。Among them, if the date is incomplete, the default completion is 1st or January 1st, such as 2020, the default is: 2020-01-01, such as 2020-08, the default is: 2020-08-01, if the same date data appears , in the order of entry, and the later records are the latest.

若该条数据缺失，则继续按时间倒序追溯，直到有数据为止；若该条数据未评估出结果，则继续按时间倒序追溯，直到评估出结果为止。此处只在当前表中追溯。If the piece of data is missing, continue to trace back in reverse chronological order until there is data; if the piece of data has not been evaluated, continue to trace in reverse chronological order until the result is evaluated. Only trace back in the current table here.

其中“影像学-”的数据，如果本次没有数据，需往前追溯；“碘131治疗前评估”部分按“预行碘治疗次数”，“碘131治疗后随诊”部分按“抽血日期”，依次往前追溯，直到这4项(胸部CT、颈部B超、其他检查、DxWBS)中，分别每项都有数据为止；再追溯“碘-131治疗”部分的RxWBS，取治疗日期为最近的一次数据，如果本次没有数据，需往前追溯；按治疗日期，依次往前追溯，直到“RxWBS”有数据为止。Among them, for the data of "imaging-", if there is no data this time, it needs to be traced back; in the section of "Assessment before Iodine-131 Treatment", press "Number of Pre-Iodine Treatments", and in the section of "Follow-up After Iodine-131 Treatment", press "Blood Drawing" Date", traced back in turn, until each of these 4 items (chest CT, neck B-ultrasound, other examinations, DxWBS) has data; The date is the latest data. If there is no data this time, it needs to be traced back; according to the treatment date, trace back in turn until "RxWBS" has data.

若上述5项(胸部CT、颈部B超、其他检查、DxWBS、RxWBS)，哪项无数据，则默认为0。If any of the above 5 items (chest CT, neck ultrasound, other examinations, DxWBS, RxWBS) has no data, the default value is 0.

其中，影像学-：无影像学证实的或功能性疾病存在证据，就是影像报告没有病灶，也没有残甲，患者正常，判断所有影像学-。具体为：Among them, imaging -: there is no evidence of imaging confirmed or functional disease, that is, the imaging report has no lesions and no residual nails, the patient is normal, and all imaging studies are judged to be -. Specifically:

胸部CT＝0且颈部B超＝(0或1)且其他检查＝(0或1)且DxWBS＝(0或1或2或1+2)且(RxWBS＝0或1或2或1+2)(这里的0已经包含无数据的情况)。Chest CT = 0 and neck ultrasound = (0 or 1) and other tests = (0 or 1) and DxWBS = (0 or 1 or 2 or 1+2) and (RxWBS = 0 or 1 or 2 or 1+ 2) (The 0 here already includes the case of no data).

判定治疗疗效：To determine the efficacy of treatment:

1.ER1.ER

取值自“碘-131治疗后随诊”部分数据或“碘131治疗前评估”部分数据，其中若是“碘131治疗前评估”时，TgAb为第二次抽血的TgAb2，TSH和Tg为第二次抽血的TSH2和Tg2。The values are taken from the data of "follow-up after iodine-131 treatment" or the data of "evaluation before iodine-131 treatment", in which, in the case of "evaluation before iodine-131 treatment", TgAb is TgAb2 of the second blood drawing, TSH and Tg are TSH2 and Tg2 of the second blood draw.

血清数据满足以下条件之一，且影像学-，则判定疗效满意。If the serum data meets one of the following conditions, and the imaging is negative, the curative effect is judged to be satisfactory.

(1)TgAb<115IU/mL，且TSH<＝2ng/mL且Tg<0.2ng/ml；(1) TgAb<115IU/mL, and TSH<=2ng/mL and Tg<0.2ng/ml;

(2)TgAb<115IU/mL，且TSH>30ng/mL且Tg<1.0ng/ml；(2) TgAb<115IU/mL, and TSH>30ng/mL and Tg<1.0ng/ml;

2.IDR2. IDR

取值自“碘-131治疗后随诊”部分数据或“碘131治疗前评估”部分数据。Values are taken from the data of "follow-up after iodine-131 treatment" or the data of "evaluation before iodine-131 treatment".

满足以下A或B条件之一，则判定疗效不确切。If one of the following A or B conditions is met, the curative effect is determined to be inexact.

A，满足TgAb<115IU/mL(若是“碘131治疗前评估”部分数据，此处条件为：TgAb1<115IU/mL且TgAb2<115IU/mL)，且影像学-，且满足以下条件之一，则满足条件A：A. Satisfy TgAb<115IU/mL (if the data in the "Iodine-131 Pre-treatment Evaluation" section, the conditions here are: TgAb1<115IU/mL and TgAb2<115IU/mL), and imaging -, and one of the following conditions is met, Then condition A is satisfied:

(1)TSH<＝2ng/mL且0.2ng/ml<＝Tg<1ng/ml；(1) TSH<=2ng/mL and 0.2ng/ml<=Tg<1ng/ml;

(2)TSH>30ng/mL且1ng/ml<＝Tg<10ng/ml；(2) TSH>30ng/mL and 1ng/ml<=Tg<10ng/ml;

B，满足TgAb>＝115IU/mL(若是“碘131治疗前评估”部分数据，此处条件为：TgAb1>＝115IU/mL或TgAb2>＝115IU/mL)且TgAb2<TgAb1*(1+20％)且影像学-。B. Satisfy TgAb>=115IU/mL (if the data of "Iodine-131 Pre-treatment Evaluation" part, the condition here is: TgAb1>=115IU/mL or TgAb2>=115IU/mL) and TgAb2<TgAb1*(1+20% ) and imaging-.

