Retrospective analysis of the influence of hashimoto thyroiditis on clinical invasiveness of papillary thyroid carcinoma / 中华内分泌外科杂志

ABSTRACT

Objective:To explore the impact of the clinicopathological characteristics of patients on the invasiveness of thyroid papillary carcinoma, especially the impact of Hashimoto’s thyroiditis.Methods:A retrospective analysis of the medical records of 5,018 patients with papillary thyroid carcinoma who were admitted to the Center for Thyroid Diseases of the First Affiliated Hospital of Kunming Medical University from Apr. 2012 to Dec. 2018 was conducted. Among them, 166 cases were excluded due to incomplete data, 394 cases with family history, 55 cases with hyperthyroidism or other thyroid diseases, 39 cases with other malignant tumors or history of radiotherapy and chemotherapy, and 548 cases with abnormal serum TSH (decreased or increased) . After screening, a total of 3816 cases were included in this study. Observation indicators included gender, age, tumor size, extraglandular invasion, vascular invasion, Hashimoto and serum TSH levels. The serum TSH results of the 3816 patients included in this study were all normal. The invasiveness of PTC was predicted by statistical analysis of tumor extraglandular infiltration and tumor size. The study used SPSS 23.0 statistical software for analysis, univariate analysis was made by non-parametric tests ( χ2 test and rank sum test) , multivariate analysis was made by Logistic regression and linear regression analysis, and the differences were statistically significant at P<0.05. Results:Multivariate logistic regression analysis showed that tumor size [ β=0.696, P<0.001, OR (95% CI) =2.006 (1.827-2.204) ], vascular invasion [ β=0.772, P<0.001, OR (95% CI) =2.165 (1.546-3.031) ], Hashimoto [ β=-0.303, P=0.006, OR (95% CI) =0.739 (0.596-0.915) ] had an independent effect on extraglandular infiltration. The results of linear regression analysis of tumor size showed that gender ( β=0.082, P<0.001) , age ( β=-0.134, P<0.001) , extraglandular infiltration ( β=0.268, P<0.001) , vascular invasion ( β=0.076, P<0.001) were independent influencing factors for tumor size. Conclusions:Lage tumor size and the presence of vascular invasion are independent risk factors for extraglandular invasion of PTC, and HT is protective factor. Male, age ≤45 years old, presence of extraglandular invasion and vascular invasion are independent risk factors for tumor size of PTC. The clinical significance and mechanism of the difference in the effect of Hashimoto’s thyroiditis on the extra-gland infiltration of thyroid papillary carcinoma remains to be further studied.