Thyroid Antibody Status is Associated with Central Lymph Node Metastases in Papillary Thyroid Carcinoma Patients with Hashimoto’s Thyroiditis

Wen, Xingzhu; Wang, Bin; Jin, Qianmei; Zhang, Wei; Qiu, Ming

doi:10.1245/s10434-019-07256-4

Cited by 27 publications

(35 citation statements)

References 27 publications

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“…Studies have shown that most patients with PTC coexistent with HT are young women, the proportion of multifocal cancer is higher, the tumor size is smaller, and the central lymph node metastasis rate and T stage are lower (14,15,21,22). Our results showed that the proportion of female patients with PTC coexistent with HT was higher.…”

Section: Discussionsupporting

confidence: 44%

The characteristics and risk factors of central compartment lymph node metastasis in cN0 papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis

Jin

Liu

et al. 2020

Gland Surg

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Background: Currently, there are few studies on the characteristics of lymph node metastasis in the central region in patients with preoperative negative lymph node (cN0) papillary thyroid carcinoma (PTC) coexistent with Hashimoto's thyroiditis (HT). There is still a significant controversy on whether to perform prophylactic central compartment lymph node dissection for T1/T2 cN0 PTC. Therefore, we aimed to investigate the characteristics and risk factors of central compartment lymph node metastasis in cN0 PTC (T1 or T2 stage) coexists with HT. Methods: From Jun. 2015 to Apr. 2019, the clinicopathological data of 354 patients with stage T1/ T2 cN0 PTC admitted to the thyroid tumor surgery of Inner Mongolia People's Hospital were analyzed retrospectively. All patients underwent central compartment lymph node dissection. According to the results of the postoperative pathological examination, the patients were divided into two groups: PTC group (n=236) and PTC coexistent with the HT group (n=118).Results: The proportion of PTC patients with HT was 33.33% (118/354) in T1/T2 cN0 PTC patients; most of them were women. The levels of serum thyrotropin, antithyroglobulin antibody, and thyroid peroxidase antibody in PTC coexistent with HT group are higher than those in the PTC group (P<0.05).The number of lymphadenectomies in PTC coexistent with HT group was more than that in PTC alone group (P<0.05). Univariate analysis showed that antithyroglobulin antibody positive, tumor diameter >1 cm, and multifocal cancer in T1/T2 stage cN0 PTC coexistent with HT group were all correlated with lymph node metastasis in the central region (P<0.05). Logistic regression analysis showed that tumor diameter >1 cm, and multifocal cancer were the risk factors of central compartment lymph node metastasis in patients with T1/T2 stage cN0 PTC coexistent with HT (P<0.05).Conclusions: HT is not a relevant factor of central lymph node metastasis in T1/T2 cN0 PTC; regardless of the presence or absence of HT, tumor diameter >1 cm and multifocal cancer are risk factors for central lymph node metastasis in patients with T1/T2 cN0 PTC. Therefore, preventive lymph node dissection in the central region should be conducted actively during the operation.

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Section: Discussionsupporting

confidence: 44%

The characteristics and risk factors of central compartment lymph node metastasis in cN0 papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis

Jin

Liu

et al. 2020

Gland Surg

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“…Currently, a range of works 13,21,30,31 , especially retrospective study, have determined a high concurrence rate of HT and PTC from surgical specimens but the relationship between these two diseases, as well as HT and CLNM, has been controversial. Immunologically, emerging evidence has shown that an abnormal in ammatory response, especially the imbalanced subsets of T cells, NK cells, and cytokines were presenting in HT condition 12,32 , which could potentially affect the tumor microenvironment and subsequent prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, results from Hu et al 17 suggested that enhanced MHC class I expression in HT conditions could decrease the PD-L1 and further overcome the CLNM in PTC patients. Serologically, Wen et al 21 conducted that different thyroid antibody status was signi cantly associated with the CLNM in PTC patients concurrent with HT. They concluded single TgAb was a risk factor in CLNM, whereas TPOAb played a protective role in preventing CLNM.…”

Section: Discussionmentioning

confidence: 99%

“…However, some other studies have reported that the coexistence of HT has no protective effect on patient outcome 18,19 . Furthermore, some scholars even suggested the high thyroid antibody status, especially serum TgAb level, could be a risk factor in promoting the CLNM of PTC patients 20,21 . For this reason, more clinical trials focusing on the effect of HT on the progression of PTC are merited.…”

