Influencing Factors and Cumulative Risk Analysis of Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma

Yin, Yirong; Xu, Xiangjie; Zhao, Wenjuan; Diao, Hongcui; Li, Chengqian

doi:10.3389/fonc.2021.644645

Cited by 8 publications

(14 citation statements)

References 51 publications

(75 reference statements)

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“…This suggests that lateral LNs are more commonly involved, especially for occult metastasis. This is different from previous studies, where central LNs were the most common area for LNM [ 15 , 21 , 39 ]. This result of a high rate of LLNM and occult LLNM could help surgeons in the decision of performing prophylactic lateral lymph node dissections to reduce recurrence.…”

Section: Discussioncontrasting

confidence: 96%

“…In the present study, we analyzed the retrospective data of 226 patients with PTMC. The results revealed that the rate of LNM was 43.8%, which is within the range previously reported [ 15 , 38 ]. The rate of CLNM was 17.7% and LLNM was 26%.…”

Section: Discussionsupporting

confidence: 90%

“…This is similar to other studies which also found extrathyroidal extension and bilaterality as predictors of lymph node metastasis [ 14 , 17 , 21 , 40 ]. However, our study differs from larger studies of other Western and far Eastern ethnicities in that we did not find any other clinico-pathological parameters as potential predictors of lymph node metastasis, whereas male gender, age, tumor size, multifocality, lymphovascular invasion, and presence of Hashimoto’s thyroiditis were reported in these ethnicities as predictors of lymph node metastasis in PTMC [ 14 , 15 , 17 , 21 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. The cohort size, ethnicity, and study design (including lateral LNM or central LNM) might contribute to these differences.…”

Section: Discussioncontrasting

confidence: 84%

“…According to several reports, LNM is considered one of the risk factors for aggressive PTMC [ 10 , 13 , 14 , 15 , 16 ]. Several clinico-pathological and molecular characteristics have been shown to increase the risk for LNM such as older age, gender, multifocality, bilaterality, extra-thyroidal extension, and the presence of Hashimoto’s thyroiditis [ 15 , 17 , 18 ]. In addition, the presence of BRAF mutations has been reported to be a significant risk factor for LNM [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Cervical Lymph Node Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

Parvathareddy

Siraj

Annaiyappanaidu

et al. 2022

JCM

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Papillary thyroid microcarcinoma (PTMC) typically has an indolent course and excellent prognosis. Nonetheless, a subset of PTMC carries a risk of lymph node metastasis (LNM) and local recurrence. PTC from the Middle Eastern population is unique with respect to demographic and clinico-pathological characteristics as compared to other ethnicities of the world. The risk factors of LNM in PTMC patients of Middle Eastern ethnicity have not been fully explored. The present study aims to investigate the influencing factors of LNM in Middle Eastern PTMC patients and its predictive impact on patient’s outcome. A total of 226 confirmed PTMC cases were selected in this retrospective study. The correlation between clinico-pathological, as well as molecular, characteristics and LNM was evaluated. Multivariate analysis was performed by logistic regression and Cox proportional hazards models. Among the 226 patients, the rate of LNM was 43.8% (99/226). Bilaterality, multifocality, gross extrathyroidal extension (ETE), and intermediate-to-high American Thyroid Association (ATA) risk tumors were significantly associated with LNM in PTMC. Multivariate logistic regression analysis showed that bilaterality and gross ETE were independent predictive factors for LNM in PTMC. The recurrence-free survival (RFS) was shorter in PTMC with LNM compared to those without LNM (p = 0.0051) and was significant on multivariate analysis. In conclusion, our study showed that bilaterality and gross ETE were independent influencing factors of LNM in Saudi patients with PTMC. LNM was also associated with shorter RFS. The identification of risk factors for LNM in patients of Middle Eastern ethnicity could help the individualization of clinical management for PTMC patients.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Cervical Lymph Node Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

