Detailed characterization of metastatic lymph nodes improves the prediction accuracy of currently used risk stratification systems in N1 stage papillary thyroid cancer

Lee, Jandee; Kim, Chan Hee; Min, In Kyung; Jeong, Seonhyang; Kim, Hyunji; Choi, Moon Jung; Kwon, Hyeong Ju; Jung, Sang Geun; Jo, Young Suk

doi:10.1530/eje-20-0131

Cited by 12 publications

(13 citation statements)

References 45 publications

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“…Previous studies have found that low ratio of metastatic LNs predicted a low risk of recurrence and better disease-specific survival [31][32][33]. In our study, patients in the HT group had lower TNM stages and number and ratio of metastasis LNs.…”

Section: Discussionsupporting

confidence: 57%

Lymph node metastasis of papillary thyroid carcinoma in the context of Hashimoto’s thyroiditis

et al. 2022

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Background Whether Hashimoto’s thyroiditis (HT) affects the lymph node metastasis of papillary thyroid carcinoma (PTC) remains uncertain. The diagnostic criteria for HT differed in previous studies. Our study focused on analysing the influence of HT on PTC lymph node metastasis (LNM) with stringent diagnostic criteria for HT. Methods A total of 444 patients diagnosed with PTC from 2019 to 2020 were enrolled and divided into two groups: HT group and non-HT group. Diagnostic criteria of HT were as follows: thyroid peroxidase antibody (+) and postoperative histopathology of Hashimoto’s disease. Results There was no significant difference in the LNM rate between HT group and non-HT group. Patients in the HT group had fewer numbers of metastatic LNs and lower metastatic LNs ratio in central region. In the HT group, age < 55 and tumor size ≥10 mm were independent risk factors for central LNM. Conclusion The autoimmune response of HT seems to reduce the central lymph node metastasis of HT PTCs. Age < 55 and tumor size ≥10 mm were independent risk factors of central lymph node metastasis in HT PTCs.

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Section: Discussionsupporting

confidence: 57%

Lymph node metastasis of papillary thyroid carcinoma in the context of Hashimoto’s thyroiditis

et al. 2022

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“…LNM of PTC occurs in a stepwise fashion. Spreading from the thyroid gland, the central and lateral lymph node compartments on the ipsilateral side of the thyroid tumor represent the first echelons of lymphatic drainage, followed by the mediastinal and contralateral lateral lymph node compartments ( 13 , 14 ). In a previous study, our team found that the region of PTC LNM was significantly associated with the location of the primary tumor ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Features of Lymph Node Metastasis and Structural Recurrence in Papillary Thyroid Carcinoma Located in the Upper Portion of the Thyroid: A Retrospective Cohort Study

et al. 2022

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BackgroundThis study aims to reveal the features of lymph node metastasis (LNM) and recurrence in papillary thyroid carcinoma (PTC) tumors located in the upper portion of the thyroid.MethodsA total of 1075 PTC patients were retrospectively reviewed, including 314 patients with a tumor in the upper portion of the thyroid. Another 103 PTC patients with upper portion diagonsis from three clinical centers were included for external validation.ResultsThe results showed no difference between the patients with a tumor in the upper portion of the thyroid and those with a tumor in the non-upper portion in terms of overall LNM rates. However, patients with a tumor in the upper portion were significantly more prone to LLNM and exhibited a significantly worse recurrence outcome than those with a tumor in other subregions. Multivariate analysis showed that four factors—age no more than 40, maximum tumor diameter no less than1.0 cm, the presence of thyroid capsular invasion, and tumor with ipsilateral nodular goiter—were independent risk factors for LLNM of the tumor in the upper thyroid. A predictive risk-scoring model was established based on these factors.ConclusionsPatients with PTC located in the upper portion may have an exclusive lymphatic drainage pathway to the lateral neck region and are more prone to suffer from LLNM and tumor recurrence than those with a tumor located in other subregions. A new postoperative strategy selection flow chart was established based on our newly created risk-scoring model that can effectively predict the individualized possibility of LLNM for PTC patients with a tumor in the upper portion.

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“…In this context, a new approach called active surveillance is being widely studied in the clinical setting [4]. However, basic experiments and clinical studies on thyroid cancer occurring in young patients and refractory thyroid cancer relatively commonly observed in the elderly are also being conducted [5][6][7][8]. These efforts have led to the development of various tyrosine kinase inhibitors, including targeted therapy for BRAFV600E, for the clinical setting.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Expression of Long Non-Coding RNA FAL1 and Extracellular Matrix Protein 1 Defines Tumour Behaviour in Young Patients with Papillary Thyroid Cancer

Jeong

Lee

Kim

et al. 2021

Cancers

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We investigated the regulatory mechanism of FAL1 and unravelled the molecular biological features of FAL1 upregulation in papillary thyroid cancer (PTC). Correlation analyses of FAL1 and neighbouring genes adjacent to chromosome 1q21.3 were performed. Focal amplification was performed using data from copy number alterations in The Cancer Genome Atlas (TCGA) database. To identify putative transcriptional factors, PROMO and the Encyclopaedia of DNA Elements (ENCODE) were used. To validate c-JUN and JUND as master transcription factors for FAL1 and ECM1, gene set enrichment analysis was performed according to FAL1 and ECM1 expression. Statistical analyses of the molecular biological features of FAL1- and ECM1-upregulated PTCs were conducted. FAL1 expression significantly correlated with that of neighbouring genes. Focal amplification of chromosome 1q21.3 was observed in ovarian cancer but not in thyroid carcinoma. However, PROMO suggested 53 transcription factors as putative common transcriptional factors for FAL1 and ECM1 simultaneously. Among them, we selected c-JUN and JUND as the best candidates based on ENCODE results. The expression of target genes of JUND simultaneously increased in FAL1- and ECM1-upregulated PTCs, especially in young patients. The molecular biological features represented RAS-driven PTC and simultaneously enriched immune-related gene sets. FAL1 and ECM1 expression frequently increased simultaneously and could be operated by JUND. The simultaneous upregulation might be a potential diagnostic and therapeutic target for RAS-driven PTC.

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Detailed characterization of metastatic lymph nodes improves the prediction accuracy of currently used risk stratification systems in N1 stage papillary thyroid cancer

Cited by 12 publications

References 45 publications

Lymph node metastasis of papillary thyroid carcinoma in the context of Hashimoto’s thyroiditis

Lymph node metastasis of papillary thyroid carcinoma in the context of Hashimoto’s thyroiditis

Features of Lymph Node Metastasis and Structural Recurrence in Papillary Thyroid Carcinoma Located in the Upper Portion of the Thyroid: A Retrospective Cohort Study

Simultaneous Expression of Long Non-Coding RNA FAL1 and Extracellular Matrix Protein 1 Defines Tumour Behaviour in Young Patients with Papillary Thyroid Cancer

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