其中，TgAb2<TgAb1*(1+20％)此部分条件中的TgAb1和TgAb2，若为“碘131治疗前评估”部分，则TgAb1和TgAb2为数据栏中原TgAb1和TgAb2，若为“碘-131治疗后随诊”则TgAb1指按时间推之前一次的TgAb,TgAb2为此次TgAb。Among them, TgAb2<TgAb1*(1+20%) TgAb1 and TgAb2 in this part of the condition, if it is the part of "Iodine-131 pre-treatment evaluation", then TgAb1 and TgAb2 are the original TgAb1 and TgAb2 in the data column, if it is "Iodine-131 "Follow-up after treatment", TgAb1 refers to the TgAb of the previous time, and TgAb2 refers to the TgAb of this time.

3.BIR3. BIR

取值自“碘-131治疗后随诊”部分数据或“碘131治疗前评估”部分数据。Values are taken from the data of "follow-up after iodine-131 treatment" or the data of "evaluation before iodine-131 treatment".

满足以下A或B条件之一，则判定生化疗效不佳。If one of the following A or B conditions is met, the biochemical efficacy is judged to be poor.

A，满足TgAb<115IU/mL(若是“碘131治疗前评估”部分数据，此处条件为：TgAb1<115IU/mL且TgAb2<115IU/mL)，且影像学-，且满足以下条件之一，则满足条件A：A. Satisfy TgAb<115IU/mL (if the data in the "Iodine-131 Pre-treatment Evaluation" section, the conditions here are: TgAb1<115IU/mL and TgAb2<115IU/mL), and imaging -, and one of the following conditions is met, Then condition A is satisfied:

(1)TSH<＝2ng/mL且Tg>＝1.0ng/ml；(1) TSH<=2ng/mL and Tg>=1.0ng/ml;

(2)TSH>30ng/mL且Tg>＝10ng/ml。(2) TSH>30ng/mL and Tg>=10ng/ml.

B，TgAb>＝115IU/mL(若是“碘131治疗前评估”部分数据，此处条件为：TgAb1>＝115IU/mL或TgAb2>＝115IU/mL)，且TgAb2>＝TgAb1*(1+20％)且影像学-。B, TgAb>=115IU/mL (if the data of "Iodine 131 Pre-treatment Evaluation" part of the data, the condition here is: TgAb1>=115IU/mL or TgAb2>=115IU/mL), and TgAb2>=TgAb1*(1+20 %) and imaging -.

TgAb2>＝TgAb1*(1+20％)此部分条件中的TgAb1和TgAb2，若为“碘131治疗前评估”部分，则TgAb1和TgAb2为数据栏中原TgAb1和TgAb2，若为“碘131治疗后随诊”，则TgAb1指按时间推之前一次的TgAb,TgAb2为此次TgAb。TgAb2>=TgAb1*(1+20%) The TgAb1 and TgAb2 in this part of the condition, if it is in the "Evaluation before iodine 131 treatment" part, then TgAb1 and TgAb2 are the original TgAb1 and TgAb2 in the data column, if it is "after iodine 131 treatment" Follow-up”, then TgAb1 refers to the previous TgAb according to time, and TgAb2 refers to this TgAb.

4.SIR4. SIR

血清学呈任何水平；影像学证实疾病存在。Serology at any level; imaging confirms the presence of disease.

满足以下条件之一，则判定结构性疗效不佳：If one of the following conditions is met, the structural efficacy is judged to be poor:

(1)颈部B超结果为2或4；(1) The result of neck B-ultrasound is 2 or 4;

(2)胸部CT超结果为1-3任一；(2) The result of chest CT ultrasonography is any one of 1-3;

(3)其他检查结果为2-5任一；(3) Other inspection results are any of 2-5;

(4)DxWBS结果为3-5任一；(4) The result of DxWBS is any one of 3-5;

(5)RxWBS结果为3-5任一。(5) The RxWBS result is any one of 3-5.

5.UCC5. UCC

影像数据满足以下任何一种情况则判定影像学不明确：Imaging data is determined to be unclear if the imaging data meets any of the following conditions:

(1)颈部B超结果为3或5；(1) The result of neck B-ultrasound is 3 or 5;

(2)胸部CT超结果为4；(2) The result of chest CT ultrasonography is 4;

(3)其他检查结果为6。(3) Other inspection results are 6.

在一个实施例中，本实施例具体描述死亡风险评估模块200，用于基于所述病理信息评估患者的死亡风险。本实施例使用TNM分期系统评估患者的死亡风险。In one embodiment, this embodiment specifically describes the death risk assessment module 200 for assessing the death risk of a patient based on the pathological information. This example uses the TNM staging system to assess a patient's risk of death.

首先，TNM分期系统是目前国际上最为通用的肿瘤分期系统。First, the TNM staging system is currently the most common tumor staging system in the world.

TNM分期系统中：In the TNM staging system:

T(“T”是肿瘤一词英文“Tumor”的首字母)指肿瘤原发灶的情况，随着肿瘤体积的增加和邻近组织受累范围的增加，依次用T1～T4来表示。T ("T" is the acronym of "Tumor" in English) refers to the condition of the primary tumor. With the increase in tumor volume and the increase in the extent of adjacent tissue involvement, it is represented by T1 to T4 in turn.

