Effects of thyroid globulin antibody and thyroid peroxidase antibody statuses on central lymph nodes in patients with differentiated thyroid cancer: a multicenter clinical study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Xiang ¹ , HUANG Tao ² , DIAO Chang ¹ ,  CHENG Ruochuan ¹

1. Department of Thyroid Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650031, P. R. China;
2. Department of Breast and Thyroid Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, P. R. China;

Corresponding?author：

CHENG Ruochuan, Email: cruochuan@foxmail.com

Keywords：

differentiated thyroid cancer; thyroid globulin antibody; thyroid peroxidase antibody; central lymph node metastasis

DOI：

10.7507/1007-9424.202003059

Video：

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Objective To investigate the effects of thyroid globulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) statuses on central lymph node (CLN) metastasis in patients with differentiated thyroid cancer (DTC).Methods A retrospective analysis was performed on 526 patients with DTC confirmed by pathology from nine participating institutions, who underwent the bilateral thyroidectomy plus bilateral CLN dissection. The clinicopathologic characteristics of different TGAb and TPOAb statuses of patients with DTC were compared, and whether the TGAb and TPOAb statuses were the independent risk factors of CLN metastasis in DTC patients or not was analyzed.Results All of 526 patients with DTC were included in this study, 152 were males and 374 were females. The age was (44±11) years old. There were 63 cases of TgAb^＋TPOAb^＋, 60 cases of TgAb^＋TPOAb^－, 30 cases of TgAb^－TPOAb^＋, and 373 cases of TgAb^－TPOAb^－. It was found that there was a significant difference in the gender among the four different antibody statuses of patients, that was, women with abnormal antibodies were more common (P<0.001), not found that there were related to the tumor size, blood vessel invasion, nerve invasion, CLN metastasis, tumor multifocality, and bilateral tumor or not (P>0.050). In this study, there were 389 cases of CLN with metastasis and 137 cases of CLN without metastasis. The results of multivariate analysis found that the age and gender of the patients were the independent risk factors (P<0.001), but didn’t find the TgAb and TPOAb Statuses and other factors were related to the CLN metastasis (P>0.050).Conclusions Statuses of TGAb and TPOAb aren’t obviously associated with CLN metastasis in patients with DTC, which is inconsistent with other studies. It needs to be further researched after expanding existing sample size and determining new predictive factors.

Citation： LI Xiang, HUANG Tao, DIAO Chang, CHENG Ruochuan. Effects of thyroid globulin antibody and thyroid peroxidase antibody statuses on central lymph nodes in patients with differentiated thyroid cancer: a multicenter clinical study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(11): 1392-1396. doi: 10.7507/1007-9424.202003059 Copy

