Abstract
Purpose
There is approximately 10%–50% of papillary thyroid carcinoma (PTC) patients with
Hashimoto's thyroiditis (HT). In this research, we sought to better understand the
role of HT in PTC progression as well as lymph node metastasis.
Methods
It is a retrospective and cross-sectional study, and 4131 PTC patients who underwent
thyroidectomy were finally enrolled. Chi-square test, univariate and multivariate
logistic regression analyses were employed to evaluate both the risk factors and the
critical roles of HT during PTC metastasis.
Result
In this cohort, 1555 patients (37.6%) were diagnosed with HT. According to multivariate
analysis, male sex, high levels of TG and TPOAb, tumor extrathyroidal extension, maximum
diameter >1 cm, and multifocality were independent risk factors for both central lymph
node metastasis (CLNM) and lateral lymph node metastasis (LLNM). In addition, age
<55 years and smoking were risk factors for CLNM, while CLNM was one of the risk factors
for LLNM. Furthermore, HT was suggested a valuable protective factor for both CLNM
and LLNM. In patients with HT, the total number of central lymph nodes was higher,
while the positive rate was lower. Compared with those without HT, age and sex did
not predict CLNM and LLNM in patients with HT.
Conclusion
HT is considered a protective factor for both CLNM and LLNM in PTC. For patients with
HT, surgeons should pay more attention to the preservation of parathyroid gland and
the protection of recurrent laryngeal nerve due to less lymph node metastasis. Otherwise,
radical operation is highly recommended.
Keywords
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Article info
Publication history
Published online: November 10, 2022
Accepted:
November 7,
2022
Received in revised form:
November 2,
2022
Received:
July 28,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd.
