A retrospective study of papillary thyroid carcinoma: Hashimoto's thyroiditis as a protective biomarker for lymph node metastasis.

Abstract

PURPOSE:

There is approximately 10%-50% of papillary thyroid carcinoma (PTC) patients with Hashimoto's thyroiditis (HT). In this research, we sought to better understand the role of HT in PTC progression as well as lymph node metastasis.

METHODS:

It is a retrospective and cross-sectional study, and 4131 PTC patients who underwent thyroidectomy were finally enrolled. Chi-square test, univariate and multivariate logistic regression analyses were employed to evaluate both the risk factors and the critical roles of HT during PTC metastasis.

RESULT:

In this cohort, 1555 patients (37.6%) were diagnosed with HT. According to multivariate analysis, male sex, high levels of TG and TPOAb, tumor extrathyroidal extension, maximum diameter >1 cm, and multifocality were independent risk factors for both central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM). In addition, age <55 years and smoking were risk factors for CLNM, while CLNM was one of the risk factors for LLNM. Furthermore, HT was suggested a valuable protective factor for both CLNM and LLNM. In patients with HT, the total number of central lymph nodes was higher, while the positive rate was lower. Compared with those without HT, age and sex did not predict CLNM and LLNM in patients with HT.

CONCLUSION:

HT is considered a protective factor for both CLNM and LLNM in PTC. For patients with HT, surgeons should pay more attention to the preservation of parathyroid gland and the protection of recurrent laryngeal nerve due to less lymph node metastasis. Otherwise, radical operation is highly recommended.

• Authors: Yu Wang, Jianwei Zheng, Xiaomeng Hu, Qing Chang, Yu Qiao, Xiaofeng Yao, Xuan Zhou
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 49 Issue 3 Pg. 560-567 (Mar 2023) ISSN: 1532-2157 [Electronic] England
• PMID: 36404253 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier Ltd.

Chemical References

• Biomarkers

Topics

• Humans
• Male
• Middle Aged
• Thyroid Cancer, Papillary (pathology)
• Retrospective Studies
• Thyroid Neoplasms (pathology)
• Lymphatic Metastasis (pathology)
• Cross-Sectional Studies
• Carcinoma, Papillary (pathology)
• Hashimoto Disease (pathology)
• Lymph Nodes (pathology)
• Risk Factors
• Biomarkers