Correlation between pre-surgery thyroid function and lymphatic metastasis in patients with papillary thyroid carcinoma

Abstract

Objective To explore the correlation between lymphatic metastasis and central lymph node metastasis and pre-surgery levels of serum thyrotropin (TSH), thyrobolulin (TG), anti-thyrobolulin antibodies (A-TG), anti-thyroid peroxidase antibodies (A-TPO) in patients with papillary thyroid carcinoma (PTC). Methods The clinical characteristics such as sex, age, tumor diameter, and some markers of thyroid function detection in 289 simple PTC cases were retrospectively analyzed, and their roles in lymphatic metastasis and central lymph node metastasis were discussed. Results Age < 45 years old (χ2 = 5.86, P = 0.02), multifocal (χ2 = 38.95, P < 0.001), serum increased A - TG level (χ2 = 13.31, P < 0.001) or A - TPO level (χ2 = 7.30, P < 0.01) leaded to higher rate of lymphatic metastasis. Different TSH levels had different impact on lymphatic metastasis (χ2 = 11.81, P = 0.02). When at 1.81-2.52 mU/L, the lowest rate of lymphatic metastasis was 34.68%. Multivariable logistic regression analysis showed that focus (OR = 3.29, 95% CI 1.85-5.52) and serum A-TG level (OR = 2.17, 95% CI 1.11-4.26) were risk factors, whereas TSH at 1.81-2.52 mIU/L was more safe factor in simple PTC cases with lymphatic metastasis(OR = 0.28, 95% CI 0.09-0.85). Different groups of age (χ2 = 11.54, P = 0.001), focal (χ2 = 38.95, P < 0.001), serum TG level (χ2 = 9.01, P = 0.01), A-TG level (χ2 = 14.51, P < 0.001) or A-TPO level (χ2 = 6.78, P = 0.02) leaded to statistically different central lymph node metastasis ending; further analysis showed that age (OR = 0.96, 95% CI 0.94-0.98) and focus (OR = 5.47, 95% CI 3.09-9.69) were risk factors of central lymph node metastatic in PTC patients. Conclusion Higher pre-surgery serum A-TG level and multifocal predict lymphatic metastasis, TSH level in 1.81-2.52 mU/L indicates lower rate of lymphatic metastasis, but age < 45 years old and multifocal PTC patients are apt to occur central lymph node metastasis. Key words: Thyroid neoplasms; Carcinoma, papillary; Lymphatic metastasis; Thyroid function