Trends in Immunotherapy

Article

High rates of aggressive features in young Vietnamese females with papillary thyroid carcinoma: Associations with preoperative risk factors

Downloads

https://doi.org/10.24294/ti.v8.i1.2997
Van De, N., Thi Huyen, D., & Huu Tam, D. (2023). High rates of aggressive features in young Vietnamese females with papillary thyroid carcinoma: Associations with preoperative risk factors. Trends in Immunotherapy, 8(1). https://doi.org/10.24294/ti.v8.i1.2997
Volume 8 Issue 1 (2024)
Copyright (c) 2023 Nguyen Van De, Dao Thi Huyen, Dinh Huu Tam
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright

The authors shall retain the copyright of their work but allow the Publisher to publish, copy, distribute, and convey the work.

License

Trends in Immunotherapy (TI)  publishes accepted manuscripts under Creative Commons Attribution 4.0 International (CC BY 4.0). Authors who submit their papers for publication by TI agree to have the CC BY 4.0 license applied to their work, and that anyone is allowed to reuse the article or part of it free of charge for any purpose, including commercial use. As long as the author and original source are properly cited, anyone may copy, redistribute, reuse, and transform the content.

Authors

  • Nguyen Van De
    Department of Pathology, 108 Military Central Hospital, Hanoi 11650, Viet Nam
  • Dao Thi Huyen
  • Dinh Huu Tam

Background: Thyroid carcinoma represents a significant global health burden, rising worldwide incidence. Papillary thyroid carcinoma (PTC) accounts for most cases, but aggressive variants with capsular invasion and nodal metastases require more intensive treatment. Reported rates of these capsular invasion and cervical lymph node metastasis vary widely. This study aimed to elucidate associations between clinical/tumor characteristics, capsular invasion, and nodal metastasis in Vietnamese PTC patients. Methods: This retrospective cohort study examined 1626 patients with cytologically/histologically confirmed thyroid carcinoma at a referral center in Vietnam during 2018–2020. Data collected included demographics, imaging, cytology, tumor features, capsular invasion, and nodal metastasis. Associations were analyzed using chi-squared tests and binary logistic regression. Results: Most patients were young (≤ 45) females with small papillary carcinomas. High rates of capsular invasion (58.7%) and nodal metastasis (28.5%) were observed. Capsular invasion was associated with higher TIRADS categories, Bethesda cytological categories, larger tumors, and papillary histology. Nodal metastasis was linked to younger age, male sex, higher TIRADS categories, larger tumors, papillary histology, and capsular invasion. Binary logistic regression identified TIRADS categories, Bethesda cytological categories, larger tumor size, younger age, male sex, and capsular invasion as independent predictors. Conclusion: Unexpectedly high rates of capsular invasion and cervical lymph node metastasis were found. TIRADS, Bethesda system, tumor size, age, sex, and capsular invasion were significant preoperative risk factors for aggressive PTC behaviors.

Keywords:

papillary thyroid carcinoma capsular invasion cervical lymph node metastasis TIRADS Bethesda tumor size age sex