2，N(“N”是淋巴结一词英文“Node”的首字母)指区域淋巴结(regional lymphnode)受累情况。淋巴结未受累时，用N0表示。随着淋巴结受累程度和范围的增加，依次用N1～N3表示,2. N ("N" is the acronym of "Node" in English) refers to the involvement of regional lymph nodes. When the lymph nodes are not involved, it is indicated by N0. With the increase in the degree and scope of lymph node involvement, N1 to N3 are used in turn.

3，M(“M”是转移一词英文“metastasis”的首字母)指远处转移(通常是血道转移)，没有远处转移者用M0表示，有远处转移者用M1表示。3. M ("M" is the acronym of "metastasis" in English) refers to distant metastases (usually blood tract metastases). Those without distant metastases are indicated by M0, and those with distant metastases are indicated by M1.

在此基础上，用TNM三个指标的组合(grouping)划出特定的分期(stage)。On this basis, a specific stage is delineated by the grouping of the three TNM indicators.

具体为分为：I期、II期、III期、ⅣA期、ⅣB期。Specifically, it is divided into: I, II, III, IVA, IVB.

TNM-T:T0、T1a、T1b、T2、T3a、T3b、T4a、T4b；TNM-T: T0, T1a, T1b, T2, T3a, T3b, T4a, T4b;

TNM-N：Nx、N0、N1、N1a、N1b；TNM-N: Nx, N0, N1, N1a, N1b;

TNM-M：M0、M1TNM-M: M0, M1

TNM取值自“手术及病理情况”部分，规则如下所示：The TNM value is taken from the "Surgical and Pathological Conditions" section, and the rules are as follows:

1.判定为I期1. Determined as Phase I

满足以下任一条件则判定为I期If any of the following conditions are met, it will be judged as Phase I

(1)确诊年龄<55且M＝0；(1) Age at diagnosis <55 and M=0;

(2)确诊年龄>＝55且(T＝1a或T＝1b或T＝2)且(N＝0或N＝X)且M＝0；(2) Age at diagnosis>=55 and (T=1a or T=1b or T=2) and (N=0 or N=X) and M=0;

2.判定为II期2. Determined as Phase II

满足以下任一条件则判定为II期If any of the following conditions are met, it will be judged as Phase II

(1)确诊年龄<55且M＝1；(1) Age at diagnosis <55 and M=1;

(2)确诊年龄>＝55且(T＝1a或T＝1b或T＝2)且(N＝1或N＝1a或N＝1b)且M＝0；(2) Age at diagnosis>=55 and (T=1a or T=1b or T=2) and (N=1 or N=1a or N=1b) and M=0;

(3)确诊年龄>＝55且(T＝3a或T＝3b)且(N＝0或N＝1或N＝1a或N＝1b)且M＝0；(3) Age at diagnosis >= 55 and (T=3a or T=3b) and (N=0 or N=1 or N=1a or N=1b) and M=0;

3.判定为III期3. Determined as stage III

若确诊年龄>＝55且T＝4a且(N＝0或N＝1或N＝1a或N＝1b)且M＝0，则判定为III期。If age at diagnosis >=55 and T=4a and (N=0 or N=1 or N=1a or N=1b) and M=0, it is determined as stage III.

4.判定为ⅣA期4. Determined as stage IVA

若确诊年龄>＝55且T＝4b且(N＝0或N＝1或N＝1a或N＝1b)且M＝0，则判定为ⅣA期.If the age of diagnosis >=55 and T=4b and (N=0 or N=1 or N=1a or N=1b) and M=0, it is judged as stage IVA.

5.判定为ⅣB期5. Determined as stage IVB

若确诊年龄>＝55且M＝1，则判定为ⅣB期.If the age of diagnosis is >=55 and M=1, it is determined as stage IVB.

其中，TNM分期依据如下表Among them, TNM staging is based on the following table

表1分化型甲状腺癌TNM分期(第8版)Table 1 TNM staging of differentiated thyroid cancer (8th edition)

TNM分期标准如下：The TNM staging criteria are as follows:

在一个实施例中，本实施例主要描述复发风险评估模块300，用于基于所述病理信息、所述血清数据和所述影像数据评估复发风险。具体为进行复发风险度分层。In one embodiment, this embodiment mainly describes the recurrence risk assessment module 300 for assessing recurrence risk based on the pathological information, the serum data and the image data. Specifically for recurrence risk stratification.

具体如下：details as follows:

复发风险度分层分为：高位、中危，低危。The recurrence risk stratification was divided into: high, intermediate, and low risk.

手术及病理情况：根据三、逻辑算法中“取值说明”中第2条规则进行取值；Surgical and pathological conditions: according to the second rule in the "value description" in the logic algorithm;

碘131治疗前评估：取“预行碘治疗次数”为1，对应第二次抽血时间的数据。Evaluation before iodine-131 treatment: Take the “number of pre-treatment iodine treatment” as 1, corresponding to the data of the time of the second blood draw.

从高危到低危依次进行逻辑判断，若已判断为高危，则不用继续判断是否为中危和低危；若已判断为中危，则不用继续判断是否为低危。Logical judgment is made in order from high risk to low risk. If it is judged to be high risk, it is not necessary to continue to judge whether it is medium risk or low risk; if it has been judged to be medium risk, it is not necessary to continue to judge whether it is low risk.

