Different Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma Patients with and without Hashimoto's...

The immune response triggered by Hashimoto's thyroiditis may influence the progression of papillary thyroid cancer (PTC), such as lymph node metastasis (LNM). The purpose of this study was to study the relationship between clinicopathological features and LNM in PTC patients with and without Hashimoto's thyroiditis.

The clinicopathological features of 767 PTC patients (age, gender, thyroid function, Hashimoto's thyroiditis, number of tumor lesions, tumor size, capsular invasion, preoperative circulating tumor cells (CTCs), and clinical stage) were collected. The relationship between clinicopathological features and LNM in PTC coexistent and non-coexistent with Hashimoto's thyroiditis patients was analyzed, respectively.

There were 210 PTC patients with Hashimoto's thyroiditis and 557 without. There was no significant difference in clinicopathological features between patients with and without Hashimoto's thyroiditis. In multivariate logistic regression analyses, multifocality (odds ratio (OR): 2.127, 95% confidence interval (CI): 1.085-4.168, p=0.028), maximum lesion diameter >1cm (OR: 3.858, 95% CI: 1.903-7.823, p<0.001), and capsular invasion (OR: 2.007, 95% CI: 1.034-3.895, p=0.040) were associated with LNM in PTC patients with Hashimoto's thyroiditis; multifocality (OR: 2.461, 95% CI: 1.595-3.797, p<0.001), maximum lesion diameter >1cm (OR: 4.108, 95% CI: 2.629-6.417, p<0.001), capsular invasion (OR: 1.680, 95% CI: 1.128-2.500, p=0.011), and positive preoperative CTCs (OR: 1.560, 95% CI: 1.065-2.285, p=0.022) were associated with LNM in PTC patients without Hashimoto's thyroiditis.

Regardless of the presence or absence of Hashimoto's thyroiditis, multifocality, maximum lesion diameter >1cm, and capsular invasion were associated with LNM in PTC patients. Positive preoperative CTCs were associated with LNM in PTC without Hashimoto's thyroiditis but not in PTC with Hashimoto's thyroiditis.