Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2023 Aug 31;14:1164069. doi: 10.3389/fendo.2023.1164069. eCollection 2023.
We aimed to investigate the association between iodine intake and nodal metastasis stratified by central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) of papillary thyroid microcarcinoma (PTMC). Urinary iodine concentration (UIC) and clinicopathological characteristics were used to identify factors associated with CLNM and LLNM using logistic regression analysis. A sum of 3,858 PTMC patients were enrolled. The median UIC (MUI) of patients with CLNM or LLNM was not statistically different from those without nodal metastasis. Male patients had a higher MUI than females (183.4 μg/L vs. 173.6 μg/L). Female patients with extracapsular extension had a higher MUI than those without it (210.0 μg/L vs. 172.1 μg/L). Male patients with LLNM had a significantly lower MUI than those without LLNM (134.7 μg/L vs. 187.9 μg/L). Female patients with more than adequate iodine intake were more likely to present with CLNM and extrathyroidal extension than those with adequate iodine intake with an odds ratio (95% confidence interval) of 1.23 (1.01-1.51) and 1.59 (1.09-2.32) after adjustment. Iodine nutrition was not found to be associated with LLNM. In addition, patients with a younger age, larger tumors, extrathyroidal extension, and intrathyroidal spread were more likely to be CLNM, whereas nodular goiter presented with a protective factor; CLNM was the only factor associated with LLNM of PTMC in both genders. In conclusion, iodine nutrition has a much closer association with female than male patients, and high iodine intake may be associated with CLNM and extrathyroidal extension in female PTMC patients.
我们旨在研究碘摄入量与甲状腺微小乳头状癌（PTMC）中央淋巴结转移（CLNM）和侧方淋巴结转移（LLNM）分层的关系。采用逻辑回归分析，使用尿碘浓度（UIC）和临床病理特征来确定与 CLNM 和 LLNM 相关的因素。共纳入 3858 例 PTMC 患者。CLNM 或 LLNM 患者的 UIC 中位数（MUI）与无淋巴结转移患者无统计学差异。男性患者的 MUI 高于女性（183.4μg/L 比 173.6μg/L）。有包膜外侵犯的女性患者的 MUI 高于无包膜外侵犯的患者（210.0μg/L 比 172.1μg/L）。有 LLNM 的男性患者的 MUI 明显低于无 LLNM 的患者（134.7μg/L 比 187.9μg/L）。碘摄入充足的女性患者发生 CLNM 和甲状腺外侵犯的可能性高于碘摄入适量的患者（调整后的比值比（95%置信区间）为 1.23（1.01-1.51）和 1.59（1.09-2.32））。未发现碘营养与 LLNM 相关。此外，年龄较小、肿瘤较大、甲状腺外侵犯和甲状腺内播散的患者更可能发生 CLNM，而结节性甲状腺肿则是一个保护因素；CLNM 是男女患者 PTMC 发生 LLNM 的唯一相关因素。总之，碘营养与女性患者的关系更为密切，高碘摄入可能与女性 PTMC 患者的 CLNM 和甲状腺外侵犯有关。