1.判断为高危1. Judged as high risk

符合以下任何条件之一，即为高危：Any of the following conditions are met to be considered high risk:

1)肉眼可见肿瘤侵犯周围组织或器官，具体来说，肉眼可见周围侵犯且最远侵及甲状腺被膜外组织。进一步具体地，手术及病理情况中周围侵犯明显度＝2且最远侵及范围＝1或2或3或4。1) The tumor can be seen to invade the surrounding tissues or organs with the naked eye. More specifically, in surgical and pathological conditions, the degree of peripheral invasion = 2 and the most distant invasion and extent = 1 or 2 or 3 or 4.

2)肿瘤未能完全切除，术中有残留，具体来说，需求解释为：颈部超声报告残留病灶。进一步具体地，碘131治疗前评估中颈部B超＝2。2) The tumor has not been completely removed, and there is residual disease in the operation. Specifically, the need to be explained as follows: the neck ultrasound reports residual disease. More specifically, the B-ultrasound of the neck in the evaluation before iodine 131 treatment = 2.

3)伴有远处转移，具体来说，DxWBS、胸部CT或骨显像等报告肺转移、骨转移等远处转移；远处转移不包括淋巴结；其他影像学检查一栏发现有肺、骨等转移也是判断条件。进一步具体地，碘131治疗前评估中满足以下任一条件即成立：3) Associated with distant metastasis, specifically, lung metastasis, bone metastasis and other distant metastasis reported by DxWBS, chest CT or bone scintigraphy; distant metastasis does not include lymph nodes; lung, bone, etc. are found in the column of other imaging examinations. Waiting for transition is also a judgment condition. Further specifically, in the pre-treatment evaluation of iodine 131, any one of the following conditions is satisfied:

(1)胸部CT结果为1-3任一；(1) Chest CT results are any of 1-3;

(2)其他检查结果为3-5任一；(2) Other inspection results are any of 3-5;

(3)碘-131全身显像(DxWBS)结果为3-5任一。(3) The result of iodine-131 whole body imaging (DxWBS) was any of 3-5.

4)全甲状腺切除术后，血清Tg水平仍较高提示有远处转移，具体来说，刺激性Tg大于47.1ng/mL。进一步具体地，碘131治疗前评估中满足以下任一条件即成立：4) After total thyroidectomy, the serum Tg level is still high, indicating distant metastasis, specifically, the stimulating Tg is greater than 47.1ng/mL. Further specifically, in the pre-treatment evaluation of iodine 131, any one of the following conditions is satisfied:

(1)TSH1大于30uIU/mL且Tg1>47.1ng/mL；(1) TSH1 greater than 30uIU/mL and Tg1>47.1ng/mL;

(2)TSH2大于30uIU/mL且Tg2>47.1ng/mL。(2) TSH2 greater than 30uIU/mL and Tg2>47.1ng/mL.

5)FTC伴有广泛血管侵犯(＞4个病灶)，具体来说，病理类型为FTC，＞4个病灶侵犯血管。进一步具体地，手术及病理情况中病理类型＝2且是否侵犯血管＝1且侵犯血管灶数＞4。5) FTC with extensive vascular invasion (>4 lesions), specifically, the pathological type is FTC with >4 lesions invading blood vessels. More specifically, in the operation and pathological conditions, the pathological type=2 and whether the blood vessel is invaded=1 and the number of blood vessel lesions>4.

2.判断为中危2. Judged as medium risk

符合以下任何条件之一即为中危：Any one of the following conditions is met as medium risk:

1)镜下发现肿瘤有甲状腺周围软组织侵犯，具体来说，镜下见周围侵犯且最远侵及甲状腺被膜外组织。进一步具体地，手术及病理情况中周围侵犯明显度＝1且最远侵及范围＝1或2或3或4。1) Microscopically, it was found that the tumor had invasion of the soft tissue around the thyroid. More specifically, in surgical and pathological conditions, the degree of peripheral invasion = 1 and the most distant invasion and extent = 1 or 2 or 3 or 4.

2)初次131I治疗后RxWBS发现有颈部甲状腺床外转移灶摄碘，具体来说，初次碘131治疗后RxWBS显示有淋巴结转移。进一步具体地，碘131治疗表中，碘治疗次数＝1，且治疗后碘-131全身显像(RxWBS)等于2或1+2。2) RxWBS after the first 131I treatment found that there were iodine uptake in the cervical thyroid metastases, specifically, the RxWBS showed lymph node metastasis after the first 131I treatment. More specifically, in the iodine-131 treatment table, the number of iodine treatments=1, and the post-treatment iodine-131 whole body imaging (RxWBS) is equal to 2 or 1+2.

3)肿瘤为侵袭性组织学亚型(如高细胞型、柱状细胞型、实性亚型、弥漫硬化型、靴钉型、鳞状细胞分化)。具体来说，病理亚型(1.3或1.4或1.5或1.7或1.10或1.15)。进一步具体地，满足手术及病理情况中病理亚型存在其中任何一个：1.3或1.4或1.5或1.7或1.10或1.15。3) The tumor is of aggressive histological subtype (eg, tall cell type, columnar cell type, solid subtype, diffuse sclerosis type, boot nail type, squamous cell differentiation). Specifically, pathological subtype (1.3 or 1.4 or 1.5 or 1.7 or 1.10 or 1.15). More specifically, any one of the pathological subtypes in the surgical and pathological conditions is satisfied: 1.3 or 1.4 or 1.5 or 1.7 or 1.10 or 1.15.

