Lymph Node Metastasis In Thyroid Carcinoma Research Articles

Tumor-Infiltrating Lymphocytes as Mediators of the Obesity and Papillary Thyroid Carcinoma Lymph Node Metastasis Association: An Observational Retrospective Cohort Study.

Obesity increases the risk of papillary thyroid carcinoma (PTC) and lymph node metastasis (LNM), possibly via modulation of the tumor immunological microenvironment. The STROCSS guideline was followed to conduct a retrospective cohort study. Binary logistic regression analysis with odds ratios (OR) was performed to assess the association between tumor-infiltrating lymphocytes (TILs), obesity, and LNM. Using The Cancer Genome Atlas (TCGA) data, we examined the relationship between immune cell subsets and obesity-regulating molecules in thyroid cancer tissues. The Cox regression risk model was used to analyze the prognosis of thyroid cancer. After adjusting for confounding factors, our findings revealed that overweight and obesity were associated with a decrease in TIL infiltration (OR 0.876, p = 0.005 and OR 0.795, p = 0.001, respectively). Furthermore, these conditions were observed to be correlated with increased likelihood of LNM (OR 1.134, p = 0.005 and OR 1.307, p < 0.001, respectively). On the contrary, TIL infiltration was inversely associated with LNM (OR 0.868, p < 0.001). When controlling for TIL infiltration as the sole variable, the combination of obesity and TIL infiltration did not independently predict LNM (adjusted OR 1.442, p = 0.113). However, obesity alone was found to elevate the likelihood of LNM (adjusted OR 1.539, p = 0.02). Additionally, adiponectin (a crucial adipokine) was reduced in obesity and demonstrated a negative correlation with the abundance of infiltrated dendritic cells and regulatory T cells, as evidenced by TCGA data analysis. Furthermore, ADIPOR2 expression negatively correlated with LNM and positively associated with unfavorable prognosis in PTC, with a hazard ratio of 0.480 (p = 0.007). TIL infiltration may affect obesity-associated PTC LNM. Obesity may affect LNM and result in poor prognosis through ADIPOR2 regulation of antitumor immune cells.

The effectiveness and safety of thermal ablation for thyroid carcinoma lymph node metastasis are affected by the diameter of metastatic lymph nodes: A meta-analysis

BackgroundTo explore the diameter of lymph nodes with metastatic thyroid carcinoma and the effectiveness and safety of thermal ablation. MethodsSeveral databases were searched for literature on the treatment of thyroid carcinoma metastatic lymph nodes by thermal ablation. A subgroup analysis was performed according to the diameter of the metastatic lymph nodes. The measures included pooled estimates of mean volume reduction, pooled proportions of total disappearance and recurrence, and the pooled proportions of overall complications. ResultsThere were 20 studies with 372 patients and 620 metastatic lymph nodes included. Based on the average maximum diameter of the metastatic lymph nodes, they were divided into three groups: A (≤ 10 mm), B (10 < diameter ≤ 20 mm), and C (> 20 mm). The study results indicated a significant decrease in the average volume only in groups A and B. The ratio of tumor disappearance showed that group A had the highest percentage, followed by group B and then group C. The recurrence rates were comparable between groups A and B, but slightly lower than in group C. Moreover, the overall complication rates for the three groups were ranked as follows: group A > group C > group B. ConclusionOverall, thermal ablation is an effective and safe treatment for thyroid cancer metastatic lymph nodes with diameters of 10-20mm.

Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma

BackgroundsThe purpose of this study is to investigate the relationship between clinical characteristics and cervical lymph node metastasis (LNM) in patients with thyroid carcinoma, as well as estimate the preoperative diagnosis values of ultrasound (US) and contrast enhanced computed tomography (CECT) examinations on the neck for detection of cervical LNM in thyroid carcinoma.MethodsA retrospective analysis of 3 026 patients with surgically proven thyroid carcinoma was conducted. Patients’ clinical characteristics, including gender, age, tumor size, bilateral lesions, multifocality, adenomatous nodules, Hashimoto’s thyroiditis (HT), and extrathyroidal extension, were collected to explore their association with cervical LNM in thyroid carcinoma. Preoperative assessments for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were conducted through US and CECT. The diagnostic value of US, CECT and US combined with CECT for detection of LNM located in various cervical compartments was estimated based on the pathological results.ResultsThe risk of cervical LNM was higher in thyroid cancer patients who were male, age < 55 years old, tumor size > 10 mm, bilateral lesions, and extrathyroidal extension, while multifocality, adenomatous nodules and HT had no significant effect on LNM. US, CECT and US combined with CECT all had a higher sensitivity to LLNM (93.1%, 57.8%, 95.4%) than to CLNM (32.3%, 29.0%, 43.4%). US and CECT had a high specificity to both CLNM and LLNM (94.3–97.8%).ConclusionPreoperative clinical characteristics and imaging examinations on patients with thyroid carcinoma are crucial to the evaluation of cervical lymph nodes and conducive to individualizing surgical treatments by clinicians. US combined with CECT are superior to single US or CECT alone in detection of CLNM and LLNM.