Parvathareddy

Siraj

Annaiyappanaidu

et al. 2022

JCM

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“…Additionally, Xue et al 67 suggest that HT is protective against recurrence. However, Yin et al 68 show that HT is independently and positively linked to LNM in female PTMC patients aged <55 years. HT was not a significant risk factor for hv‐CLNM in PTMC patients herein.…”

Section: Discussionmentioning

confidence: 97%

Clinical and ultrasonic risk factors for high‐volume central lymph node metastasis in cN0 papillary thyroid microcarcinoma: A retrospective study and meta‐analysis

Wang

Gui

Wang

et al. 2022

Clinical Endocrinology

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Objective: Papillary thyroid microcarcinoma (PTMC) comprises more than 50% of all newly detected cases of papillary thyroid carcinoma (PTC). High-volume lymph node metastasis (involving >5 lymph nodes) (hv-LNM) is associated with PTMC recurrence. In half of the clinically node-negative (cN0) PTMC patients, central lymph node metastasis (CLNM) is pathologically present. However, clinical risk factors for high-volume CLNM (hv-CLNM) in cN0 PTMC have not been defined well.Therefore, we aimed to obtain evidence for hv-CLNM risk factors in cN0 PTMC.Design: Data on patients who visited our hospital between January 2020 and December 2021 were collected; a preoperative diagnosis of cN0 and a postoperative pathological confirmation of PTMC were obtained. After filtering by inclusion versus exclusion criteria, the obtained data (N = 2268) were included in the meta-analysis. Relevant studies published as of 10 April 2022, were identified from the Web of Science, PubMed, WANFANG, and CNKI databases. These eligible studies were included in the meta-analysis and the association between clinicopathological factors and hv-CLNM in cN0 PTMC was assessed. SPSS and MetaXL were used for statistical analyses. Results:The meta-analysis included 10 previous studies (11,734 patients) and 2268 patients enroled in our hospital for a total of 14,002 subjects. The results of which suggested that younger age (<40, odds ratio [OR] = 3.28, 95% confidence interval[CI] = 2.75-3.92, p < .001 or <45 odds ratio [OR] = 2.93, 95% CI = 2.31-3.72, p < .001),

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Clinical and molecular features of progressive papillary thyroid microcarcinoma

Wang,

Ji,

Zhang

et al. 2024

International Journal of Surgery

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In recent decades, the prevalence of thyroid cancer has risen substantially, with papillary thyroid microcarcinoma (PTMC) constituting over 50% of cases. Although most PTMCs exhibit indolent growth and a favorable prognosis, some present an increased risk of recurrence and an unfavorable prognosis due to high-risk characteristics such as lymph node metastasis, extrathyroidal extension, and distant metastasis. The early identification of clinically progressing PTMC remains elusive. In this review, we summarize findings from PTMC progression-related literature, highlighting that factors such as larger tumor size, cervical lymph node metastasis, extrathyroidal extension, younger age, higher preoperative serum thyroid-stimulating hormone levels, family history, and obesity positively correlate with PTMC progression. The role of multifocality in promoting PTMC progression, however, remains contentious. Furthermore, recent studies have shed light on the impact of mutations, such as BRAF and TERT mutations, on PTMC progression. Researchers have identified several mRNAs, non-coding RNAs, and proteins associated with various features of PTMC progression. Some studies propose that peripheral and tumor tissue-infiltrating immune cells could serve as biomarkers for the clinical progression of PTMC. Collectively, these clinical and molecular features offer a rationale for the early detection and the development of precision theranostic strategies of clinically progressive PTMC.

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Influencing Factors and Cumulative Risk Analysis of Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma

Cited by 8 publications

References 51 publications

Risk Factors for Cervical Lymph Node Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

Risk Factors for Cervical Lymph Node Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma

Clinical and ultrasonic risk factors for high‐volume central lymph node metastasis in cN0 papillary thyroid microcarcinoma: A retrospective study and meta‐analysis

Clinical and molecular features of progressive papillary thyroid microcarcinoma

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