References

  1. Pizzato M, Li M, Vignat J, et al. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. The Lancet Diabetes & Endocrinology. 2022, 10(4): 264-272. doi: 10.1016/s2213-8587(22)00035-3
  2. Shank JB, Are C, Wenos CD. Thyroid Cancer: Global Burden and Trends. Indian Journal of Surgical Oncology. 2021, 13(1): 40-45. doi: 10.1007/s13193-021-01429-y
  3. Lam AK. Papillary Thyroid Carcinoma: Current Position in Epidemiology, Genomics, and Classification. Papillary Thyroid Carcinoma. 2022, 1-15. doi: 10.1007/978-1-0716-2505-7_1
  4. Coca-Pelaz A, Shah JP, Hernandez-Prera JC, et al. Papillary Thyroid Cancer—Aggressive Variants and Impact on Management: A Narrative Review. Advances in Therapy. 2020, 37(7): 3112-3128. doi: 10.1007/s12325-020-01391-1
  5. Akbulut D, Kuz ED, Kursun N, et al. Capsular Invasion Matters Also in “Papillary Patterned” Tumors: A Study on 121 Cases of Encapsulated Conventional Variant of Papillary Thyroid Carcinoma. Endocrine Pathology. 2021, 32(3): 357-367. doi: 10.1007/s12022-020-09650-1
  6. Mete O, Asa SL. Thyroid Tumor Capsular Invasion: the Bottom Line or Much Ado About Nothing? Endocrine Pathology. 2020, 31(2): 141-142. doi: 10.1007/s12022-020-09621-6
  7. Han B, Hao S, Wu J, et al. Predictive features of central lymph node metastasis in papillary thyroid microcarcinoma: Roles of active surveillance in over-treatment. Frontiers in Medicine. 2022, 9. doi: 10.3389/fmed.2022.906648
  8. Gao X, Luo W, He L, et al. Predictors and a Prediction Model for Central Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma (cN0). Frontiers in Endocrinology. 2022, 12. doi: 10.3389/fendo.2021.789310
  9. Liu W qing, Yang J yi, Wang X hui, et al. Analysis of factors influencing cervical lymph node metastasis of papillary thyroid carcinoma at each lateral level. BMC Surgery. 2022, 22(1). doi: 10.1186/s12893-022-01678-w
  10. Geng D, Zhou Y, Su GY, et al. Influence of sex, age and thyroid function indices on dual-energy computed tomography-derived quantitative parameters of thyroid in patients with or without Hashimoto’s thyroiditis. BMC Medical Imaging. 2023, 23(1). doi: 10.1186/s12880-023-00983-x
  11. Alexander EK, Cibas ES. Diagnosis of thyroid nodules. The Lancet Diabetes & Endocrinology. 2022, 10(7): 533-539. doi: 10.1016/s2213-8587(22)00101-2
  12. Sugitani I, Ito Y, Miyauchi A, et al. Active Surveillance Versus Immediate Surgery: Questionnaire Survey on the Current Treatment Strategy for Adult Patients with Low-Risk Papillary Thyroid Microcarcinoma in Japan. Thyroid. 2019, 29(11): 1563-1571. doi: 10.1089/thy.2019.0211
  13. Pham DX, Nguyen HD, Phung AHT, et al. Trends in incidence and histological pattern of thyroid cancer in Ho Chi Minh City, Vietnam (1996–2015): a population-based study. BMC Cancer. 2021, 21(1). doi: 10.1186/s12885-021-08023-z
  14. Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology. 2017, 14(5): 587-595. doi: 10.1016/j.jacr.2017.01.046
  15. Ali SZ, VanderLaan PA. The Bethesda System for Reporting Thyroid Cytopathology. Springer International Publishing; 2023.
  16. Baloch ZW, Asa SL, Barletta JA, et al. Overview of the 2022 WHO Classification of Thyroid Neoplasms. Endocrine Pathology. 2022, 33(1): 27-63. doi: 10.1007/s12022-022-09707-3
  17. Ismail M, Raza AA, Khan MK, et al. Clinicopathological features and surgical treatment of thyroid papillary carcinoma in Hashimoto thyroiditis. International journal of health sciences. 2023, 7(S1): 1187-1194. doi: 10.53730/ijhs.v7ns1.14332
