Division of Thyroid Surgery, General Surgery Department, Xiangya Hospital, Central South University, No.87 Xiangya Road, Changsha, 410008, Hunan, China.
Department of Thyroid and Breast Surgery, LiXian People's Hospital, No.682 Xinhe Road, Changde, 415500, Hunan, China.
World J Surg Oncol. 2024 Aug 27;22(1):224. doi: 10.1186/s12957-024-03501-7.
Although the potential association between autoimmune thyroiditis and papillary thyroid cancer (PTC) has been acknowledged, whether the clinicopathological features of PTC will be affected by thyroid autoantibodies remains unknown.
We conducted a case-control study to investigate the association of thyroid autoantibodies with clinicopathological characteristics of PTC in 15,305 patients (including 11,465 females and 3,840 males) from 3 medical centers in the central province of China. Logistic regression and restricted cubic spline models were performed to analyze the association of thyroid autoantibodies with clinicopathological features of PTC.
In total, out of the 15,305 patients enrolled in this study, 10,087 (65.9%) had negative thyroid autoantibodies, while 5,218(34.1%) tested positive thyroid autoantibodies. Among these individuals, 1,530(10.0%) showed positivity for TPOAb only, 1,247(8.2%) for TGAb only and a further 2,441(15.9%) exhibited dual positivity for both TPOAb and TGAb combined. Thyroid autoantibodies level demonstrated significant correlations with certain aggressive features in PTC. Specifically, TGAb level displayed a direct correlation to an increased likelihood of multifocality, bilateral tumor, extrathyroidal extension, lymph node metastasis, as well as more than five affected lymph nodes. However, TPOAb level exhibited an inverse association with the risk associated with extrathyroidal extension, lymph node metastasis, and more than five affected lymph nodes.
Elevated level of TGAb were positively correlated with the risk of aggressive features in PTC, while high level of TPOAb were inversely associated with the risk of extrathyroidal extension and lymph node metastasis.
虽然自身免疫性甲状腺炎与甲状腺乳头状癌(PTC)之间存在潜在关联已得到认可,但甲状腺自身抗体是否会影响 PTC 的临床病理特征尚不清楚。
我们进行了一项病例对照研究,以调查来自中国中部 3 家医疗中心的 15305 例患者(包括 11465 名女性和 3840 名男性)中甲状腺自身抗体与 PTC 临床病理特征的关联。使用逻辑回归和限制立方样条模型分析甲状腺自身抗体与 PTC 临床病理特征的关系。
在这项研究中,总共纳入的 15305 例患者中,10087 例(65.9%)甲状腺自身抗体阴性,5218 例(34.1%)甲状腺自身抗体阳性。在这些人中,1530 例(10.0%)仅 TPOAb 阳性,1247 例(8.2%)仅 TGAb 阳性,另有 2441 例(15.9%)同时 TPOAb 和 TGAb 双阳性。甲状腺自身抗体水平与 PTC 的某些侵袭性特征显著相关。具体而言,TGAb 水平与多灶性、双侧肿瘤、甲状腺外侵犯、淋巴结转移以及 5 个以上受累淋巴结的可能性增加直接相关。然而,TPOAb 水平与甲状腺外侵犯、淋巴结转移以及 5 个以上受累淋巴结的风险呈负相关。
TGAb 水平升高与 PTC 侵袭性特征的风险呈正相关,而 TPOAb 水平升高与甲状腺外侵犯和淋巴结转移的风险呈负相关。