Yang Ping, Chen Songhao, Hu Xi'e, Peng Shujia, Yang Lin, Dong Yanming, Yang Zhenyu, Yuan Lijuan, Yang Xiaojun, Tang Haili, Fan Dong, Zhao Huadong, He Xianli, Bao Guoqiang
Department of General Surgery, Tangdu Hospital, Air Force Military Medical University, Xi'an, China.
Transl Cancer Res. 2023 Oct 31;12(10):2508-2517. doi: 10.21037/tcr-23-374. Epub 2023 Oct 24.
Cervical lymph node enlargement caused by coronavirus disease 2019 (COVID-19) vaccination has been reported, but little is known on whether the vaccination would influence preoperative cervical lymph node evaluation and its risk of lymph node metastasis in thyroid cancer.
We retrospectively analyzed data of patients who underwent thyroid cancer surgery in Tangdu Hospital, China, from 1 March 2021 to 30 June 2021. A total of 182 patients were included in the cohort study. All patients with suspected malignant tumors underwent ultrasound (US)-guided fine needle aspiration (FNA) of thyroid lesions before surgery to confirm the diagnosis. Cervical lymph nodes were evaluated by preoperative physical examination and imaging. Wilcoxon rank-sum test and Fisher's exact test were used to evaluate the effect of vaccination on cervical lymph nodes in patients with thyroid cancer. Statistical significance was defined at P<0.05.
The patients were divided into two groups according to whether they had been vaccinated or not. Our results showed that there were no significant differences between the two groups in the brand of the vaccine, operation method, and the extent of surgery. Moreover, there was no significant difference in the evaluation of US characteristics of cervical lymph nodes between the two groups regardless of having the vaccination or not. Interestingly, US evaluation found that the experimental group's proportion of cervical lymph node enlargement increased significantly within 14 days after vaccination, which was statistically significant.
This study found that vaccination against COVID-19 did not increase the number of cervical lymph node metastases, but inaccurate assessment of cervical lymph nodes in thyroid cancer patients within 14 days of vaccination (due to temporary lymph node enlargement) may lead to more extensive surgery.
已有报告称2019冠状病毒病（COVID-19）疫苗接种可导致颈部淋巴结肿大，但对于该疫苗接种是否会影响甲状腺癌术前颈部淋巴结评估及其淋巴结转移风险，目前知之甚少。
我们回顾性分析了2021年3月1日至2021年6月30日在中国唐都医院接受甲状腺癌手术的患者数据。队列研究共纳入182例患者。所有疑似恶性肿瘤患者在手术前均接受了超声（US）引导下甲状腺病变细针穿刺抽吸（FNA）以确诊。术前通过体格检查和影像学对颈部淋巴结进行评估。采用Wilcoxon秩和检验和Fisher精确检验评估疫苗接种对甲状腺癌患者颈部淋巴结的影响。统计学显著性定义为P<0.05。
根据患者是否接种疫苗将其分为两组。我们的结果显示，两组在疫苗品牌、手术方式和手术范围方面无显著差异。此外，无论是否接种疫苗，两组在颈部淋巴结US特征评估方面均无显著差异。有趣的是，US评估发现，实验组在接种疫苗后14天内颈部淋巴结肿大比例显著增加，具有统计学意义。
本研究发现，接种COVID-19疫苗不会增加颈部淋巴结转移的数量，但在接种疫苗后14天内对甲状腺癌患者颈部淋巴结的评估不准确（由于暂时性淋巴结肿大）可能导致手术范围扩大。
