The role of age and antibodies in central regional lymph node metastases of papillary thyroid carcinoma combined with hashimoto’s thyroiditis

BACKGROUND: The coexistence of Hashimoto thyroiditis (HT) and papillary thyroid carcinoma (PTC) is increasing year by year, and the role of age, thyroglobulin antibodies (TgAb), and thyroid peroxidase antibodies (TPOAb) in central neck lymph node metastasis (CLNM) in PTC patients with HT is still controversial. METHODS: In this study, we retrospectively collected information about 540 PTC patients with HT, explored the risk prediction of CLNM by related factors through univariate, multivariate logistic regression and restricted cubic spline (RCS) plots. RESULTS: In univariate logistic analysis, age, gender, no history of hypertension, ultrasound image characteristics (largest diameter of the suspicious thyroid nodule, calcification of the suspicious thyroid nodule, suspicious lymph nodes), thyroid-related antibodies (TgAb, TPOAb) were statistically significant in CLNM in PTC patients with HT (PTC-HT) significance (P < 0.05) ; after adjustment for many variables, age, TgAb, and TPOAb were significantly associated with CLNM. Age < 45 years and TgAb positivity were risk factors for CLNM in PTC patients combined with HT, and TPOAb positivity was a protective factor for CLNM in PTC patients with HT. Between age and TgAb, the risk of CLNM was greatest at age < 45 years combined with TgAb positivity (P < 0.001, OR = 5.771, 95% CI 2.690-12.383); between age and TPOAb, the risk of CLNM metastasis was greatest when age < 45 years combined with negative TPOAb (P < 0.001, OR = 4.856, 95% CI 2.732-8.630) ; between TgAb and TPOAb, the risk of CLNM metastasis was greatest when TgAb positivity combined with negative TPOAb (P = 0.002, OR = 2596, 95% CI 1.430-4.713). CONCLUSIONS: Younger age and TgAb positivity are significant risk factors for CLNM in PTC patients with HT, and TPOAb positivity plays a protective role, therefore, age, TgAb and TPOAb have important predictive value. Patients aged < 45 years, with TgAb positivity and TPOAb negativity should not only pay attention to adequately assessing the metastatic status of CLNM preoperatively and formulating a suitable surgical scope, but also to monitoring antibody levels for follow-up after the operation.