|Table of Contents|

The clinicopathologic features of papillary thyroid carcinoma patients with or without Hashimoto' s thyroiditis and its correlation with lymph node metastasis

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 02
Page:
252-257
Research Field:
Publishing date:

Info

Title:
The clinicopathologic features of papillary thyroid carcinoma patients with or without Hashimoto' s thyroiditis and its correlation with lymph node metastasis
Author(s):
YIN Xiuling; FAN Jing; YAN Changjiao; GUO Sijin
Department of Thyroid,Breast and Vascular Surgery,Xijing Hospital,Air Force Medical University,Shaanxi Xi'an 710032,China.
Keywords:
papillary thyroid carcinoma; Hashimoto's thyroiditis; lymph node metastasis; risk factors
PACS:
R736.1
DOI:
10.3969/j.issn.1672-4992.2023.02.010
Abstract:
Objective:To investigate the clinicopathologic features of papillary thyroid carcinoma with Hashimoto's thyroiditis and the effect of Hashimoto's thyroiditis on lymph node metastasis.Methods:The clinical data of 3 411 patients with pathologically confirmed papillary thyroid carcinoma from October 2014 to October 2019 in Xijing Hospital were retrospectively analyzed,including 498 patients with Hashimoto's disease and 2 913 patients without Hashimoto's disease.The two groups were matched by propensity score matching method to obtain a balanced sample of group covariates.The clinical case characteristics of the two groups were compared and the risk factors of lymph node metastasis were analyzed.Results:After propensity score matching,papillary thyroid carcinoma patients with Hashimoto's thyroiditis were significantly correlated with lesion size and BRAF V600E gene mutation only (P＜0.05),but not with the number of lesions,invasion capsule,lymph node metastasis,central lymph node metastasis,cervical lymph node metastasis and the number of lymph node metastasis (P＞0.05).Logistic regression analysis showed that PTC patients age≥55 years had a 0.957-fold higher risk of lymph node metastasis than patients age<55 years (OR=0.957,P＜0.001).The risk of lymph node metastasis was 2.697-fold higher in patients with tumor lesions>1 cm than in those with lesions≤1 cm (OR=2.697,P＜0.001).Patients with multifocal tumor lesions had a 2.186-fold higher risk of lymph node metastasis than those with unifocal lesions (OR=2.186,P＜0.001).Conclusion:Combined Hashimoto's thyroiditis is significantly associated with smaller tumor lesions and a higher rate of BRAF V600E gene mutation,but not with lymph node metastasis.Patient age≥55 years was an independent protective factor for lymph node metastasis in patients with papillary thyroid carcinoma,while lesions>1 cm and multifocal lesions were independent risk factors for lymph node metastasis.

References:

