Yu Ming, Deng Jiaqin, Gu Yihua, Lai Yeqian, Zheng Zhijuan
Department of Thyroid Surgery, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China.
Intensive Care Unit, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China.
World J Surg Oncol. 2025 May 14;23(1):190. doi: 10.1186/s12957-025-03842-x.
Capsular invasion in papillary thyroid cancer(PTC) refers to thyroid cancer penetrating the capsule without attaching to the surrounding tissue. Patients with and without capsular invasion may differ in the likelihood of lymph node metastasis(LNM). The purpose of this study is to study the relationship between circulating tumor cells(CTCs) and LNM in PTC with or without capsular invasion.
The clinical records of patients (age, gender, CTCs, thyroid function, Hashimoto's thyroiditis, lesions number, lesions diameter, capsular invasion, clinical stage, and LNM) were analyzed retrospectively. The relationship between CTCs level and LNM was analyzed. Logistic regression analyses were used to evaluate the relationship between CTCs and LNM after adjusting for confounding factors.
A total of 746 PTC patients were included, and 320 patients with capsular invasion and 426 without. The patients with capsular invasion had higher proportions of multifocality, maximum lesion diameter > 1 cm, T3-T4 stage, and LNM than patients without (all p < 0.05). In multivariate logistic regression analyses, maximum lesion diameter > 1 cm (odds ratio(OR): 4.108, 95% confidence interval(CI): 2.459-6.862, p < 0.001) was associated with LNM in patients without capsular invasion; positive preoperative CTCs levels (OR: 1.705, 95% CI: 1.023-2.842, p = 0.041), multifocality (OR: 2.811, 95% CI: 1.669-4.736, p < 0.001), and maximum lesion diameter > 1 cm (OR: 3.233, 95% CI: 1.884-5.546, p < 0.001) were associated with LNM in patients with capsular invasion.
Maximum lesion diameter > 1 cm was associated with LNM in PTC patients with and without capsular invasion. Positive preoperative CTCs levels and multifocality were associated with LNM in patients with capsular invasion, but not in patients without capsular invasion.
甲状腺乳头状癌（PTC）的包膜侵犯是指甲状腺癌穿透包膜且未与周围组织粘连。有或无包膜侵犯的患者发生淋巴结转移（LNM）的可能性可能不同。本研究旨在探讨有或无包膜侵犯的PTC患者循环肿瘤细胞（CTC）与LNM之间的关系。
回顾性分析患者的临床记录（年龄、性别、CTC、甲状腺功能、桥本甲状腺炎、病灶数量、病灶直径、包膜侵犯、临床分期和LNM）。分析CTC水平与LNM之间的关系。采用Logistic回归分析在调整混杂因素后评估CTC与LNM之间的关系。
共纳入746例PTC患者，其中有包膜侵犯者320例，无包膜侵犯者426例。有包膜侵犯的患者多灶性、最大病灶直径>1 cm、T3 - T4期和LNM的比例高于无包膜侵犯者（均p<0.05）。在多因素Logistic回归分析中，最大病灶直径>1 cm（比值比（OR）：4.108，95%置信区间（CI）：2.459 - 6.862，p<0.001）与无包膜侵犯患者的LNM相关；术前CTC水平阳性（OR：1.705，95% CI：1.023 - 2.842，p = 0.041）、多灶性（OR：2.811，95% CI：1.669 - 4.736，p<0.001）和最大病灶直径>1 cm（OR：3.233，95% CI：1.884 - 5.546，p<0.001）与有包膜侵犯患者的LNM相关。
最大病灶直径>1 cm与有或无包膜侵犯的PTC患者的LNM相关。术前CTC水平阳性和多灶性与有包膜侵犯患者的LNM相关，但与无包膜侵犯患者无关。
