Abstract
Intraglandular dissemination is one of the metastatic pathways of papillary thyroid carcinoma (PTC). However, few studies have assessed the impact of intraglandular dissemination among patients with PTC. The purpose of this study was to investigate the potential correlation between intraglandular dissemination and various clinicopathological parameters in PTC patients. We retrospectively collected the data of 1,043 consecutive PTC patients in Wuhan Union Hospital from 1 June 2020 to 1 May 2021. The patients were divided into 2 groups according to the presence or absence of intraglandular dissemination. A propensity score matching (PSM) analysis with a matching ratio of 1:2 and a caliper value of 0.05 was used to compare the clinicopathological differences between groups. Logistic regression analysis was performed to quantify the association between intraglandular dissemination and cervical lymph node (LN) metastasis. In total, 117 and 204 PTC patients with and without intraglandular dissemination, respectively, were successfully matched. The LN metastasis rate of PTC patients with intraglandular dissemination (88%) was significantly higher than that of patients without intraglandular dissemination (67.2%; P<0.001). The number of metastatic LNs in patients with and without intraglandular dissemination also varied greatly, at 9.62 (SD =7.92) and 3.33 (SD =4.23), respectively. Intraglandular dissemination was associated with an increased risk of LN metastasis in both the unmatched patients [odds ratio (OR), 3.19; 95% confidence interval (CI): 1.74 to 5.86; P<0.001] and the matched subset (OR, 4.00; 95% CI: 1.98 to 8.05; P<0.001). No statistically significant differences were found in age, gender, tumor size, histological subtypes, extrathyroidal extension, or presence of Hashimoto's thyroiditis (HT) (all P values >0.05). Intraglandular dissemination is a risk factor for LN metastasis in PTC, which suggests a need for more thorough LN dissection and closer follow-up in these patients. This finding may provide reliable reference data for the risk stratification of patients with PTC.
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