Thyroid functional parameters and correlative autoantibodies as prognostic factors for differentiated thyroid cancers

et al. 2021

BMC Cancer

Background Predicting the possibility of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan for patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the independent risk factors for ipsi-LLNM in PTC patients by combining dual-energy computed tomography (DECT) with thyroid function indicators. Methods We retrospectively enrolled 406 patients with a pathological diagnosis of PTC from Jan 2016 to Dec 2019. Ensure the DECT images were clear and the thyroid function indicators were complete. Univariate and multivariate logistic analyses explored the independent risk factors for ipsi-LLNM. To evaluate the cutoff value of each risk factor by using receiver operating characteristic (ROC) curves. Results A total of 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without ipsi-LLNM. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in the arterial and the venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in the arterial and the venous phases (P < .05). The combined application of the above independent risk factors can predict the possibility of ipsi-LLNM, with an AUC of 0.834. Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/mL, Anti-Tg > 89.43 IU/mL, IC in arterial phase > 3.4 mg/mL and IC in venous phase > 3.1 mg/mL. Conclusions The combined application of DECT quantitative parameters and thyroid function indicators can help clinicians accurately predict ipsi-LLNM before surgery, thereby assisting the individualized formulation of surgical procedures.

Section: Discussionsupporting

confidence: 91%

“…Some studies [ 21 , 22 ] have shown that thyroid stimulating hormone (TSH) is closely related to the occurrence and development of PTC. However, it is not clear whether there is an association between other thyroid function indicators and LLNM.…”

Section: Introductionmentioning

confidence: 99%

Prediction of ipsilateral lateral cervical lymph node metastasis in papillary thyroid carcinoma: a combined dual-energy CT and thyroid function indicators study

Zou

et al. 2021

BMC Cancer

“…In the current study, univariate analysis results suggested that Tg and Anti-Tg were related to ipsi-LLNM (P range, .000 -.001). Further multivariate analysis showed that Tg > 100.01ng/ml and Anti-Tg > 89.43 IU/ml were also independent risk factors for ipsi-LLNM, which was in agreement with Li's reports (19). Based on these results, we may conclude that Tg and Anti-Tg may be correlated with tumor aggressiveness and prognosis in patients with PTC, and the measurement could give additional information for predicting aggressiveness and ipsi-LLNM.…”

Section: Discussionsupporting

confidence: 90%

“…Some studies (19,20) have shown that thyroid stimulating hormone (TSH) is closely related to the occurrence and development of PTC, but the relationship between other thyroid functional indicators and LLNM is inconclusive, for example, preoperative serum thyroglobulin (Tg), anti-thyroid stimulating hormone (Anti-Tg) and anti-thyroid peroxidase (Anti-TPO).…”

Section: Introductionmentioning

confidence: 99%

Prediction of Ipsilateral Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Combined Dual-energy CT and Thyroid Functional Indicators Study

Zou

et al. 2020

Preprint

BackgroundThe prediction of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan in patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the risk factors for ipsi-LLNM using dual-energy computed tomography (DECT) and thyroid functional indicators in patients with PTC. MethodsThe medical records of 406 patients with a pathological diagnosis of PTC were retrospectively reviewed from Jan 2016 to Dec 2019. Demographic, clinical, pathological findings, and parameters from DECT were evaluated. Risk factors for ipsi-LLNM were explored by univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were used to evaluate the cut-off value of each risk factor.ResultsTotally 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in arterial and venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in arterial and venous phases (P < .05). Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/ml, Anti-Tg > 89.43 IU/ml, IC in arterial phase > 3.4 mg/ml and IC in venous phase > 3.1 mg/ml.ConclusionsApplication of DECT parameters and thyroid functional indicators can improve the diagnostic performance in the evaluation of ipsi-LLNM in patients with PTC.

“…TSH is a well-established risk factor of thyroid cancer. The association between TSH and CLNM was only observed by few of studies [ 3 , 27 ]. The current study showed that although significant differences were observed in HT, TSH, TGAB, and TMAB between male and female groups, the predictive value of HT, TSH, TGAB, and TMAB for CLNM was not differed by gender.…”

Section: Discussionmentioning

confidence: 99%

Gender-Specific Risk of Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma

Sun

International Journal of Endocrinology

et al. 2018

Our aim was to evaluate the impact of gender on the predictive factors of central compartment lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC). A retrospective study of 590 patients treated for PTC was performed. Univariate and multivariate analyses showed that gender (female; P = 0.001), age (≥45 y; P < 0.001), tumor size (>1 cm; P < 0.001), and multifocality (P = 0.004) were independent predictive factors of CLNM in PTC patients. Patients were divided into male group (n = 152) and female group (n = 438). Age (≥45 y; P = 0.001), T4 (P = 0.006) and multifocality (P = 0.024) were independent predictive risk factors of CLNM in male patients. As for female patients, age (≥45 y; P < 0.001), tumor size (>1 cm; P < 0.001), multifocality (P = 0.002), and microcalcification (P = 0.027) were independently correlated with CLNM. The sensitivity of the multivariate model for predicting CLNM in male patients was 64.9%, specificity was 82.9%, and area under the ROC curve (AUC) was 0.764. As for female patients, the sensitivity was 55.7%, specificity was 77.9%, and AUC was 0.73. This study showed that the predictive factors of CLNM indeed varied according to gender. To have a more accurate evaluation of CLNM, different predictive systems should be used for male and female patients.