Section: Introductionmentioning

confidence: 99%

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A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

Min¹,

Feng²,

Xiang³

et al. 2021

Preprint

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PurposeCentral lymph node metastasis (CLNM) has been regarded as a predictor of relatively poor prognosis in patients with papillary thyroid carcinoma (PTC). Our study aimed to identify the risk factors for CLNM and develop a nomogram helping clinical decisions.MethodA total of 1,054 patients underwent thyroidectomy between January 2019 and September 2020 in the Second Affiliated Hospital of Chongqing Medical University. Among these patients, 747 patients with histopathologically confirmed PTC were included in this retrospective study. The perioperative clinical data of these patients were reviewed and analyzed. Univariate and multivariate logistic regression were used to analyze the correlation between clinicopathological characteristics and CLNM. A nomogram model was subsequently established and validated by a decision curve analysis (DCA) curve.Result33.6% (251/747) patients with PTC were confirmed with CLNM. And the CLNM was determined in 31.4% (168/535) non- Hashimoto’s thyroiditis (HT) patients and 39.2% (83/212) HT patients, respectively. 4 clinicopathological factors including gender, age, size, and HT were confirmed significantly associated with CLNM. The established nomogram showed promising discrimination and consistency in the study group with a C-index of 0.703. The decision curve analysis showed the nomogram has clinical feasibility.ConclusionOur data suggested that male gender, younger age, larger tumor size, and HT condition played a pivotal role in promoting the CLNM of PTC patients. And the nomogram we developed can help surgeons make the individualized clinical decision in PTC patients during preoperative and interoperative management.

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“…[ 32 ] Recently, Wen et al have reported that the antibody status (TPOAb and TgAb double negative, TPOAb and TgAb double positive, and TgAb single positive) acts as an independent risk factor for CLNM in PTC patients with CLT. [ 33 ] However, some investigators reported conflicting results to this. Donangelo et al have found that a larger number of cervical lymph nodes were excised in the TgAb positive group than in the TgAb negative group, but the number of metastatic cervical lymph nodes was similar.…”

Section: Discussionmentioning

confidence: 99%

Prediction mode of more than 5 central lymph nodes metastases in clinically node-negative ipsilateral papillary thyroid carcinoma with tumor size 1 to 4 cm

Jin¹,

Sun

Zhou³

et al. 2020

Medicine

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According to the 2015 American Thyroid Association guidelines, either lobectomy or total thyroidectomy was recommended for patients with papillary thyroid carcinoma (PTC) of 1 to 4 cm without extrathyroidal extension and lymph node metastasis. However, lymph node metastases showed strong association with recurrence and low survival rate, especially in PTC patients with more than 5 metastatic lymph nodes. Therefore, this study aimed to investigate the predictive factors of more than 5 central lymph nodes metastases (CLNM) in PTC patients with tumor sizes of 1 to 4 cm. A total of 382 patients with clinically node-negative (cN0) ipsilateral PTC who underwent thyroidectomy with central neck dissection between January 2012 and December 2016 were retrospectively analyzed. CLNMs of >5 were found in 54 (14.1%) patients, while CLNM was detected in 230 (60.2%) patients. Multivariate logistic regression revealed age < 45 years ( P < .001), male gender ( P = .013), and tumor sizes of >2 cm ( P = .001) as independent predictive factors of >5 CLNMs in cN0 ipsilateral PTC patients with tumor sizes 1 to 4 cm. The prediction equation (Y = 1.694 × age + 0.807 × gender + 1.190 × tumor size − 3.530) was developed, with a sensitivity (57.4%) and a specificity (80.8%), respectively, at an optimal cut-off point of −1.685. Therefore, if the predictive value was higher than −1.685 according to the equation in cN0 ipsilateral PTC patients with tumor sizes 1 to 4 cm, then total thyroidectomy might be considered.

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Thyroid Antibody Status is Associated with Central Lymph Node Metastases in Papillary Thyroid Carcinoma Patients with Hashimoto’s Thyroiditis

Cited by 27 publications

References 27 publications

The characteristics and risk factors of central compartment lymph node metastasis in cN0 papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis

The characteristics and risk factors of central compartment lymph node metastasis in cN0 papillary thyroid carcinoma coexistent with Hashimoto’s thyroiditis

A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

Prediction mode of more than 5 central lymph nodes metastases in clinically node-negative ipsilateral papillary thyroid carcinoma with tumor size 1 to 4 cm

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