Antibody status predicts metastasis in thyroid cancer + Hashimoto’s disease

  • Wen X & al.
  • Ann Surg Oncol
  • 1 Apr 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Status of antibodies against thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) is associated with increased risk of central lymph node metastases (CLNM) in patients with papillary thyroid carcinoma (PTC) and Hashimoto’s thyroiditis (HT).

Why this matters

  • The interactions between PTC and HT, as well as the prognostic role of thyroid antibody status, are controversial.

Key results

  • The following factors were associated with CLNM in multivariate analysis:
    • male sex (OR, 3.269; P=.017);
    • tumor size (OR, 5.880; P=.002 for >2 cm; OR, 6.947; P<.001 for cm both vs>
    • TgAb single-positive status (OR, 6.024; P=.001), TPOAb/TgAb double-negative status (OR, 3.791; P=.009), and TPOAb/TgAb double-positive status (OR, 4.047; P=.005) (all vs TPOAb single-positive status).
  • A risk score scale based on sex, tumor size, and antibody status had 55.7% sensitivity, 84.4% specificity, 74.4% positive predictive value, 70% negative predictive value, and 70.18% accuracy for predicting CLNM.

Study design

  • 346 patients with PTC and HT who underwent thyroidectomy and ipsilateral central lymph node dissection (90 in a validation cohort and 256 in a training cohort) were included.
  • Funding: National Natural Science Foundation of China.

Limitations

  • Retrospective study.
  • BRAF and TERT mutation status not analyzed.

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