Tan Jie, Ge Junna, Wei Zhigang, Sun Baihui, Li Tingting, Zhang Zhicheng, Chen Weisheng, Zheng Jixiang, Zou Jiayuan, Wang Ting, Yu Shi-Tong, Lei Shangtong
Eur Thyroid J. 2025 Apr 28;14(2). doi: 10.1530/ETJ-24-0343. Print 2025 Apr 1.
Tumor deposits (TDs), nodules in the peritumoral adipose tissue with no architectural residue of lymph node, have previously been described in colorectal adenocarcinomas with poor prognosis. However, the significance of TD has not been fully investigated in patients with papillary thyroid carcinoma (PTC).
We retrospectively enrolled 541 patients undergoing surgery between 2015 and 2021. The patients were classified into two groups according to TD status (TD vs non-TD), and the clinicopathologic characteristics and disease-free survival (DFS) were compared. Associations of TD presence with other clinicopathologic factors were evaluated by logistic regression analysis. Univariate and multivariate Cox regression analyses were performed to determine the primary cohort's prognostic factors for DFS. A nomogram was constructed for clinicians as a quantitative tool for estimating DFS.
In our cohort, TD were identified in 16.1% of patients and had higher rate of aggressive features, including microscopic and gross extrathyroidal extension, invasion of the recurrent laryngeal nerve and esophagus, prevertebral fascia involvement or encasement of the carotid artery/internal jugular vein, extranodal extension, advanced clinical stage, tumor recurrence and distant metastasis (all P < 0.05). Univariate and multivariate Cox regression analyses confirmed TD as an independent prognostic factor for DFS, with a 2.501-fold increased risk of recurrence (P < 0.001). The nomogram, incorporating TD and other significant factors, demonstrated good discrimination and calibration (C-index = 0.79).
The presence of TD was significantly associated with poor prognosis in PTC patients. TD showed promising efficacy as a potential prognostic indicator for PTC patients.
肿瘤沉积物（TDs）是指肿瘤周围脂肪组织中的结节，无淋巴结结构残留，此前已在预后较差的结直肠癌中被描述。然而，TD在甲状腺乳头状癌（PTC）患者中的意义尚未得到充分研究。
我们回顾性纳入了2015年至2021年间接受手术的541例患者。根据TD状态（TD与非TD）将患者分为两组，并比较其临床病理特征和无病生存期（DFS）。通过逻辑回归分析评估TD的存在与其他临床病理因素的关联。进行单因素和多因素Cox回归分析以确定该主要队列DFS的预后因素。为临床医生构建了一个列线图，作为估计DFS的定量工具。
在我们的队列中，16.1%的患者被发现有TD，且具有更高比例的侵袭性特征，包括显微镜下和大体甲状腺外扩展、喉返神经和食管侵犯、椎前筋膜受累或颈动脉/颈内静脉包绕、结外扩展、临床晚期、肿瘤复发和远处转移（所有P<0.05）。单因素和多因素Cox回归分析证实TD是DFS的独立预后因素，复发风险增加2.501倍（P<0.001）。纳入TD和其他重要因素的列线图显示出良好的区分度和校准度（C指数=0.79）。
TD的存在与PTC患者的不良预后显著相关。TD作为PTC患者潜在的预后指标显示出良好的效果。
