Correlation Between Preoperative Thyroid Autoantibodies And Clinicopathologicai Characteristics In Patients With Papillary Thyroid Carcinoma Study

BackgroundPapillary thyroid cancer(PTC)is the most common type of thyroid cancer.However,the incidence of PTC with thyroid autoantibodies(TPOAb and TgAb)varies across studies.This study aims to investigate whether thyroid autoantibodies increase the incidence of PTC.We also analyzed the association between thyroid autoantibodies and clinicopathologic features of PTC.MethodsA total of 3,934 participants who underwent thyroidectomy were enrolled in this retrospective study.Patients were divided into PTC and benign nodule group according to pathological diagnosis.PTC patients were further divided into negative group,TPOAb positive group,TgAb positive group,and dual TPOAb and TgAb positive group(dual positive group)according to the positivity of thyroid autoantibodies.Data analysis was performed using SPSS software.Continuous data were presented as mean and standard deviations(SD).The Chi-squared test,Student's t test,one-way ANOVA analysis with post hoc tests and non-parametric tests were performed when appropriate.A multinomial multiple logistic regression model was used to determine the association between clinicopathologic features of PTC and the positivity of thyroid autoantibodies.The adjusted odds ratio(OR)with the 95%confidence interval(CI)was presented.p<0.05 was considered statistically significant.ResultsOf the 3,934 enrolled patients,2,926(74.4%)were diagnosed with PTC.Higher serum TSH levels,as well as higher frequency of positive TPOAb and TgAb were found in PTC patients as compared to patients with benign nodular goiter(TSH 1.8 IU/ml versus 1.4 lU/ml p<0.001,TPOAb 23.5%versus 12.7%p<0.001,TgAb 31.1%versus 17.5%p<0.001).Multivariate regression analysis suggested that high TSH level(adjusted OR=1.732 95%CI(1.485-2.021),p<0.001),positive TgAb(adjusted OR=1.768 95%CI(1.436-2.178),p<0.001),or positive TPOAb(adjusted OR=1.45295%CI(1.148-1.836),p=0.002)was an independent risk factor for predicting malignancy in patients with thyroid nodules.Multinomial multiple logistic regression analyses indicated that positive TPOAb alone is an independent predictor for less central lymph node metastasis in PTC patients(adjusted OR=0.643 95%CI(0.448-0.923),p=0.017),while positive TgAb alone is significantly associated with less ETE(adjusted OR=0.778 95%CI(0.622-0.974),p=0.028).PTC patients with dual positive TPOAb and TgAb displayed decreased incidence of ETE(adjusted OR=0.767 95%CI(0.623-0.944),p=0.012),as well as lower frequency of central lymph node metastasis(adjusted OR=0.784 95%CI(0.624-0.986),p=0.037).ConclusionPreoperative positive TPOAb and TgAb are independent predictive markers for PTC.However,positive TPOAb and TgAb are associated with better clinicopathologic features of PTC.Thyroid peroxidase antibody positive can be used as an independent predictor of central lymph node metastasis and anti-thyroglobulin antibody positive can be used to predict the less extrathyroidal extension.Positive dual autoantibodies reflect the combination of these two good clinicopathological features.