［1］ BENEDETTO U,HEAD SJ,ANGELINI GD,et al.Statistical primer:propensity score matching and its alternatives ［J］.European Journal of Cardio-Thoracic Surgery,2018,53(6):1112-1117.
［2］ STUART BL,GREBEL LE,BUTLER CC,et al.Comparison between treatment effects in a randomised controlled trial and an observational study using propensity scores in primary care ［J］.The British Journal of General Practice,2017,67(662):e643-e649.
［3］ 王永吉,蔡宏伟,夏结来,等.倾向指数第一讲倾向指数的基本概念和研究步骤 ［J］.中华流行病学杂志,2010,31(3):347-348. WANG YJ,CAI HW,XIA JL,et al.Scores on propesity(I) conception and measures ［J］.Chineses Journal of Epidemiology,2010,31(3):347-348.
［4］ UHLIAROVA B,HAJTMAN A.Hashimoto's thyroiditis-an independent risk factor for papillary carcinoma ［J］.Brazilian Journal of Otorhinolaryngology,2018,84(6):729-735.
［5］ NOURELDINE SI,TUFANO RP.Association of Hashimoto's thyroiditis and thyroid cancer ［J］.Current Opinion in Oncology,2015,27(1):21-25.
［6］ FELDT-RASMUSSEN U.Hashimoto's thyroiditis as a risk factor for thyroid cancer ［J］.Current Opinion in Endocrinology,Diabetes and Obesity,2020,27(5):364-371.
［7］ 斯诚.桥本甲状腺炎与乳头状甲状腺癌颈淋巴结转移的相关性分析 ［J］.中国地方病防治杂志,2014,3(3):206-208. SI C.Hashimoto's thyroiditis and papilary thyroid cancer lymph node metastasis correlation analysis ［J］.Chinese Journal of Endemic Disease Control,2014,3(3):206-208.
［8］ 胡晓萌.桥本氏甲状腺炎与甲状腺乳头状癌淋巴结转移相关性的探讨 ［D］.天津:天津医科大学,2020. HU XM.Study on the relationship between Hashimoto's thyroiditis and lymph node metastasis of papillary thyroid carcinoma ［D］.Tianjin:Tianjin University,2020.
［9］ 孙永亮，王梦一，袁宏伟，等.伴有桥本甲状腺炎的甲状腺乳头状癌患者颈淋巴结转移规律的研究 ［J］.中华普通外科杂志,2015,12(30):1004-1005. SUN YL,WANG MY,YUAM HW,et al.Study on the regularity of cervical lymph node metastasis in patients with papillary thyroid carcinoma with Hashimoto's thyroiditis ［J］.Chinese Journal of General Surgery,2015,12(30):1004-1005.
［10］ 孙文文,李秧秧,钟申,等.甲状腺乳头状癌中桥本甲状腺炎与颈部中央区淋巴结转移的关系 ［J］.中华内分泌代谢杂志，2016,32(11):906-909. SUN WW,LI YY,ZHONG S,et al.The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in papillary thyroid carcinoma ［J］.Chin J Endocrinology and Metabolism,2016,32(11):906-909.
［11］ RAGUSA F,FALLAHI P,ELIA G,et al.Hashimotos' thyroiditis:Epidemiology,pathogenesis,clinic and therapy ［J］.Best Practice & Research Clinical Endocrinology & Metabolism,2019,33(6):101367.
［12］ AJJAN RA,WEETMAN AP.The pathogenesis of Hashimoto's thyroiditis:Further developments in our understanding ［J］.Hormone and Metabolic Research,2015,47(10):702-710.
［13］ GRACEFFA G,PATRONE R,VIENI S,et al.Association between Hashimoto's thyroiditis and papillary thyroid carcinoma:a retrospective analysis of 305 patients ［J］.BMC Endocrine Disorders,2019,19(Suppl 1):26.
［14］ GUL K,DIRIKOC A,KIYAK G,et al.The association between thyroid carcinoma and Hashimoto's thyroiditis:the ultrasonographic and histopathologic characteristics of malignant nodules ［J］.Thyroid,2010,20(8):873-878.
［15］ ZHANG L,LI H,JI Q H,et al.The clinical features of papillary thyroid cancer in Hashimoto's thyroiditis patients from an area with a high prevalence of Hashimoto's disease ［J］.BMC Cancer,2012,12:610.
［16］ 邢宝迪,赵宇航,余霄龙,等.桥本甲状腺炎与甲状腺乳头状癌临床病理特征的相关性分析［J］.现代肿瘤医学，2020,28（22）：3873-3877. XING Baodi,ZHAO Yuhang,YU Xiaolong,et al.Correlation analysis between Hashimoto's thyroiditis and clinicopathological features of papillary thyroid carcinoma ［J］.Modern Oncology，2020,28（22）：3873-3877.
［17］ 孙婷,秦国友,武振宇,等.不同混杂结构条件下各倾向性评分方法的模拟比较研究 ［J］.中国卫生统计,2017,34(3):415-420. SUN T,QIN GY,WU ZY,et al.Comparison of propensity score methods under different confounding structures:a simulation study ［J］.Chinese Journal of Health Statistics,2017,34(3):415-420.
［18］ EHLERS M,SCHOTT M.Hashimoto's thyroiditis and papillary thyroid cancer:are they immunologically linked［J］.Trends in Endocrinology and Metabolism,2014,25(12):656-664.
［19］ YAN C,HUANG M,LI X,et al.Relationship between BRAF V600E and clinical features in papillary thyroid carcinoma ［J］.Endocrine Connections,2019,8(7):988-996.
［20］ 孟凡萍,郝坡,范慧.甲状腺乳头状癌并发桥本氏甲状腺炎患者BRAF-V600E基因表达及T淋巴细胞亚群分析 ［J］.现代检验医学杂志,2020,35(1):32-34. MENG FP,HAO P,FAN H.BRAF-V600E gene expression and T lymphocyte subset analysis in patients with papillary thyroid carcinoma complicated with Hashimoto's thyroiditis ［J］.Journal of Modern Laboratory Medicine,2020,35(1):32-34.
［21］ WU Y,HAN J,VLADIMIROVNA KE,et al.Upregulation of protein tyrosine phosphatase receptor type C associates to the combination of Hashimoto's thyroiditis and papillary thyroid carcinoma and is predictive of a poor prognosis ［J］.OncoTargets and Therapy,2019,14(12):8479-8489.
［22］ QU N,ZHANG L,LIN DZ,et al.The impact of coexistent Hashimoto's thyroiditis on lymph node metastasis and prognosis in papillary thyroid microcarcinoma ［J］.Tumour Biology,2016,37(6):7685-7692.
［23］ 刘捷.甲状腺乳头状癌合并桥本氏甲状腺炎的临床病理特征［J］.现代肿瘤医学,2016,24(2):222-225. LIU J.Clinical pathology features of papillary thyroid carcinoma coexistent with Hashimoto's thyroiditis［J］.Modern Oncology,2016,24(2):222-225.
［24］ ZHU F,SHEN YB,LI FQ,et al.The effects of hashimoto thyroiditis on lymph node metastases in unifocal and multifocal papillary thyroid carcinoma:A retrospective Chinese cohort study ［J］.Medicine,2016,95(6):e2674.
［25］ 石臣磊，石铁锋，吴佳奇，等.桥本甲状腺炎对乳头状甲状腺癌颈淋巴结转移的影响［J］.中国普通外科杂志,2013,22(5):580-584. SHI CL,SHI TF,WU JQ,et al.Does Hashimoto's thyroiditis have an influence on lymph node metastasis of papillary thyroid carcinoma［J］.Chinese Journal of General Surgery,2013,22(5):580-584.
［26］ 闫维,姜涛,郑晓.甲状腺乳头状癌颈淋巴结转移特点及危险因素分析 ［J］.现代肿瘤医学,2017,25(5):709-712. YAN W,JIANG T,ZHENG X.An analysis of features and risk factors for neck lymph node metastasis in papillary thyroid carcinoma ［J］.Modern Oncology,2017,25(5):709-712.
［27］ LIU C,XIAO C,CHEN J,et al.Risk factor analysis for predicting cervical lymph node metastasis in papillary thyroid carcinoma:a study of 966 patients ［J］.BMC Cancer,2019,19(1):622.

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