4)PTC伴有血管侵犯，具体来说，手术及病理情况中病理类型＝1且是否侵犯血管(IS_BLOOD_VIOLATION)＝1。4) PTC is accompanied by vascular invasion, specifically, pathological type=1 and vascular invasion (IS_BLOOD_VIOLATION)=1 in surgical and pathological conditions.

5)临床发现淋巴结转移或病理检查发现＞5个淋巴结转移，具体来说，手术及病理情况中肿瘤TNM分期-N为：1或1a或1b，且淋巴结转移数量总计＞5。5) Lymph node metastasis was found clinically or >5 lymph node metastases were found by pathological examination. Specifically, the tumor TNM stage-N in surgery and pathological conditions was: 1 or 1a or 1b, and the total number of lymph node metastases was >5.

3.判断为低危3. Judged as low risk

符合以下A、B、C和D任一一条者为低危:Those who meet any of the following A, B, C and D are considered low risk:

A,病理类型＝1且符合以下全部条件1)-7)的PTC为低危：A, PTC with pathological type=1 and meeting all of the following conditions 1)-7) is low risk:

1)无局部或远处转移，具体来说，由诊断性显像DxWBS、治疗后显像RxWBS、颈部超声、胸部CT、骨显像等报告来判断。进一步具体地，碘131治疗前评估中：胸部CT＝0，且颈部B超＝0或＝1，且其他检查＝0或＝1，且诊断性碘-131全身显像(DxWBS)＝0或＝1；且碘131治疗中：治疗后碘-131全身显像(RxWBS)＝0或＝1。1) No local or distant metastasis, specifically, judged by reports such as diagnostic imaging DxWBS, post-treatment imaging RxWBS, neck ultrasound, chest CT, and bone imaging. More specifically, in the evaluation before iodine-131 treatment: chest CT = 0, and neck ultrasound = 0 or = 1, and other examinations = 0 or = 1, and diagnostic iodine-131 whole body imaging (DxWBS) = 0 or=1; and during iodine-131 treatment: post-treatment iodine-131 whole body imaging (RxWBS)=0 or=1.

2)所有肉眼可见的肿瘤均被彻底切除，具体来说，除非病理报告所述手术切缘阳性，否则这条均成立。进一步具体地，手术及病理情况中手术切缘为空或等于0。2) All macroscopic tumors were completely excised, specifically, unless the pathology report stated that the surgical margins were positive, this was true. More specifically, in surgical and pathological conditions, the surgical margin is empty or equal to 0.

3)肿瘤没有侵犯周围组织，具体来说，原发灶无周围侵犯。进一步具体地，手术及病理情况中手术及病理情况中最远侵及范围＝0。3) The tumor does not invade surrounding tissues, specifically, the primary tumor has no surrounding invasion. More specifically, the most distant invasion and extent=0 in the surgical and pathological conditions.

4)肿瘤不是侵袭性组织学亚型(如高细胞型、柱状细胞型、实性亚型，弥漫硬化型、靴钉型、鳞状细胞分化等)，具体来说，病理亚型，病理亚型判断条件应该为除外上述侵袭型。进一步具体地，手术及病理情况中：病理亚型不存在其中任何一个：1.3或1.4或1.5或1.7或1.10或1.15。4) The tumor is not an aggressive histological subtype (such as tall cell type, columnar cell type, solid subtype, diffuse sclerosis type, boot nail type, squamous cell differentiation, etc.), specifically, pathological subtype, pathological subtype Type judgment conditions should be the exclusion of the above aggressive type. More specifically, in surgical and pathological conditions: none of the pathological subtypes were present: 1.3 or 1.4 or 1.5 or 1.7 or 1.10 or 1.15.

5)若行131I治疗，则首次RxWBS显示甲状腺床外无异常放射性碘摄取灶，具体来说，首次治疗后显像RxWBS显示无局部或远处转移，仅残甲。进一步具体地，碘131治疗信息表(碘131_treat)中治疗后碘-131全身显像(RxWBS)＝0或＝1，且碘治疗次数＝1。5) If 131I treatment is performed, the first RxWBS shows no abnormal radioactive iodine uptake outside the thyroid bed. Specifically, after the first treatment, the RxWBS shows no local or distant metastasis, only residual nails. More specifically, in the iodine 131 treatment information table (iodine 131_treat), post-treatment iodine-131 whole body imaging (RxWBS)=0 or=1, and the number of iodine treatments=1.

6)无血管侵犯，具体来说手术及病理情况中：是否侵犯血管＝0。6) No vascular invasion, specifically, in the case of surgery and pathology: whether blood vessels are violated = 0.

7)临床未发现有淋巴结转移，或病理检查发现≤5个淋巴结微转移。具体地，手术及病理情况中满足以下2个条件任意一个即成立：7) No lymph node metastasis was found clinically, or ≤5 lymph node micrometastases were found by pathological examination. Specifically, any one of the following two conditions is satisfied in the surgical and pathological conditions:

(1)肿瘤TNM分期-N(TNM_N)为：0；(1) Tumor TNM stage-N (TNM_N): 0;

(2)(肿瘤TNM分期-N(TNM_N)为：1或1a或1b)且(淋巴结转移数量总计<＝5)。(2) (tumor TNM stage-N (TNM_N): 1 or 1a or 1b) and (total number of lymph node metastasis<=5).

