Clinical analysis of cervical lymph node metastasis patterns and multivariate factors in differentiated thyroid carcinoma

Liu,Jingquan; Guo,Mingyue

doi:10.3892/ol.2023.14018

Clinical analysis of cervical lymph node metastasis patterns and multivariate factors in differentiated thyroid carcinoma

Authors:
- Jingquan Liu
- Mingyue Guo
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Affiliations: Department of General Surgery, Chifeng Municipal Hospital, Inner Mongolia University, Chifeng, Inner Mongolia Autonomous Region 024000, P.R. China
Published online on: August 22, 2023 https://doi.org/10.3892/ol.2023.14018
Article Number: 431

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Abstract

The incidence rate of thyroid cancer is rising rapidly in numerous parts of the world, but the mortality rate is relatively stable or even declining. The aim of the present study was to analyze the risk factors of cervical lymph node metastasis (LNM) in differentiated thyroid carcinoma (DTC). The clinical data of 846 patients with DTC were collected from the Department of General Surgery of Chifeng Municipal Hospital of Inner Mongolia Medical University (Chifeng, China) from June 2018 to June 2022. The relationship between central LNM (CLNM) and lateral LNM (LLNM) was explored in terms of sex, age, tumor diameter, multifocality, capsular invasion and Hashimoto's thyroiditis. It was revealed that male sex, age <35 years, tumor size >1 cm, multifocality and capsular invasion were associated with CLNM and LLNM (P<0.001), while there was no relationship between Hashimoto's thyroiditis, CLNM and LLNM (P>0.05). The number of positive lymph nodes in CLNM dissection, accounting for ≥50% of the total number of lymph nodes dissected, was significantly associated with LLNM (P<0.0001). In conclusion, there was no correlation between Hashimoto's thyroiditis and CLNM and LLNM. The present study revealed that patients with the characteristics of sex, age <35 years, tumor size >1 cm, multifocality and capsular invasion were associated with cervical LNM. The proportion of the number of central lymph node metastases to the total number of lymph nodes cleared during surgery is more than or equal to 50%, indicating a susceptibility to external cervical lymph node metastasis. The results of multivariate logistic analysis showed that male sex, multifocality, capsular invasion and CLNM were risk factors for LLNM, and age was a protective factor for LLNM in DTC.