1.	Kashima K, Yokoyama S, Noguchi S, et al. Chronic thyroiditis as a favorable prognostic factor in papillary thyroid carcinoma. Thyroid, 1998, 8(3): 197-202.
2.	Kim EY, Kim WG, Kim WB, et al. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf), 2009, 71(4): 581-586.
3.	Qu N, Zhang L, Lin DZ, et al. The impact of coexistent Hashimoto’s thyroiditis on lymph node metastasis and prognosis in papillary thyroid microcarcinoma. Tumour Biol, 2016, 37(6): 7685-7692.
4.	Takasu N, Yoshimura Noh J. Hashimoto’s thyroiditis: TGAb, TPOAb, TRAb and recovery from hypothyroidism. Expert Rev Clin Immunol, 2008, 4(2): 221-237.
5.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin, 2015, 65(1): 5-29.
6.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
7.	Moo TA, Umunna B, Kato M, et al. Ipsilateral versus bilateral central neck lymph node dissection in papillary thyroid carcinoma. Ann Surg, 2009, 250(3): 403-408.
8.	Gul K, Dirikoc A, Kiyak G, et al. The association between thyroid carcinoma and Hashimoto’s thyroiditis: the ultrasonographic and histopathologic characteristics of malignant nodules. Thyroid, 2010, 20(8): 873-878.
9.	Okayasu I, Fujiwara M, Hara Y, et al. Association of chronic lymphocytic thyroiditis and thyroid papillary carcinoma. A study of surgical cases among Japanese, and white and African Americans. Cancer, 1995, 76(11): 2312-2318.
10.	Tamimi DM. The association between chronic lymphocytic thyroiditis and thyroid tumors. Int J Surg Pathol, 2002, 10(2): 141-146.
11.	Lee JH, Kim Y, Choi JW, et al. The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. Eur J Endocrinol, 2013, 168(3): 343-349.
12.	Sch?ffler A, Palitzsch KD, Seiffarth C, et al. Coexistent thyroiditis is associated with lower tumour stage in thyroid carcinoma. Eur J Clin Invest, 1998, 28(10): 838-844.
13.	中華醫學會內分泌學分會, 中華醫學會外科學分會, 中國抗癌協會頭頸腫瘤專業委員會, 中華醫學會核醫學分會. 甲狀腺結節和分化型甲狀腺癌診治指南. 中國腫瘤臨床, 2012, 39(17): 1249-1272.
14.	Yoon YH, Kim HJ, Lee JW, et al. The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis. Eur Arch Otorhinolaryngol, 2012, 269(3): 1013-1017.
15.	Loh KC, Greenspan FS, Dong F, et al. Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J Clin Endocrinol Metab, 1999, 84(2): 458-463.
16.	Vasileiadis I, Boutzios G, Charitoudis G, et al. Thyroglobulin antibodies could be a potential predictive marker for papillary thyroid carcinoma. Ann Surg Oncol, 2014, 21(8): 2725-2732.
17.	Karatzas T, Vasileiadis I, Zapanti E, et al. Thyroglobulin antibodies as a potential predictive marker of papillary thyroid carcinoma in patients with indeterminate cytology. Am J Surg, 2016, 212(5): 946-952.
18.	Paparodis R, Imam S, Todorova-Koteva K, et al. Hashimoto’s thyroiditis pathology and risk for thyroid cancer. Thyroid, 2014, 24(7): 1107-1114.
19.	Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med, 1996, 335(2): 99-107.
20.	Kim SS, Lee BJ, Lee JC, et al. Coexistence of Hashimoto’s thyroiditis with papillary thyroid carcinoma: the influence of lymph node metastasis. Head Neck, 2011, 33(9): 1272-1277.
21.	Jara SM, Carson KA, Pai SI, et al. The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma. Surgery, 2013, 154(6): 1272-1280.
22.	Kim YS, Choi HJ, Kim ES. Papillary thyroid carcinoma with thyroiditis: lymph node metastasis, complications. J Korean Surg Soc, 2013, 85(1): 20-24.
23.	Giordano C, Stassi G, De Maria R, et al. Potential involvement of Fas and its ligand in the pathogenesis of Hashimoto's thyroiditis. Science, 1997, 275(5302): 960-963.
24.	Arscott PL, Stokes T, Myc A, et al. Fas (CD95) expression is up-regulated on papillary thyroid carcinoma. J Clin Endocrinol Metab, 1999, 84(11): 4246-4252.
25.	Bagnasco M, Venuti D, Paolieri F, et al. Phenotypic and functional analysis at the clonal level of infiltrating T lymphocytes in papillary carcinoma of the thyroid: prevalence of cytolytic T cells with natural killer-like or lymphokine-activated killer activity. J Clin Endocrinol Metab, 1989, 69(4): 832-836.

