Clinical and Pathological Factors that Affecting the Lymph Node  Metastasis in Papillary Thyroid Carcinoma

Hayder Mohammed Ali  Zainy

doi:10.48165/sajssh.2024.6102

Authors

Hayder Mohammed Ali Zainy M.B.Ch.B./F.I.C.M.S. (General surgery) at Safeer Al-Imam Al-Hussain Surgical Hospital. Karbala, Iraq.

DOI:

https://doi.org/10.48165/sajssh.2024.6102

Keywords:

Papillary Thyroid Carcinoma, Lymph Node Metastasis (LNM), Thyroidectomy

Abstract

Background: Papillary thyroid carcinoma (PTC) is the most common form of thyroid cancer, characterized by its indolent growth and propensity to metastasize to lymph nodes, understanding the factors affecting metastasis in PTC is crucial for improving patient outcomes. Aim of the Study: To evaluate the influence of various clinical and pathological factors on the occurrence of lymph node metastasis (LNM) in patients with PTC. Methodology: A prospective interventional study was conducted at Safeer Al-Imam Al Hussain Surgical Hospital, Imam Hussain medical city, Zain Al-Abedin surgical hospital and Al-Kafeel specialized hospital / Karbalaa/ Iraq over 13 years from 2011-2024, involving 40 patients diagnosed with PTC that underwent total thyroidectomy, and data on demographic, clinical, and pathological variables were collected and evaluated to identify correlations between these variables and N. Results: The mean age of patients was 42.4 ± 12.3 years, with a predominance of females (75%). LNM was observed in 50% of the patients. Significant correlations were found between N and age (p = 0.036), nodule site (p = 0.004), tumor type (p = 0.012), and adjacent lymphatic and vascular invasion (p < 0.001). Older patients, males, patients with nodules in the isthmus or bilateral nodules, and those with multinodular tumors or adjacent lymphatic and vascular invasion had a higher likelihood of LNM. Conclusions: Age, nodule site, tumor type, and adjacent lymphatic and vascular invasion significantly influence N in papillary thyroid carcinoma.

References

Agrawal, N., Akbani, R., Aksoy, B. A., Ally, A., Arachchi, H., Asa, S. L., Auman, J. T., Balasundaram, M., Balu, S., & Baylin, S. B. (2014). Integrated genomic characterization of papillary thyroid carcinoma. Cell, 159(3), 676–690.

Akbulut, D., Kuz, E. D., Kursun, N., & Dizbay Sak, S. (2021). Capsular invasion matters also in “papillary patterned” tumors: a study on 121 cases of encapsulated conventional variant of papillary thyroid carcinoma. Endocrine Pathology, 1–11.

Al Quraini , A. N. H. A. (2024). Knowledge & Attitude among Parents of Children with Bronchial Asthma whom Attending Iraq Pediatric Hospital . South Asian Journal of Social Sciences and Humanities, 5(5), 26-40. https://doi.org/10.48165/sajssh.2024.5502

Asa, S. L. (2019). The current histologic classification of thyroid cancer. Endocrinology and Metabolism Clinics, 48(1), 1–22.

Bible, K. C., Kebebew, E., Brierley, J., Brito, J. P., Cabanillas, M. E., Clark Jr, T. J., Di Cristofano, A., Foote, R., Giordano, T., & Kasperbauer, J. (2021). 2021 American thyroid association guidelines for management of patients with anaplastic thyroid cancer: American thyroid association anaplastic thyroid cancer guidelines task force. Thyroid, 31(3), 337–386.

Cabanillas, M. E., McFadden, D. G., & Durante, C. (2016). Thyroid cancer. The Lancet, 388(10061), 2783–2795.

Carling, T., & Udelsman, R. (2014). Thyroid cancer. Annual Review of Medicine, 65(1), 125– 137.

Chen, D. W., Lang, B. H. H., McLeod, D. S. A., Newbold, K., & Haymart, M. R. (2023). Thyroid cancer. The Lancet, 401(10387), 1531–1544.

Guo, K., & Wang, Z. (2014). Risk factors influencing the recurrence of papillary thyroid carcinoma: a systematic review and meta-analysis. International Journal of Clinical and Experimental Pathology, 7(9), 5393.

Ito, Y., Miyauchi, A., Kihara, M., Higashiyama, T., Kobayashi, K., & Miya, A. (2014). Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid, 24(1), 27–34.

Jamal, . A. A. ., Hassan, S. A., Kadhim, B. M., & Muhammad, S. . O. F. (2024). Simple Closure and Rhomboid Flap Closure for Pilonidal Sinus Disease . South Asian Journal of Social Sciences and Humanities, 5(6), 1-12. https://doi.org/10.48165/sajssh.2024.5601

Liu, C., Xiao, C., Chen, J., Li, X., Feng, Z., Gao, Q., & Liu, Z. (2019). Risk factor analysis for predicting cervical lymph node metastasis in papillary thyroid carcinoma: a study of 966 patients. BMC Cancer, 19, 1–10.

Pellegriti, G., Frasca, F., Regalbuto, C., Squatrito, S., & Vigneri, R. (2013). Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. Journal of Cancer Epidemiology, 2013(1), 965212.

Seib, C. D., & Sosa, J. A. (2019). Evolving understanding of the epidemiology of thyroid cancer. Endocrinology and Metabolism Clinics, 48(1), 23–35.

Sessa, L., Lombardi, C. P., De Crea, C., Tempera, S. E., Bellantone, R., & Raffaelli, M. (2018). Risk Factors for Central Neck Lymph Node Metastases in Micro‐Versus Macro‐Clinically Node Negative Papillary Thyroid Carcinoma. World Journal of Surgery, 42(3), 623–629.

Shah, J. P., Loree, T. R., Dharker, D., Strong, E. W., Begg, C., & Vlamis, V. (1992). Prognostic factors in differentiated carcinoma of the thyroid gland. The American Journal of Surgery, 164(6), 658–661.

Shaha, A. R., Loree, T. R., & Shah, J. P. (1994). Intermediate-risk group for differentiated carcinoma of thyroid. Surgery, 116(6), 1036–1041.

Tang, T., Li, J., Zheng, L., Zhang, L., & Shi, J. (2018). Risk factors of central lymph node metastasis in papillary thyroid carcinoma: a retrospective cohort study. International Journal of Surgery, 54, 129–132.

Wu, X., Li, B.-L., Zheng, C.-J., & He, X.-D. (2020). Predictive factors for central lymph node metastases in papillary thyroid microcarcinoma. World Journal of Clinical Cases, 8(8), 1350.

Xu, Y., Xu, L., & Wang, J. (2018). Clinical predictors of lymph node metastasis and survival rate in papillary thyroid microcarcinoma: analysis of 3607 patients at a single institution. Journal of Surgical Research, 221, 128–134.