B,局限于甲状腺内的FV-PTC，具体来说，病理类型、肿瘤无周围侵犯，FV-PTC为滤泡性乳头状癌，所以应为病理类型＝1且病理亚型＝1.2滤泡亚型，进一步具体地，手术及病理情况中最远侵及范围＝0且病理类型＝1且病理亚型＝1.2。B, FV-PTC confined to the thyroid gland, specifically, the pathological type, the tumor has no surrounding invasion, FV-PTC is follicular papillary carcinoma, so it should be pathological type=1 and pathological subtype=1.2 follicular subtype type, further specifically, in surgical and pathological conditions, most distant and extent = 0 and pathological type = 1 and pathological subtype = 1.2.

C,局限于甲状腺内、伴有包膜侵犯的高分化FTC，无血管侵犯或仅有微血管侵犯(＜4个病灶)，具体来说，肿瘤无周围侵犯，病理类型为FTC，高分化，血管侵犯＜4个病灶或无血管侵犯。进一步具体地，手术及病理情况中满足以下全部条件：C, Well-differentiated FTC confined to the thyroid gland with capsular invasion, no vascular invasion or only microvascular invasion (<4 lesions), specifically, the tumor has no surrounding invasion, the pathological type is FTC, well-differentiated, vascular Invasion of <4 lesions or no vascular invasion. More specifically, all the following conditions are met in the surgical and pathological conditions:

(1)最远侵及范围＝0(1) Farthest invasion and range = 0

(2)病理类型＝2(2) Pathological type = 2

(3)分化程度＝3(3) Degree of differentiation = 3

(4)是否侵犯血管＝0或(是否侵犯血管＝1且侵犯血管灶数<4)。(4) Whether the blood vessel is invaded = 0 or (whether the blood vessel is invaded = 1 and the number of blood vessel lesions is less than 4).

D，局限于甲状腺内、单灶或多灶的PTMC，具体来说，肿瘤直径≤1cm，病理类型为PTC，肿瘤无周围侵犯。进一步具体地，手术及病理情况中病理类型＝1且原发灶最大径≤1cm且最远侵及范围＝0。D, PTMC confined to the thyroid gland, unifocal or multifocal, specifically, the tumor diameter is ≤1 cm, the pathological type is PTC, and the tumor has no surrounding invasion. More specifically, in the surgical and pathological conditions, the pathological type=1, the largest diameter of the primary tumor is ≤ 1 cm, and the most distant invasion and extent=0.

在一个实施例中，本实施例描述随访时长模块600，随访时长模块600用于基于患者的信息的得出治疗后随访时长。In one embodiment, this embodiment describes a follow-up duration module 600, which is used to derive a post-treatment follow-up duration based on patient information.

随访时长模块600包括第一时长单元，用于在已做首次碘131治疗的时候判定随访时长，具体来说，(1)患者的信息内的碘131治疗中，存在碘治疗次数等于1的数据，取当前数据的治疗日期数据；(2)碘131治疗后随诊中，若存在数据，取最近一次抽血日期，减去(1)中治疗日期，计算得出随访时长。The follow-up duration module 600 includes a first duration unit, which is used to determine the follow-up duration when the first iodine-131 treatment has been performed. Specifically, (1) in the iodine-131 treatment in the patient's information, there is data that the number of iodine treatments is equal to 1 , take the treatment date of the current data; (2) in the follow-up after iodine-131 treatment, if there is data, take the date of the latest blood draw, subtract the treatment date in (1), and calculate the follow-up duration.

随访时长模块600包括第二时长单元，用于在已做未做碘131治疗的时候判定随访时长，具体来说，(1)碘131治疗表中，只存在碘治疗次数等于0的数据；(2)手术及病理情况表中手术方式等于2，若存在，则取该数据的手术时间；(3)碘131治疗后随诊表中，若存在数据，取最近一次抽血日期，减去(2)中手术时间，计算得出随访时长。The follow-up duration module 600 includes a second duration unit, which is used to determine the follow-up duration when the iodine-131 treatment has been done but not done. Specifically, (1) in the iodine-131 treatment table, there is only data that the number of iodine treatments is equal to 0; ( 2) In the table of surgical and pathological conditions, the surgical method is equal to 2, if it exists, the operation time of the data is taken; (3) In the follow-up table after iodine-131 treatment, if there is data, take the date of the latest blood draw, minus ( 2) In the middle operation time, the follow-up time was calculated.

举例来说，随访时长单位为“个月”，计算规则：For example, the unit of follow-up time is "month", and the calculation rules are as follows:

后一个日期减去前一个日期，按整月进行减，不满1月的，剩余天数除30天，取2位小数，最终组合而成。Subtract the previous date from the next date, and subtract it by the whole month. If it is less than one month, divide the remaining days by 30 days, take 2 decimal places, and finally combine them.

如首次治疗日期为“2020-08-12”，最后一次随诊抽血日期为“2020-12-05”，则计算如下：If the date of the first treatment is "2020-08-12" and the date of the last follow-up blood draw is "2020-12-05", the calculation is as follows:

(1)因“12-05”未满“12-12”，故整月按“11-12”减“08-12”计算，即11-8，为3个月；(1) Since "12-05" is less than "12-12", the whole month is calculated as "11-12" minus "08-12", that is, 11-8, which is 3 months;

(2)剩余天数按“12-05”减去“11-12”计算，为23天，23除30取2位小数为0.77个月；(2) The remaining days are calculated by subtracting "11-12" from "12-05", which is 23 days, and dividing 23 by 30 and taking 2 decimal places is 0.77 months;

(3)则最终随访时长为3+0.77＝3.77个月。(3) The final follow-up time was 3+0.77=3.77 months.

