Yan Caigu, Zhao Yuxuan, Zhang Qingyu, He Xianghui
Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China.
Front Endocrinol (Lausanne). 2025 May 27;16:1567181. doi: 10.3389/fendo.2025.1567181. eCollection 2025.
Hashimoto's thyroiditis plays a crucial role in the biological behavior of papillary thyroid carcinoma. The purpose of this study was to explore the impact of Hashimoto's thyroiditis on the preoperative evaluation of thyroid cancer.
Univariate and multivariate analyses were performed to explore the clinicopathological characteristics and the risk factors for lymph node metastasis (LNM) in 2,261 patients with papillary thyroid carcinoma.
The clinical data showed that the clinicopathological characteristics varied in different states of Hashimoto's thyroiditis and levels of the thyroid peroxidase (TPO) antibody ( < 0.05). In cases without Hashimoto's thyroiditis, the multivariate analysis showed that male sex (OR = 1.991, 95%CI = 1.574-2.517, < 0.05) was the independent risk factor for LNM, but not in the cases with concurrent Hashimoto's thyroiditis. The area under the receiver operating characteristic (ROC) curve of the non-Hashimoto's thyroiditis cases was 0.727 (95% CI = 0.703-0.752, < 0.05), while that in cases with Hashimoto's thyroiditis was 0.632 (95% CI = 0.590-0.674, < 0.05). Analysis of the differentially expressed genes in the different subgroups found that, in men, the differential genes among the different LNM statuses were mainly enriched in immune pathways, while in women and in younger patients, the genes were mainly enriched in cytokine and kinase pathways; in older patients, the genes were enriched in the extracellular matrix.
Hashimoto's thyroiditis can affect the preoperative evaluation of thyroid cancer. In addition, sex might affect the biological behavior of papillary thyroid carcinoma, which may result from the different immune and cellular statuses among different sexes and ages.
桥本甲状腺炎在甲状腺乳头状癌的生物学行为中起关键作用。本研究旨在探讨桥本甲状腺炎对甲状腺癌术前评估的影响。
对2261例甲状腺乳头状癌患者进行单因素和多因素分析，以探讨其临床病理特征及淋巴结转移（LNM）的危险因素。
临床资料显示，桥本甲状腺炎不同状态及甲状腺过氧化物酶（TPO）抗体水平下的临床病理特征存在差异（P<0.05）。在无桥本甲状腺炎的病例中，多因素分析显示男性（OR = 1.991，95%CI = 1.574 - 2.517，P<0.05）是LNM的独立危险因素，但在合并桥本甲状腺炎的病例中并非如此。无桥本甲状腺炎病例的受试者操作特征（ROC）曲线下面积为0.727（95%CI = 0.703 - 0.752，P<0.05），而有桥本甲状腺炎病例的该面积为0.632（95%CI = 0.590 - 0.674，P<0.05）。对不同亚组中差异表达基因的分析发现，在男性中，不同LNM状态间的差异基因主要富集于免疫途径，而在女性和年轻患者中，基因主要富集于细胞因子和激酶途径；在老年患者中，基因富集于细胞外基质。
桥本甲状腺炎可影响甲状腺癌的术前评估。此外，性别可能影响甲状腺乳头状癌的生物学行为，这可能源于不同性别和年龄间免疫及细胞状态的差异。
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