1. Kashima K, Yokoyama S, Noguchi S, et al. Chronic thyroiditis as a favorable prognostic factor in papillary thyroid carcinoma. Thyroid, 1998, 8(3): 197-202.
2. Kim EY, Kim WG, Kim WB, et al. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf), 2009, 71(4): 581-586.
3. Qu N, Zhang L, Lin DZ, et al. The impact of coexistent Hashimoto’s thyroiditis on lymph node metastasis and prognosis in papillary thyroid microcarcinoma. Tumour Biol, 2016, 37(6): 7685-7692.
4. Takasu N, Yoshimura Noh J. Hashimoto’s thyroiditis: TGAb, TPOAb, TRAb and recovery from hypothyroidism. Expert Rev Clin Immunol, 2008, 4(2): 221-237.
5. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin, 2015, 65(1): 5-29.
6. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
7. Moo TA, Umunna B, Kato M, et al. Ipsilateral versus bilateral central neck lymph node dissection in papillary thyroid carcinoma. Ann Surg, 2009, 250(3): 403-408.
8. Gul K, Dirikoc A, Kiyak G, et al. The association between thyroid carcinoma and Hashimoto’s thyroiditis: the ultrasonographic and histopathologic characteristics of malignant nodules. Thyroid, 2010, 20(8): 873-878.
9. Okayasu I, Fujiwara M, Hara Y, et al. Association of chronic lymphocytic thyroiditis and thyroid papillary carcinoma. A study of surgical cases among Japanese, and white and African Americans. Cancer, 1995, 76(11): 2312-2318.
10. Tamimi DM. The association between chronic lymphocytic thyroiditis and thyroid tumors. Int J Surg Pathol, 2002, 10(2): 141-146.
11. Lee JH, Kim Y, Choi JW, et al. The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. Eur J Endocrinol, 2013, 168(3): 343-349.
12. Sch?ffler A, Palitzsch KD, Seiffarth C, et al. Coexistent thyroiditis is associated with lower tumour stage in thyroid carcinoma. Eur J Clin Invest, 1998, 28(10): 838-844.
13. 中華醫學會內分泌學分會, 中華醫學會外科學分會, 中國抗癌協會頭頸腫瘤專業委員會, 中華醫學會核醫學分會. 甲狀腺結節和分化型甲狀腺癌診治指南. 中國腫瘤臨床, 2012, 39(17): 1249-1272.
14. Yoon YH, Kim HJ, Lee JW, et al. The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis. Eur Arch Otorhinolaryngol, 2012, 269(3): 1013-1017.
15. Loh KC, Greenspan FS, Dong F, et al. Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J Clin Endocrinol Metab, 1999, 84(2): 458-463.
16. Vasileiadis I, Boutzios G, Charitoudis G, et al. Thyroglobulin antibodies could be a potential predictive marker for papillary thyroid carcinoma. Ann Surg Oncol, 2014, 21(8): 2725-2732.
17. Karatzas T, Vasileiadis I, Zapanti E, et al. Thyroglobulin antibodies as a potential predictive marker of papillary thyroid carcinoma in patients with indeterminate cytology. Am J Surg, 2016, 212(5): 946-952.
18. Paparodis R, Imam S, Todorova-Koteva K, et al. Hashimoto’s thyroiditis pathology and risk for thyroid cancer. Thyroid, 2014, 24(7): 1107-1114.
19. Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med, 1996, 335(2): 99-107.
20. Kim SS, Lee BJ, Lee JC, et al. Coexistence of Hashimoto’s thyroiditis with papillary thyroid carcinoma: the influence of lymph node metastasis. Head Neck, 2011, 33(9): 1272-1277.
21. Jara SM, Carson KA, Pai SI, et al. The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma. Surgery, 2013, 154(6): 1272-1280.
22. Kim YS, Choi HJ, Kim ES. Papillary thyroid carcinoma with thyroiditis: lymph node metastasis, complications. J Korean Surg Soc, 2013, 85(1): 20-24.
23. Giordano C, Stassi G, De Maria R, et al. Potential involvement of Fas and its ligand in the pathogenesis of Hashimoto's thyroiditis. Science, 1997, 275(5302): 960-963.
24. Arscott PL, Stokes T, Myc A, et al. Fas (CD95) expression is up-regulated on papillary thyroid carcinoma. J Clin Endocrinol Metab, 1999, 84(11): 4246-4252.
25. Bagnasco M, Venuti D, Paolieri F, et al. Phenotypic and functional analysis at the clonal level of infiltrating T lymphocytes in papillary carcinoma of the thyroid: prevalence of cytolytic T cells with natural killer-like or lymphokine-activated killer activity. J Clin Endocrinol Metab, 1989, 69(4): 832-836.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects of thyroid globulin antibody and thyroid peroxidase antibody statuses on central lymph nodes in patients with differentiated thyroid cancer: a multicenter clinical study

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