第二实施方式Second Embodiment

如图2所示，本实施方式提供了分化型甲状腺癌的全切术后评估方法，包括：获取患者的信息，所述患者的信息包括：病理信息、血清数据和影像数据；基于所述病理信息评估死亡风险；基于所述病理信息、所述血清数据和所述影像数据评估复发风险；基于血清数据和影像数据判定手术疗效；基于所述病理信息、所述血清数据和所述影像数据评估患者治疗疗效。本实施方式的评估方法可明确判断手术疗效和治疗疗效，给患者和明确一个明确的判定标准，以便患者明确自身状况，并且便于医生有针对性的选择治疗方案对患者进行治疗。As shown in FIG. 2 , this embodiment provides an evaluation method for differentiated thyroid cancer after total resection, including: acquiring patient information, where the patient information includes: pathological information, serum data and image data; information to evaluate the risk of death; to evaluate the risk of recurrence based on the pathological information, the serum data and the image data; to determine the surgical efficacy based on the serum data and the image data; to evaluate based on the pathology information, the serum data and the image data patient treatment efficacy. The evaluation method of this embodiment can clearly determine the surgical efficacy and treatment efficacy, and provide a patient with a clear judgment standard, so that the patient can identify his own condition, and it is convenient for the doctor to select a treatment plan to treat the patient in a targeted manner.

在一实施例中，评估方法还包括：基于患者的信息的得出治疗后随访时长。In one embodiment, the assessment method further includes: deriving a post-treatment follow-up time based on the patient's information.

本实施方式与上一实施方式相同的部分在此不多做赘述。The parts of this embodiment that are the same as those of the previous embodiment are not repeated here.

应当理解的是，本发明的上述具体实施方式仅仅用于示例性说明或解释本发明的原理，而不构成对本发明的限制。因此，在不偏离本发明的精神和范围的情况下所做的任何修改、等同替换、改进等，均应包含在本发明的保护范围之内。此外，本发明所附权利要求旨在涵盖落入所附权利要求范围和边界、或者这种范围和边界的等同形式内的全部变化和修改例。It should be understood that the above-mentioned specific embodiments of the present invention are only used to illustrate or explain the principle of the present invention, but not to limit the present invention. Therefore, any modifications, equivalent replacements, improvements, etc. made without departing from the spirit and scope of the present invention should be included within the protection scope of the present invention. Furthermore, the appended claims of this invention are intended to cover all changes and modifications that fall within the scope and boundaries of the appended claims, or the equivalents of such scope and boundaries.

Claims (11)

1. A post-pancreatectomy evaluation model for differentiated thyroid cancer comprising:

a data module for storing patient information, the patient information comprising: pathology information, serum data, and image data;

the death risk assessment module is used for acquiring the pathological information and assessing the death risk based on the pathological information;

a recurrence risk assessment module for acquiring the pathological information, the serum data and the image data, and assessing a recurrence risk based on the pathological information, the serum data and the image data;

a pre-operative iodine therapy evaluation module for acquiring the serum data and the image data and determining the operative effect based on the serum data and the image data;

a real-time dynamic assessment module for assessing a patient treatment efficacy based on obtaining the pathology information, the serum data, and the image data, and based on the pathology information, the serum data, and the image data.

2. The post-total-resection evaluation model for differentiated thyroid cancer according to claim 1, further comprising:

and the follow-up visit duration module is used for acquiring the information of the patient and obtaining the follow-up visit duration after treatment based on the information of the patient.

3. The post-total-resection evaluation model for differentiated thyroid cancer according to claim 1, wherein the serum data comprises: tg, TSH, TgAb and sTg data.

4. The post-pancreatectomy evaluation model for differentiated thyroid cancer according to claim 1, wherein the image data comprises: ultrasound data, CT data, DxWBS data, RxWBS data, and bone visualization data.

5. The model for post-total resection evaluation of differentiated thyroid cancer according to claim 1, wherein the module for pre-post-operative iodine therapy evaluation comprises:

a first determination unit configured to derive a first determination condition based on the serum data;

a first evaluation module for evaluating a surgical effect based on the first determination condition and the image data;

wherein the serum data comprises: first bleeding data were TgAb1, Tg1, sTg1 and TSH 1; the second bleeding data were TgAb2, Tg2, sTg2 and TSH 2;

the first determination condition includes the following A, B and C:

a: under the condition that TgAb2 is less than 115IU/mL, one of the following two conditions is further met:

a1: TSH2< (2 ng/mL) and Tg0<0.2 ng/mL;

a2: TSH2>30ng/mL and Tg2<1.0 ng/mL;

b: one of the following two conditions is satisfied:

B1. under the conditions that TgAb1 is less than 115IU/mL and TgAb2 is less than 115IU/mL, one of the following two conditions is further met:

b11: TSH1< ═ 2ng/mL and 0.2ng/mL < ═ Tg1< ═ 1 ng/mL;

b12: TSH2>30ng/mL and 1ng/mL < Tg2< 10 ng/mL;

b2: under the condition that TgAb1> -115 IU/mL or TgAb2> -115 IU/mL, TgAb2< TgAb1 (1+ 20%);

c: one of the following two conditions is satisfied:

c1: under the conditions that TgAb1 is less than 115IU/mL and TgAb2 is less than 115IU/mL, one of the following two conditions is further met:

c11: TSH2< (2 ng/mL) and Tg2>1.0 ng/mL;

c12: TSH2>30ng/mL and Tg2>10 ng/mL;

c2: under the condition that TgAb1> -115 IU/mL or TgAb2> -115 IU/mL, TgAb2< TgAb1 (1+ 20%) is satisfied.