Diagnostic Efficacy of Ultrasonographic Characteristics of Thyroid Carcinoma in Predicting Cervical Lymph Node Metastasis

The goals of this study were to determine the ultrasonographic characteristics of thyroid carcinoma (TC) and to explore the diagnostic efficacy of these ultrasonographic characteristics in predicting cervical lymph node metastasis (LNM). From June 2012 to June 2014, a total of 186 TC patients were recruited from the Central Hospital of Chengde City, Hebei, China. We divided them into two groups: the metastatic group comprised 129 nodules (n = 86), and the non-metastatic group 117 nodules (n = 100). Univariate and multivariate analyses were used to evaluate the relationship between ultrasonographic characteristics and cervical LNM. Spectral Doppler ultrasound was employed to estimate peak systolic velocity, pulsatility index and resistive index. Receiver operating characteristic curves were drawn to evaluate the efficacy of ultrasonographic characteristics in predicting cervical LNM. The sensitivity, specificity, positive predictive value and negative predictive value of ultrasonographic diagnosis were 81.40% (105/129), 92.32% (108/117), 92.11% (105/114) and 81.82% (108/132), respectively. Cervical LNM in TC frequently occurred at the cervical level VI (37.98%) and was located mainly in the middle pole (46.51%) or lower pole (41.09%). Peak systolic velocity and resistive index values were significantly higher in the metastatic group than in the non-metastatic group (both p < 0.001). Multivariate analysis revealed that nodular diameter, capsular invasion, microcalcification and flow grade were risk factors for TC patients with cervical LNMs (all p < 0.05). Furthermore, receiver operating characteristic curve analysis revealed that nodular diameter, capsular invasion, microcalcification and flow grade had excellent accuracy in predicting cervical LNM. We conclude that ultrasonographic characteristics of TC, including maximum nodular diameter, capsular invasion, microcalcification and flow grade, may predict cervical LNM.

Ultrasound evaluation on cervical lymph nodes metastasis regions and characteristics in thyroid carcinoma

Objective To investigate the value of ultrasonic diagnosis on cervical lymph nodes metastasis regions and characteristics in thyroid carcinoma.Methods Ultrasound image of 290 patients with thyroid carcinoma were analyzed restrospectively.The cervical lymph node metastasis regions diagnosed by ultrasonography were compared with histopathologic results,and the ultrasound characteristics of metastasis lymph nodes were assessed.Results Among 290 patients,167 cases with cervical lymph node metastasis were comfirmed by pathology (57.6％),and 185 cases were detected by pre-operative ultrasound (63.8％).The region of thyroid carcinoma lymph node metastasis comfirmed by histopathology was most commonly the central region (54.1％),followed by the lateral neck (20.7％).The diagnostic rate of central region lymph node metastatic by pre-operative ultrasound was only 31.7％,which was sharply lower than that of lateral region (57.6％,P ＜0.05).However,the diagnostic specificity (72.8 ％) was apparently higher than lateral region (35.9％,P ＜0.05).The ultrasonic characteristics of metastatic cervical lymph nodes included rounded shape,absence of echogenic hilus,presence of calcitication,hyperechogenicity and cystic change.Conclusions The cervical central region is the predominant region for thyroid carcinoma lymph node metastasis,and ultrasound diagnosis on central region lymph node metastasis possesses positive specificity but negative sensitivity.Improving ultrasound diagnostic accuracy on central lymph nodes metastasis would be of important clinical significance. Key words: Ultrasonography; Thyroid neoplasms; Lymphatic metastasis

Application of selective neck lymphadenectomy in papillary thyroid carcinoma

Objective To explore the rule of papillary thyroid carcinoma lymph node metastasis,and provide the basis for cervical lymph node dissection in papillary thyroid carcinoma selective node.Methods The clinical data and follow-up results of 50 cases with thyroid papillary carcinoma were retrospectively analyzed.Results Average number of selective neck dissection was 4.2 cases,lymph node metastasis in 19 cases (38.0％),6 cases had postoperative complications(12.0％).The patients were followed-up for 4 years without recurrence or metastasis of thyroid cancer.4 cases during the follow-up period appeared neck lymph node metastasis,accounted for 8.0％.Conclusion Primary radical combined with selective neck dissection is an effective procedure for the treatment of Ⅰ,Ⅱ stage of thyroid papillary carcinoma. Key words: Lymph node excision; Thyroid neoplasms

