Objective To analyze and compare the pathological data characteristics of patients with sim-ple papillary thyroid carcinoma(PTC)and PTC combined with Hashimoto's thyroiditis(HT),so as to provide clinical treatment ideas.Methods A retrospective analysis was performed on the medical records of 326 PTC pa-tients who met the requirements and underwent surgical treatment in the Department of Thyroid and Breast Sur-gery,Nanjing Hospital of Traditional Chinese Medicine from Jan.2020 to May.2022.There were 81 males and 245 females.They were divided into PTC group and HT-PTC group,according to whether they were combined with HT.Clinical data were collected and organized.The collection indicators included patient gender,age,body mass index(BMI),five preoperative thyroid function items including free triiodothyronine(FT3),free thyroxine(FT4),triio-dothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),BRAF gene mutation,single or bilateral le-sions,single or multiple lesions,largest postoperative pathological tumor lesions diameter,cervical lymph node me-tastasis(LNM)status,etc.At the same time,all patients were divided into CLNM group and no CLNM group ac-cording to CLNM status.The two groups were compared in terms of gender,age ≥55 years old,whether combined with HT,number of lesions,unilateral and bilateral,extraglandular invasion,microcarcinoma,and BRAF gene.Sta-tistical software was used to analyze the results.t test,x2 test,and logistic regression analysis were adopted.P＜0.05 indicates that the difference is statistically significant.Results The proportion of female patients in both groups was higher,and the proportion of female patients in the HT-PTC group(90/100,90％)was higher than that in the PTC group(155/226,69.59％).HT-PTC patients were younger than patients in the PTC group(43.03±12.72 vs.43.70±12.63)years old,and their TSH(2.71±1.69 vs.2.02±1.46)uIU/mL was higher.The differences were statis-tically significant(all P＜0.05).There were no statistically significant differences in BMI,FT3,FT4,T3,or T4(all P＞0.05).The HT-PTC group had a lower proportion of BRAF gene mutations[87/100(87％)vs.212/226(93.8％)],a smaller maximum tumor diameter(1.06±0.73 vs.1.32±0.97 cm),and a lower proportion of CLNM[37/100(37％)vs.118/226(52.2％)].The number of LNMs with metastasis is less(3.33±2.21 vs.4.76±4.00),and it was more likely to be multifocal[44/100(44％)vs.73/226(32.74％)].All differences were statistically significant(all P＜0.05),and the differences in bilateral gland lobes involvement and extra-glandular invasion were not statisti-cally significant.When accompanied by CLNM,gender(male vs.female)[55/100(35.45％/64.52％)vs.26/145(15.2％/84.85％)],age ≥ 55 years(yes vs.no)[21/134(13.55)％/86.45％)vs.50/121(29.24％/70.76％)],HT(yes vs.no)[37/118(23.87％/76.13％)vs.63/108(36.84％/63.16％),number of lesions(single focus vs.multiple focus)[90/65(41.94％/50.06％)vs.119/52(69.59％/30.41％)],microcarcinoma(yes vs.no)[83/72(53.55％/45.45％)vs.139/32(81.29％/18.71％)]and extraglandular invasion(with vs.without)[38/117(24.52％/75.48％)vs.27/144(17.42％/84.21％)]had statistics significance(both P＜0.05).There was no statistical significance in bi-lateral lesion involvement or BRAF gene mutation(all P＞0.05).Multivariate logistic regression analysis showed that age,microcarcinoma,HT,gender,and number of lesions were independent risk factors for CLNM,and male gender and multifocal cancer were risk factors for CLNM.Age ≥55 years,microcarcinoma,and combined HT were negatively associated with CLNM.Conclusions HT may promote the occurrence of PTC,but can inhibit its devel-opment.In the short term,patients with HT can have a better prognosis than those with simple PTC.
万方数据
维普