6. The post-total excision assessment model for differentiated thyroid cancer according to claim 5, wherein said first assessment module is used for:

judging that the curative effect is satisfactory based on the first judgment condition A and imaging;

judging that the curative effect is not definite based on the first judgment condition B and imaging;

judging that the biochemical treatment effect is poor based on the first judgment condition C and imaging;

based on the image data indicating a recurrence or metastasis, a structural therapy is determined to be poor.

7. The post-pancreatectomy evaluation model for differentiated thyroid cancer according to claim 1, wherein the real-time dynamic evaluation module comprises:

a second determination unit configured to derive a second determination condition based on the serum data and the image data;

a second evaluation module for evaluating a patient treatment efficacy based on the second determination condition;

the second determination condition includes the following a to E:

a, serum data meets one of the following two conditions, and imaging-;

a1: TgAb <115IU/mL, and TSH < ═ 2ng/mL and Tg <0.2 ng/mL;

a2: TgAb <115IU/mL, and TSH >30ng/mL and Tg <1.0 ng/mL;

b, one of the following two conditions is satisfied;

b1, satisfies TgAb <115IU/mL, and is imagewise-, and satisfies one of the following conditions, then satisfies condition B1:

b11 TSH 2ng/mL and 0.2ng/mL Tg1 ng/mL;

b12 TSH >30ng/mL and 1ng/mL < Tg <10 ng/mL;

b2, satisfying TgAb > -115 IU/mL, and TgAb2< TgAb1 (1+ 20%) and imageology-;

c, one of the following two conditions is met;

c1, satisfies TgAb <115IU/mL, and is imagewise-, and satisfies one of the following conditions, then satisfies condition C1:

c11: TSH < ═ 2ng/mL and Tg > -1.0 ng/mL;

c12: TSH >30ng/mL and Tg > -10 ng/mL;

c2 TgAb > -115 IU/mL, and TgAb2> -TgAb 1 (1+ 20%) and imageology-;

d, any level of serology; imaging to confirm the presence of disease;

e, the imaging results are ambiguous.

8. The post-total-resection evaluation model for differentiated thyroid cancer according to claim 7,

the second evaluation module is to:

judging that the curative effect is satisfactory based on the second judgment condition A;

judging that the curative effect is not exact based on the second judgment condition B;

if the second judgment condition is C, judging that the biochemical treatment effect is poor;

determining that the structural treatment effect is poor based on the second determination condition being D;

and judging that the iconography is not clear based on the second judgment condition being E.

9. The model for the evaluation of differentiated thyroid cancer after total resection according to claim 1, wherein the risk of recurrence comprises high risk, intermediate risk and low risk;

wherein, accord with any one of following condition, be high-risk:

the tumor can be seen to invade the surrounding tissues or organs by naked eyes;

failure of the tumor to be completely resected;

the image data shows that the remote transfer exists;

serum data showed distant metastasis;

FTC is associated with extensive vascular invasion;

meeting any one of the following conditions, namely, being in medium risk;

under the microscope, the tumor is found to be invaded by soft tissues around the thyroid;

after primary iodine 131 treatment, RxWBS finds that the transfer focus outside the thyroid bed of the neck part takes iodine;

tumors are invasive histological subtypes;

PTC is associated with vascular invasion;

lymph node metastasis is found clinically or > 5 lymph node metastases are found in pathological examination;

low risk in compliance with either of A, B, C and D:

a, PTC with a pathological type of 1 and meeting all of the following conditions a1-a7 is at low risk:

a1: no local or distant metastasis;

a2: all macroscopic tumors were completely excised;

a3: the tumor does not invade surrounding tissues;

a4: tumors are not an aggressive histological subtype;

a5, if treated with iodine 131, RxWBS shows no abnormal radioactive iodine uptake outside thyroid bed for the first time;

a6: no vessel invasion;

a7: no lymph node metastasis is found clinically or less than 5 lymph node micrometastases are found in pathological examination

B, FV-PTC restricted to intrathyroid;

c, highly differentiated FTC localized in the thyroid, with invasion of the envelope, with no or only microvascular invasion (< 4 lesions);

d, intrathyroid, unifocal or multifocal PTMC.

10. The post-pancreatectomy evaluation model for differentiated thyroid cancer according to claim 2, wherein the follow-up duration module comprises:

a first duration unit for determining a follow-up duration when a first iodine 131 treatment has been made;

a second duration unit for determining a follow-up duration when the iodine 131 treatment has not been performed.

11. A method for post-pancreatectomy evaluation of differentiated thyroid cancer, comprising:

obtaining information of a patient, the information of the patient comprising: pathology information, serum data, and image data;

assessing a risk of death based on the pathological information;

assessing a risk of relapse based on the pathology information, the serum data, and the image data;

determining the surgical effect based on the serum data and the image data;

assessing a patient treatment efficacy based on the pathology information, the serum data, and the image data.

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