The Relationship Between Hashimoto's Thyroiditis And Lymph Node Metastasis In Papillary Thyroid Carcinoma

Objective: To investigate the risk factors of central lymph node metastasis(CLNM)and lateral neck lymph node metastasis in papillary thyroid carcinoma(PTC)patients.Methods:A retrospective protocol was applied,and a total of 1835 PTC patients were reviewed.These patients underwent central lymph node dissection or thyroidectomy with lateral neck lymph node dissection between January in 2016 and November in 2016 in Tianjin Medical University Cancer Institute and Hospital.Univariate and multivariate logistic regression analysis were used to analyze the related factors that may affect lymph node metastasis of papillary thyroid cancer.Postoperative pathological diagnosis of 785 patients with Hashimoto's thyroiditis,Univariate and multivariate analysis of the impact of Hashimoto's thyroiditis on lymph node metastasis were used.Results: Central lymph node metastasis(CLNM)were found in 1007 of 1835 patients(54.88%),and 371 out of 1835 patients had lateral neck lymph node metastasis(20.22%).Central lymph node metastasis(CLNM)were found in 1007 of 1835 patients(54.88%),and 371 out of 1835 patients had lateral neck lymph node metastasis(20.22%).In the univariate analysis,patients with the following risk factors were at high risk of CLNM(P<0.05): male,age<55years old,tumor size >10mm,multifocality,Anti-Tg>100IU/ml.In the univariate analysis,patients with the following risk factors were at high risk of lateral lymph node metastasis(P<0.05): male,age<55years old,tumor size >10mm,multifocality,CLNM and Anti-Tg>100IU/ml.PTC patients coexisted with Hashimoto's thyroiditis and Anti-TPO>100 IU/ml had lower central lymph node metastasis rate(P<0.05).Multivariate analysis revealed that male(OR 2.072,95% CI 1.631-2.631),age <55 years(OR 2.433,95% CI 2.002-2.956),multifocal(OR1.404),95% CI 1.219-1.618),tumor size > 10 mm(OR 1.921,95% CI 1.548-2.384),Anti-TG > 100 IU / ml(OR 2.042,95% CI 1.262-3.304)is associated with an increased risk of central lymph node metastasis of papillary thyroid carcinoma.Patients with Hashimoto's thyroiditis(OR 0.484,95% CI 0.363-0.644)and Anti-TPO> 100 IU/ml(OR 0.658,95% CI 0.463-0.936)are protective factor for central lymph node metastasis..Multivariate analysis revealed that male(OR1.816,95% CI 1.348-2.447),age <55 years(OR 1.755,95% CI 1.420-2.170),tumor size>10 mm(OR 1.496,95% CI 1.138-1.966),multifocal(OR 1.182,95% CI 1.081-1.293),Tg> 130.7ug/L(OR 2.823,95% CI 1.286-6.200),Anti-TG>100IU/ml(OR 2.954,95% CI 1.703-5.124),CLNM(OR 5.953,95% CI 4.157-8.524)are risk factors for lateral lymph node metastasis.Conclusion: Males,age <55 years,tumor diameter >10 mm,and multifocality were associated with an increased risk of cervical lymph node metastasis in papillary thyroid carcinoma.PTCs coexisted with HT and Anti-TPO>100IU/ml showed a lower central lymph node metastasis rate and they are protective independent predictive factors for central lymph node metastasis.While,Anti-Tg>100IU/ml is an independent risk factor of cervical lymph node metastasis in PTC.