Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
IntroductionThyroid cancer is the most prevalent endocrine malignancy, with its global incidence increasing annually in recent years. Papillary carcinoma is the most common subtype, frequently accompanied by cervical lymph node metastasis early on. Central lymph node metastasis (CLNM) is particularl...
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1288527/full |
| _version_ | 1797612042891296768 |
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| author | Jiachen Du Qing Yang Yixuan Sun Peng Shi Hao Xu Xiao Chen Tianyi Dong Wenjing Shi Yatong Wang Zhenzhi Song Xingchen Shang Xingchen Shang Xingsong Tian Xingsong Tian |
| author_facet | Jiachen Du Qing Yang Yixuan Sun Peng Shi Hao Xu Xiao Chen Tianyi Dong Wenjing Shi Yatong Wang Zhenzhi Song Xingchen Shang Xingchen Shang Xingsong Tian Xingsong Tian |
| author_sort | Jiachen Du |
| collection | DOAJ |
| description | IntroductionThyroid cancer is the most prevalent endocrine malignancy, with its global incidence increasing annually in recent years. Papillary carcinoma is the most common subtype, frequently accompanied by cervical lymph node metastasis early on. Central lymph node metastasis (CLNM) is particularly the common metastasis form in this subtype, and the presence of lymph node metastasis correlates strongly with tumor recurrence. However, effective preoperative assessment methods for CLNM in patients with papillary thyroid carcinoma (PTC) remain lacking.MethodsData from 400 patients diagnosed with PTC between January 1, 2018, and January 1, 2022, at the Shandong Provincial Hospital were retrospectively analyzed. This data included clinicopathological information of the patients, such as thyroid function, BRAF V600E mutation, whether complicated with Hashimoto’s thyroiditis, and the presence of capsular invasion. Univariate and multivariate logistic regression analyses were performed to assess the risk factors associated with cervical CLNM in patients with PTC. Subsequently, a clinical prediction model was constructed, and prognostic risk factors were identified based on univariate and multivariate Cox regression analyses.ResultsUnivariate and multivariate analyses identified that age >45 years (P=0.014), body mass index ≥25 (P=0.008), tumor size ≥1 cm (P=0.001), capsular invasion (P=0.001), and the presence of BRAF V600E mutation (P<0.001) were significantly associated with an increased risk of CLNM. Integrating these factors into the nomogram revealed an area-under-the-curve of 0.791 (95% confidence interval 0.735–0.846) and 0.765 (95% confidence interval: 0.677–0.852) for the training and validation sets, respectively, indicating strong discriminative abilities. Subgroup analysis further confirmed that patients with papillary thyroid microcarcinoma and BRAF V600E mutations who underwent therapeutic central compartment neck dissection had significantly better 3-year disease-free survival than those who had prophylactic central compartment neck dissection (P<0.001).ConclusionThe study revealed that age >45 years, body mass index ≥25, tumor size ≥1 cm, BRAF V600E mutation, and capsular invasion are the related risk factors for CLNM in patients with PTC. For patients with clinically nodal-negative (cN0) papillary thyroid microcarcinoma, accurately identifying the BRAF V600E mutation is essential for guiding the central lymph node dissection approach and subsequent treatments. |
| first_indexed | 2024-03-11T06:36:26Z |
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| spelling | doaj.art-fbc9c15707ff41aabc246f8f2b6e89982023-11-17T10:53:34ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-11-011410.3389/fendo.2023.12885271288527Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective studyJiachen Du0Qing Yang1Yixuan Sun2Peng Shi3Hao Xu4Xiao Chen5Tianyi Dong6Wenjing Shi7Yatong Wang8Zhenzhi Song9Xingchen Shang10Xingchen Shang11Xingsong Tian12Xingsong Tian13Department of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Hematology, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Breast and Thyroid Surgery, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, ChinaIntroductionThyroid cancer is the most prevalent endocrine malignancy, with its global incidence increasing annually in recent years. Papillary carcinoma is the most common subtype, frequently accompanied by cervical lymph node metastasis early on. Central lymph node metastasis (CLNM) is particularly the common metastasis form in this subtype, and the presence of lymph node metastasis correlates strongly with tumor recurrence. However, effective preoperative assessment methods for CLNM in patients with papillary thyroid carcinoma (PTC) remain lacking.MethodsData from 400 patients diagnosed with PTC between January 1, 2018, and January 1, 2022, at the Shandong Provincial Hospital were retrospectively analyzed. This data included clinicopathological information of the patients, such as thyroid function, BRAF V600E mutation, whether complicated with Hashimoto’s thyroiditis, and the presence of capsular invasion. Univariate and multivariate logistic regression analyses were performed to assess the risk factors associated with cervical CLNM in patients with PTC. Subsequently, a clinical prediction model was constructed, and prognostic risk factors were identified based on univariate and multivariate Cox regression analyses.ResultsUnivariate and multivariate analyses identified that age >45 years (P=0.014), body mass index ≥25 (P=0.008), tumor size ≥1 cm (P=0.001), capsular invasion (P=0.001), and the presence of BRAF V600E mutation (P<0.001) were significantly associated with an increased risk of CLNM. Integrating these factors into the nomogram revealed an area-under-the-curve of 0.791 (95% confidence interval 0.735–0.846) and 0.765 (95% confidence interval: 0.677–0.852) for the training and validation sets, respectively, indicating strong discriminative abilities. Subgroup analysis further confirmed that patients with papillary thyroid microcarcinoma and BRAF V600E mutations who underwent therapeutic central compartment neck dissection had significantly better 3-year disease-free survival than those who had prophylactic central compartment neck dissection (P<0.001).ConclusionThe study revealed that age >45 years, body mass index ≥25, tumor size ≥1 cm, BRAF V600E mutation, and capsular invasion are the related risk factors for CLNM in patients with PTC. For patients with clinically nodal-negative (cN0) papillary thyroid microcarcinoma, accurately identifying the BRAF V600E mutation is essential for guiding the central lymph node dissection approach and subsequent treatments.https://www.frontiersin.org/articles/10.3389/fendo.2023.1288527/fullpapillary thyroid carcinomacentral lymph node metastasisBRAF V600E mutationprognosisnomogram |
| spellingShingle | Jiachen Du Qing Yang Yixuan Sun Peng Shi Hao Xu Xiao Chen Tianyi Dong Wenjing Shi Yatong Wang Zhenzhi Song Xingchen Shang Xingchen Shang Xingsong Tian Xingsong Tian Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study Frontiers in Endocrinology papillary thyroid carcinoma central lymph node metastasis BRAF V600E mutation prognosis nomogram |
| title | Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study |
| title_full | Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study |
| title_fullStr | Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study |
| title_full_unstemmed | Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study |
| title_short | Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study |
| title_sort | risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma a retrospective study |
| topic | papillary thyroid carcinoma central lymph node metastasis BRAF V600E mutation prognosis nomogram |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1288527/full |
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