Hashimoto’s thyroiditis, nodular goiter or follicular adenoma combined with papillary thyroid carcinoma play protective role in patients

Ma, Heng; Li, L; Li, K; Wang, T; Zhang, Y; Zhang, C; Xu, Ying; Wu, Xiaoxiao; Yu, Jin; Wang, H; Xiang, Bin; Zhang, R; Wang, W

doi:10.4149/neo_2018_170428n317

Cited by 10 publications

(5 citation statements)

References 32 publications

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“…Logistics multivariate analysis showed that tumor size ≥0.55 cm, age <55 years old, and no nodular goiter were the influencing factors of central lymph node metastasis in patients with cT1N0M0 solitary PTCI. Our findings revealed that nodular goiter associated with PTCI was a protective factor for lymph node metastasis in patients with PTC, which is consistent with those of previous studies (30). Therefore, we believe that this kind of patient should actively perform central lymph node dissection.…”

Section: Discussionsupporting

confidence: 92%

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Zhang¹,

Xu²,

Ge³

et al. 2021

Gland Surg

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Background: prognosis, identify clinicopathological characteristics, and determine optimal modalities for cT1N0M0 solitary papillary thyroid carcinoma in the isthmus (PTCI). Methods:The clinical data of 124 patients with cT1N0M0 solitary PTCI from 3 medical centers were analyzed retrospectively. Of these, 32 participants had undergone total thyroidectomy plus unilateral central neck dissection, 36 had received total thyroidectomy plus bilateral central neck dissection, 24 had lessthan-total thyroidectomy plus unilateral central neck dissection, and 32 had less-than-total thyroidectomy plus bilateral central neck dissection. We compared the effects of different surgical modalities and clinicopathological characteristics on the prognosis of cT1N0M0 solitary PTCI. Results: There was no significant difference in postoperative recurrence-free survival between participants who received different extents of central region lymph node dissection and thyroidectomies (P>0.05). Temporary hypocalcemia occurred in participants who underwent total thyroidectomy plus bilateral central neck dissection [chi-square (X2) =7.87, P=0.005]. Tumors with primary lesions ≥0.55 cm were prone to have central lymph node metastasis [95% confidence interval (CI): 0.51 to 0.71, P=0.047]. Multiple logistic analysis suggested that age over 55 years [odds ration (OR) =11.90, 95% CI: 1.36 to 104.03, P=0.025], tumor size greater than 0.55 cm (OR =4.16, 95% CI: 1.28 to 13.52, P=0.018), and absence of nodular goiter (OR =2.57, 95% CI: 1.05 to 6.32, P=0.04) were risk factors for central lymph node metastasis of patients with cT1N0M0 solitary PTCI.Conclusions: Less-than-total thyroidectomy is recommended for patients with cT1N0M0 solitary PTCI.Central lymph node dissection is recommended for patients who are prone to have central occult lymph node metastases with tumor size ≥55 cm, older than 55 years, and without nodular goiter.

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Section: Discussionsupporting

confidence: 92%

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Zhang¹,

Xu²,

Ge³

et al. 2021

Gland Surg

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“…Besides, research showed that the incidence of LNM in patients with PTC accompanied by HT was low [ 31 ], which might be due to a significantly larger number of removed lymph nodes from patients with HT and then a lower LNM rate in HT patients. Also, according to related literature, PTC or MTC patients with nodular goiter or follicular adenoma had a lower LNM rate [ 32 ]. However, based on our results, thyroid carcinoma patients with adenomatous nodules had a lower risk of CLNM than those without in the central cervical compartment (OR = 0.815, P = 0.045), and LLNM had no significant influence on them (OR = 1.015, P = 0.924).…”

