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Thyroid Antibody Status is Associated with Central Lymph Node Metastases in Papillary Thyroid Carcinoma Patients with Hashimoto’s Thyroiditis

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to explore the impact of thyroid antibody status on central lymph node metastases (CLNM) in papillary thyroid carcinoma (PTC) patients with Hashimoto’s thyroiditis (HT).

Methods

A retrospective analysis was performed on 346 PTC patients with HT who underwent thyroidectomy and ipsilateral central lymph node dissection (CLND). Histopathological characteristics of the tumor and serum levels of thyroid hormone, as well as antibodies, were collected and analyzed.

Results

The multivariate logistic regression analysis showed that being male [odds ratio (OR) 3.269, 95% confidence interval (CI) 1.240–8.619], tumor size > 1 cm [1 cm < diameter (D) ≤ 2 cm: OR 6.947, 95% CI 2.886–16.722; 2 cm < D: OR 5.880, 1.937–17.846], and antibody status [thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) double negative: OR 3.791, 95% CI 1.391–10.331; TPOAb and TgAb double positive: OR 4.047, 95% CI 1.509–10.856; TgAb single positive: OR 6.024, 95% CI 2.019–17.970] were independent risk factors for CLNM. Additionally, a risk-score scale, including sex, antibody status, and tumor size, was established to predict CLNM. The sensitivity, specificity, positive predictive value, and negative predictive value were 55.7%, 84.4%, 74.4%, and 70%, respectively, when the cut-off point was chosen as 3.

Conclusions

Antibody status is a critical independent risk factor for CLNM in PTC patients with HT. For the CLND strategy, a more conservative option could be considered in a low-risk cohort with the following characteristics: female sex, smaller tumor size, and TPOAb single positive.

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81703854).

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Author notes

  1. Xingzhu Wen, Bin Wang, and Qianmei Jin contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China

    Xingzhu Wen MD, Bin Wang MD, Wei Zhang MD & Ming Qiu MD

  2. Department of Rheumatology and Immunology, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China

    Qianmei Jin MD

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  1. Xingzhu Wen MD
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  2. Bin Wang MD
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  3. Qianmei Jin MD
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  4. Wei Zhang MD
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Correspondence to Wei Zhang MD or Ming Qiu MD.

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Xingzhu Wen, Bin Wang, Qianmei Jin, Wei Zhang, and Ming Qiu declare no conflicts of interest.

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Wen, X., Wang, B., Jin, Q. et al. Thyroid Antibody Status is Associated with Central Lymph Node Metastases in Papillary Thyroid Carcinoma Patients with Hashimoto’s Thyroiditis. Ann Surg Oncol 26, 1751–1758 (2019). https://doi.org/10.1245/s10434-019-07256-4

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  • DOI: https://doi.org/10.1245/s10434-019-07256-4

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