Department of Thyroid and Breast Surgery, Wenzhou Central Hospital, Wenzhou, Zhejiang, China.
Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Br J Hosp Med (Lond). 2024 Oct 30;85(10):1-14. doi: 10.12968/hmed.2024.0235. Epub 2024 Oct 29.
The connection between lymph node (LN) metastases in papillary thyroid carcinoma (PTC) and chronic lymphocytic thyroiditis (CLT) has been examined in a number of prior investigations. However, there is ongoing debate over the effect of CLT on LN metastasis in PTC. In order to explain the relationship between CLT and LN metastasis more convincingly, we aimed to retrospectively review clinical data to investigate the correlation between CLT and LN metastasis in PTC using propensity score matching (PSM). Data on PTC patients at Wenzhou Central Hospital were collected retrospectively between 1 January 2018, and 31 March 2022. The patients were split into two groups based on whether they had CLT or not. The clinicopathological characteristics of the two groups were compared using a PSM analysis. The relationship between CLT and LN metastases was analyzed using logistic regression analysis. Among the 773 PTC patients collected and examined, 213 showed simultaneous CLT. Prior to PSM, patients with CLT displayed a significantly lower incidence of LN metastasis (34.3% VS 44.8%, = 0.008), a lower metastatic LN ratio (0 (0, 0.17) VS 0 (0, 0.38), = 0.011), and a greater number of LNs dissected (7 (5, 11) VS 5 (3, 7), < 0.001). These differences persisted after the PSM of 208 pairs. After PSM, patients with CLT displayed a significantly lower incidence of LN metastasis (35.0% VS 44.7%, = 0.045), a lower metastatic LN ratio (0 (0, 0.17) VS 0 (0, 0.33), = 0.038), and a higher number of dissected LNs (7 (5, 11) VS 5 (3, 7), ≤ 0.001). Additionally, the multivariate logistic regression analysis indicated that CLT had a protective role against LN metastasis in both the matched group (odds ratio (OR), 0.62; 95% confidence interval (CI): 0.39-0.96; = 0.032) and the unmatched group (OR, 0.63; 95% CI: 0.44-0.91; = 0.014). Our data indicate that CLT may protect against LN metastases in patients with PTC. Patients having PTC with coexisting CLT have fewer LN metastases, a greater number of LNs dissected, and a lower metastatic LN ratio.
甲状腺乳头状癌（PTC）淋巴结（LN）转移与慢性淋巴细胞性甲状腺炎（CLT）之间的关系已在许多先前的研究中进行了探讨。然而，CLT 对 PTC 的 LN 转移的影响仍存在争议。为了更有说服力地解释 CLT 与 LN 转移之间的关系，我们旨在通过倾向评分匹配（PSM）回顾性地研究 CLT 与 PTC 中 LN 转移之间的相关性。
收集并回顾了 2018 年 1 月 1 日至 2022 年 3 月 31 日期间在温州市中心医院就诊的 PTC 患者的数据。根据是否存在 CLT 将患者分为两组。使用 PSM 分析比较两组的临床病理特征。使用逻辑回归分析分析 CLT 与 LN 转移之间的关系。
在收集并检查的 773 例 PTC 患者中，213 例同时患有 CLT。在 PSM 之前，患有 CLT 的患者 LN 转移的发生率明显较低（34.3% VS 44.8%，=0.008），转移的 LN 比值较低（0（0，0.17）VS 0（0，0.38），=0.011），并且切除的 LN 数量更多（7（5，11）VS 5（3，7），<0.001）。在对 208 对患者进行 PSM 后，这些差异仍然存在。PSM 后，患有 CLT 的患者 LN 转移的发生率明显较低（35.0% VS 44.7%，=0.045），转移的 LN 比值较低（0（0，0.17）VS 0（0，0.33），=0.038），并且切除的 LN 数量更多（7（5，11）VS 5（3，7），≤0.001）。此外，多变量逻辑回归分析表明，CLT 在匹配组（比值比（OR），0.62；95%置信区间（CI）：0.39-0.96；=0.032）和未匹配组（OR，0.63；95%CI：0.44-0.91；=0.014）中均对 LN 转移具有保护作用。
我们的数据表明，CLT 可能对 PTC 患者的 LN 转移具有保护作用。患有共存 CLT 的 PTC 患者的 LN 转移较少，切除的 LN 较多，转移的 LN 比值较低。