The preeminence of growth pattern and invasiveness and the limited influence of BRAF and RAS mutations in the occurrence of papillary thyroid carcinoma lymph node metastases

Prognostic factors indicative of papillary thyroid carcinoma (PTC) aggressive behaviour remain incompletely established partially due to the different composition of the series on record regarding the relative proportion of classic PTC (CPTC) and follicular variant PTC (FVPTC) subtypes. Several clinico-morphological features of PTC, together with the occurrence of BRAF mutations, are still not fully accepted as markers of aggressiveness. In the present clinico-pathological study of a series of 75 CPTC and FVPTC cases, we evaluated the relative contribution of the morphological features of the tumours and their BRAF and N-RAS status for the occurrence of nodal metastases. The morphological features most closely related to the occurrence of nodal metastases were extra-thyroid extension and poorly circumscribed growth pattern, in both CPTC and FVPTC. Additional features significantly associated to nodal metastases were multicentricity in the CPTC and vascular invasion in the FVPTC group. BRAF V600E mutation was detected in 29% of tumours, 41% of CPTC and 16% of FVPTC; N-RAS Q61R mutation was detected in 6% of tumours, 3% of CPTC and 10% of FVPTC. BRAF mutation was significantly more frequent in the CPTC group and in females, and it was detected only in patients older than 20years, suggesting a late tumourigenic effect in the development of PTC. BRAF mutation was not significantly associated to any of the other studied features related to aggressiveness or nodal metastases. These results highlight the importance of infiltrative growth pattern and invasiveness over the presence of BRAF mutation in classic and follicular variant PTC for the development of nodal metastases.

Abstract 5219: The LIM protein LIMD2 functions as an effector and biomarker for metastasis in multiple tumor types

Abstract The LIM domain is found in proteins from a wide variety of eukaryotic organisms. The LIM domain is organized as a tandem zinc-finger structure that functions as a modular protein-binding interface. LIM domain containing proteins have diverse cellular roles such as regulators of gene expression, cytoarchitecture, cell adhesion, cell motility, signal transduction, and biosensors. LIMD2 belongs to the LIM only family of LIM proteins and was identified as a biomarker for papillary thyroid carcinoma lymph node metastasis from molecular profiling of matched samples. However, the biological function of LIMD2 remains unknown. To identify whether LIMD2 is a biomarker for other cancers, highly specific LIMD2 polyclonal and monoclonal antibodies were developed and several cancer cell lines were tested for LIMD2 expression. These cancer cell lines were derived from breast cancer, melanoma, bladder cancer, and thyroid cancer. We found that the cancer cell lines derived from more aggressive tumors exhibited higher levels of LIMD2 protein expression. Furthermore, cells expressing higher levels of LIMD2 had increased migratory capabilities. Over-expression of LIMD2 protein in the less aggressive bladder cancer cell line (RT4) showed an increase in migration and colony formation ability. Conversely, knockdown of LIMD2 using siRNA decreased the migratory ability of the malignant melanoma cancer cell line and caused morphological changes in these cells. These data not only underscore the importance of LIMD2 as a key metastatic biomarker, but also suggest that LIMD2 may play a functional role in tumorgenicity. LIMD2 may also serve as a novel anti-metastatic target to improve the efficacy of conventional cancer therapeutics. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5219. doi:10.1158/1538-7445.AM2011-5219

Significance of survivin, caspase-3, and VEGF expression in thyroid carcinoma

To investigate the clinical significance of survivin, caspase-3, and vascular endothelial growth factor expression in a subset of thyroid carcinoma and their correlation with prognosis. Sixty-eight cases of thyroid carcinoma (TC), 12 cases of thyroid adenoma (TA) and 10 cases of normal thyroid tissue (NT) were involved in immunohistochemical and real-time RT-PCR analyses for survivin, caspase-3, and VEGF expression. Statistical analyses were performed for differential expression among NT, TA and TC, correlations of their expression with the clinicopathological parameters of TC including histological typing, clinical staging and lymphnode metastasis, and relationship of survivin with caspase-3 or VEGF in TC. We observed higher mRNA expression and positive immunostaining for survivin and VEGF in TC compared with TA and NT, with a significant positive correlation among them and significant correlations with histological typing, clinical staging and lymphnode metastasis in TC, but we could not find any significance of caspase-3 in TC and its significant relationship with survivin expression. Our results indicate that survivin and VEGF are unfavorable molecules for TC evolution and prognosis, and possess positive correlation in TC.