Section: Discussionmentioning

confidence: 99%

Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma

Wei,

Yao,

Peng

et al. 2023

BMC Cancer

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Backgrounds The purpose of this study is to investigate the relationship between clinical characteristics and cervical lymph node metastasis (LNM) in patients with thyroid carcinoma, as well as estimate the preoperative diagnosis values of ultrasound (US) and contrast enhanced computed tomography (CECT) examinations on the neck for detection of cervical LNM in thyroid carcinoma. Methods A retrospective analysis of 3 026 patients with surgically proven thyroid carcinoma was conducted. Patients’ clinical characteristics, including gender, age, tumor size, bilateral lesions, multifocality, adenomatous nodules, Hashimoto’s thyroiditis (HT), and extrathyroidal extension, were collected to explore their association with cervical LNM in thyroid carcinoma. Preoperative assessments for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were conducted through US and CECT. The diagnostic value of US, CECT and US combined with CECT for detection of LNM located in various cervical compartments was estimated based on the pathological results. Results The risk of cervical LNM was higher in thyroid cancer patients who were male, age < 55 years old, tumor size > 10 mm, bilateral lesions, and extrathyroidal extension, while multifocality, adenomatous nodules and HT had no significant effect on LNM. US, CECT and US combined with CECT all had a higher sensitivity to LLNM (93.1%, 57.8%, 95.4%) than to CLNM (32.3%, 29.0%, 43.4%). US and CECT had a high specificity to both CLNM and LLNM (94.3–97.8%). Conclusion Preoperative clinical characteristics and imaging examinations on patients with thyroid carcinoma are crucial to the evaluation of cervical lymph nodes and conducive to individualizing surgical treatments by clinicians. US combined with CECT are superior to single US or CECT alone in detection of CLNM and LLNM.

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“…Future discussions may consider grouping PTMCs based on tumor size. The role of TGAB and TPOAB in PTMC development and metastasis remains debated; nevertheless, it has been reported that elevated levels of TGAB and TPOAB are associated with HT which may contribute to thyroid cancer tumorigenesis and CLNM while also possessing prognostic value ( 27 ). High levels of TPOAB demonstrated a certain degree of protection against CLNs despite not showing significant effects during univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

The model for predicting the central lymph node metastasis in cN0 papillary thyroid microcarcinoma with Hashimoto’s thyroiditis

Lin,

Cui,

et al. 2024

Front. Endocrinol.

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BackgroundThe relationship between Hashimoto’s thyroiditis (HT) and papillary thyroid microcarcinoma (PTMC) is controversial. These include central lymph node metastasis (CLNM), which affects the prognosis of PTMC patients. This study aimed to establish a predictive model combining ultrasonography and clinicopathological features to accurately evaluate latent CLNM in PTMC patients with HT at the clinical lymph node-negative (cN0) stage.MethodsIn this study, 1102 PTMC patients who received thyroidectomy and central cervical lymph node dissection (CLND) from the First Affiliated Hospital of Shandong First Medical University from January 2021 to December 2022 and the 960th Hospital of PLA from January 2021 to December 2022 were jointly collected. The clinical differences between PTMCs with HT and those without HT were compared. A total of 373 PTMCs with HT in cN0 were randomly divided into a training cohort and a validation cohort. By analyzing and screening the risk factors of CLNM, a nomogram model was established and verified. The predictive performance was measured by the receiver operating characteristic (ROC) curve, calibration curve, and clinical decision curve analysis (DCA).ResultsThe ratio of central lymph node metastasis (CLNMR) in PTMCs with HT was 0.0% (0.0%, 15.0%) and 7.7% (0.0%, 40.0%) in the non-HT group (P<0.001). Multivariate logistic regression analysis showed that age, gender, calcification, adjacent to trachea or capsule, and TPOAB were predictors of CLNM in PTMCs with HT. The areas under the curve (AUC) of the prediction models in the training cohort and the validation cohort were 0.835 and 0.825, respectively, which showed good differentiation ability. DCA indicates that the prediction model also has high net benefit and clinical practical value.ConclusionThis study found that CLN involvement was significantly reduced in PTMC patients with HT, suggesting that different methods should be used to predict CLNM in PTMC patients with HT and without HT, to more accurately assist preoperative clinical evaluation. The actual CLNM situation of PTMCs with HT in cN0 can be accurately predicted by the combination of ultrasonography and clinicopathological features.

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Hashimoto’s thyroiditis, nodular goiter or follicular adenoma combined with papillary thyroid carcinoma play protective role in patients

Cited by 10 publications

References 32 publications

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma

The model for predicting the central lymph node metastasis in cN0 papillary thyroid microcarcinoma with Hashimoto’s thyroiditis

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