  18. Smulever A, Pitoia F. Conservative management of low-risk papillary thyroid carcinoma: A review of the active surveillance experience. Thyroid Research. 2023, 16(1). doi: 10.1186/s13044-023-00148-6
  19. Tuli G, Munarin J, Scollo M, et al. Evaluation of the efficacy of EU-TIRADS and ACR-TIRADS in risk stratification of pediatric patients with thyroid nodules. Frontiers in Endocrinology. 2022, 13. doi: 10.3389/fendo.2022.1041464
  20. Behbahaninia M, Nabahati M, Moazezi Z, et al. Diagnostic performance of ACR-TIRADS, Korean TIRADS, and American Thyroid Association guidelines for risk stratification of thyroid nodules: a prospective study. Journal of Ultrasound. 2022, 25(4): 887-894. doi: 10.1007/s40477-022-00669-0
  21. Zhu Y, Li Y, Jung CK, et al. Histopathologic Assessment of Capsular Invasion in Follicular Thyroid Neoplasms—An Observer Variation Study. Endocrine Pathology. 2020, 31(2): 132-140. doi: 10.1007/s12022-020-09620-7
  22. Ni X, Xu S, Zhan W, et al. Ultrasonographic features of cervical lymph node metastases from medullary thyroid cancer: A retrospective study. BMC Medical Imaging. 2022, 22(1). doi: 10.1186/s12880-022-00882-7
  23. Yu F, Wu W, Zhang L, et al. Cervical lymph node metastasis prediction of postoperative papillary thyroid carcinoma before 131I therapy based on clinical and ultrasound characteristics. Frontiers in Endocrinology. 2023, 14. doi: 10.3389/fendo.2023.1122517
  24. Zhou TH, Zhao LQ, Zhang Y, et al. The Prediction of Metastases of Lateral Cervical Lymph Node in Medullary Thyroid Carcinoma. Frontiers in Endocrinology. 2021, 12. doi: 10.3389/fendo.2021.741289
  25. Leong D, Gill AJ, Turchini J, et al. The Prognostic Impact of Extent of Vascular Invasion in Follicular Thyroid Carcinoma. World Journal of Surgery. 2022, 47(2): 412-420. doi: 10.1007/s00268-022-06696-6
  26. Ghossein R. Update to the College of American Pathologists Reporting on Thyroid Carcinomas. Head and Neck Pathology. 2009, 3(1): 86-93. doi: 10.1007/s12105-009-0109-2
  27. Smith DWY, Botz B, et al. Thyroid Imaging Reporting and Data System (ACR TI-RADS). Radiopaedia; 2017.
  28. Yaprak Bayrak B, Eruyar AT. Malignancy rates for Bethesda III and IV thyroid nodules: a retrospective study of the correlation between fine-needle aspiration cytology and histopathology. BMC Endocrine Disorders. 2020, 20(1). doi: 10.1186/s12902-020-0530-9
  29. Lee JS, Lee JS, Yun HJ, et al. Aggressive Subtypes of Papillary Thyroid Carcinoma Smaller Than 1 cm. The Journal of Clinical Endocrinology & Metabolism. 2022, 108(6): 1370-1375. doi: 10.1210/clinem/dgac739
  30. Follicular thyroid carcinoma. Available online: https://www.pathologyoutlines.com/topic/thyroidfollicular.html (accessed on 20 September 2023).
  31. Laksmi Delyuzar LI, Alferraly TI, Joko SL. Histomorpology of papillary thyroid carcinoma and follicular thyroid carcinoma in the laboratory of anatomic pathology unit rsup h.adam malik medan 2015-2019. Available online: https://www.ijrp.org//paper-detail/1609 (accessed 20 October 2023).
  32. Zhang J, Jia G, Su Y, et al. Prediction of Cervical Lymph Nodes Metastasis in Papillary Thyroid Carcinoma (PTC) Using Nodal Staging Score (NSS). Muddassir Ali M, ed. Journal of Oncology. 2022, 2022: 1-7. doi: 10.1155/2022/9351911