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1	Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A and Bray F: Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 71:209–249. 2021. View Article : Google Scholar : PubMed/NCBI
2	Ferlay J, Ervik M and Lam F: Global cancer observatory: Cancer today. International Agency for Research on Cancer; November 25–2020gco.iarc.fr/today2020
3	Malone C, Barnabas RV, Buist DSM, Tiro JA and Winer RL: Cost-effectiveness studies of HPV self-sampling: A systematic re-view. Prev Med. 132:1059532020. View Article : Google Scholar : PubMed/NCBI
4	Moo TA, McGill J, Allendorf J, Lee J, Fahey T III and Zarnegar R: Effect of prophylactic central lymph node dissection on early recurrence of papillary thyroid carcinoma. World Med J. 34:1187–1191. 2010.
5	Wang W, Gu J, Shang J and Wang K: Correlation analysis on central lymph node metastasis in 276 patients with cN0 papillry thyroidcarcinoma. Int J Clin Exp Pathol. 6:510–515. 2013.PubMed/NCBI
6	Colakoglu B, Alis D and Seymen H: Diagnostic accuracy of ultrasound for the evaluation of lateral compartment lymph nodes in papillary thyroid carcinoma. Curr Med Imaging. 16:459–465. 2020. View Article : Google Scholar : PubMed/NCBI
7	Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, Som PM and Day TA; Committee for Neck Dissection Classification, : American Head and Neck Society: Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 134:536–538. 2008. View Article : Google Scholar : PubMed/NCBI
8	Chebib E, Eymerit C, Chabbert-Buffet N, Angelard B, Lacau St Guily J and Périé S: High rate of IIA/IIB neck groups involvement supports complete lateral neck dissection in thyroid carcinoma. Gland Surg. 9:1973–1981. 2020. View Article : Google Scholar : PubMed/NCBI
9	Malterling RR, Andersson RE, Falkmer S, Falkmer U, Niléhn E and Järhult J: Differentiated thyroid cancer in Sweden county-long-term outcomes and quality of life. Acta Oncol. 49:454–459. 2010. View Article : Google Scholar : PubMed/NCBI
10	Lee YM, Sung TY, Kim WB, Chung KW, Yoon JH and Hong SJ: Risk factors forrecurrence in patients with papillary thyroid carcinoma undergoingmodified radical neck dissection. Br J Surg. 103:1020–1025. 2016. View Article : Google Scholar : PubMed/NCBI
11	Takada H, Kikumori T, Imai T, Sawaki M, Shibata A and Kiuchi T: Patterns of lymph node metastases in papillary thyroid carcinoma: Results from consecutive bilateral cervical lymph node dissection. World J Surg. 35:1560–1566. 2011. View Article : Google Scholar : PubMed/NCBI
12	Roh JL, Kim JM and Park CI: Lateral cervical lymph node metastases from papillary thyroid carcinoma: Pattern of nodal metastases and optimal strategy for neck dissection. Ann Surg Oncol. 15:1177–1182. 2008. View Article : Google Scholar : PubMed/NCBI
13	Ferlito A, Rinaldo A, Robbins KT, Leemans CR, Shah JP, Shaha AR, Andersen PE, Kowalski LP, Pellitteri PK, Clayman GL, et al: Changing concepts in the surgical management of the cervical node metastasis. Oral Oncol. 39:213–217. 2003. View Article : Google Scholar
14	Lei J, Zhong J, Jiang K, Li Z, Gong R and Zhu J: Skip latetal lymph nodemetastasis leaping over the central neck compartment in papillary thyroidcarcinoma. Oncotarget. 8:27022–27033. 2017. View Article : Google Scholar : PubMed/NCBI
15	Liu C, Xiao C, Chen J, Li X, Feng Z, Gao Q and Liu Z: Risk factor analysis for predicting cervicallymph node metastasis in papillary thyroidcarcinoma: A study of 966 patients. BMC Cancer. 19:6222019. View Article : Google Scholar : PubMed/NCBI
16	Glattre E and Kravdal O: Male and female parity and risk of thyroidcancer. Int J Cancer. 58:616–617. 1994. View Article : Google Scholar : PubMed/NCBI
17	Ito Y, Higashiyama T, Takamura Y, Miya A, Kobayashi K, Matsuzuka F, Kuma K and Miyauchi A: Risk factors for recurrenceto the lymph node in papillary thyroid carcinoma patients withoutpreoperatively detectable lateral node metastasis: Validity of prophylactic modified radical neck dissection. World J Surg. 31:2085–2091. 2007. View Article : Google Scholar : PubMed/NCBI
18	Yan DG, Zhang B, Wang JY, Xu ZG and Tang PZ: Central compartment lymph node metastasis in cN0 papillary thyroid carcinoma. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 45:891–894. 2010.(In Chinese). PubMed/NCBI
19	Ahn BH, Kim JR, Jeong HC, Lee JS, Chang ES and Kim YH: Predictive factors ofcentral lymph node metastasis in papillary thyroid carcinoma. Ann SurgTreat Res. 88:63–68. 2015. View Article : Google Scholar
20	Chenlei S, Tiefeng S and Huadong Q: The pattern of cervical lymph node metastasis in papillary thyroid carcinoma and its related influencing factors. Chinese J Basic Clin General Surg. 29–34. 2014.
21	Shindo M, Wu JC, Park EE and Tanzella F: The importance of central compartment elective lymph node excision in the staging and treatment of papillary thyroid cancer. Arch Otolaryngol Head Neck Surg. 132:650–654. 2006. View Article : Google Scholar : PubMed/NCBI
22	Li S, Zhang D, Sun H, et al: Influencing factors of lymph node metastasis in papillary thyroid carcinoma study on the expression of serum protein. Chin J Lab Diagnostics. 2160–2163. 2013.
23	Jara SM, Carson KA, Pai SI, Agrawal N, Richmon JD, Prescott JD, Dackiw A, Zeiger MA, Bishop JA and Tufano RP: The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma. Surgery. 154:1272–1280. 2013. View Article : Google Scholar : PubMed/NCBI
24	Lun Y, Wu X, Xia Q, Han Y, Zhang X, Liu Z, Wang F, Duan Z, Xin S and Zhang J: Hashimoto's thyroiditis as a risk factor papillary thyroid cancer may improve cancer prognosis. Otolaryngol Head Neck Surg. 148:396–402. 2013. View Article : Google Scholar : PubMed/NCBI