  33. Zhou L, Zheng Y, Yao J, et al. Association between papillary thyroid carcinoma and cervical lymph node metastasis based on ultrasonic radio frequency signals. Cancer Medicine. 2023, 12(13): 14305-14316. doi: 10.1002/cam4.6107
  34. Hay ID. Papillary Thyroid Carcinoma. Endocrinology and Metabolism Clinics of North America. 1990, 19(3): 545-576. doi: 10.1016/s0889-8529(18)30310-4
  35. Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. The American Journal of Medicine. 1994, 97(5): 418-428. doi: 10.1016/0002-9343(94)90321-2
  36. Machens A, Holzhausen H, Dralle H. The prognostic value of primary tumor size in papillary and follicular thyroid carcinoma. Cancer. 2005, 103(11): 2269-2273. doi: 10.1002/cncr.21055
  37. Nguyen XV, Roy Choudhury K, Tessler FN, et al. Effect of Tumor Size on Risk of Metastatic Disease and Survival for Thyroid Cancer: Implications for Biopsy Guidelines. Thyroid. 2018, 28(3): 295-300. doi: 10.1089/thy.2017.0526
  38. Lundgren CI, Hall P, Dickman PW, et al. Clinically significant prognostic factors for differentiated thyroid carcinoma. Cancer. 2005, 106(3): 524-531. doi: 10.1002/cncr.21653
  39. LiVolsi VA. Papillary thyroid carcinoma: an update. Modern Pathology. 2011, 24: S1-S9. doi: 10.1038/modpathol.2010.129
  40. Ito Y, Miyauchi A, Kihara M, et al. Overall Survival of Papillary Thyroid Carcinoma Patients: A Single-Institution Long-Term Follow-Up of 5897 Patients. World Journal of Surgery. 2018, 42(3): 615-622. doi: 10.1007/s00268-018-4479-z
  41. Ulisse S, Baldini E, Lauro A, et al. Papillary Thyroid Cancer Prognosis: An Evolving Field. Cancers. 2021, 13(21): 5567. doi: 10.3390/cancers13215567
  42. Vuong HG, Le HT, Le TTB, et al. Clinicopathological significance of major fusion oncogenes in papillary thyroid carcinoma: An individual patient data meta-analysis. Pathology-Research and Practice. 2022, 240: 154180. doi: 10.1016/j.prp.2022.154180
  43. Mao J, Zhang Q, Zhang H, et al. Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis. Frontiers in Endocrinology. 2020, 11. doi: 10.3389/fendo.2020.00265
  44. Risks and causes of thyroid cancer. Available online: https://www.cancerresearchuk.org/about-cancer/thyroid-cancer/causes-risks (accessed on 20 October 2023).
  45. Thyroid Cancer Risk Factors | Risk Factors for Thyroid Cancer. @cancer.org. Available online: https://www.cancer.org/cancer/types/thyroid-cancer/causes-risks-prevention/risk-factors.html (accessed on 25 October 2023).
  46. Zloczower E, Atas O, London D, et al. Agreement Between Ti-RADS Classification and Bethesda Cytopathological Findings from Thyroid Nodules in Young Adults. Military Medicine. 2020, 185(11-12): 2020-2025. doi: 10.1093/milmed/usaa174
  47. Park J, Kim K, Lim DJ, et al. Male sex is not an independent risk factor for recurrence of differentiated thyroid cancer: A propensity score-matching study. Scientific Reports. 2021, 11(1). doi: 10.1038/s41598-021-94461-5
  48. Thyroidfriends. Male sex is not an independent prognostic factor for thyroid cancer. @thyroidfriends; 2023.
  49. Cai M, Chen L, Shui L, et al. Explore the diagnostic performance of 2020 Chinese Thyroid Imaging Reporting and Data Systems by comparing with the 2017 ACR-TIRADS guidelines: A single-center study. Endocrine. 2023, 80(2): 399-407. doi: 10.1007/s12020-023-03304-y
  50. Chen Z, Du Y, Cheng L, et al. Diagnostic performance of simplified TI-RADS for malignant thyroid nodules: comparison with 2017 ACR-TI-RADS and 2020 C-TI-RADS. Cancer Imaging. 2022, 22(1). doi: 10.1186/s40644-022-00478-y