AUTHOR=Tan Hai-Long , Nyarko AdolphusOsei , Duan Sai-li , Zhao Ya-Xin , Chen Pei , He Qiao , Zhang Zhe-Jia , Chang Shi , Huang Peng 

TITLE=Comprehensive analysis of the effect of Hashimoto’s thyroiditis on the diagnostic efficacy of preoperative ultrasonography on cervical lymph node lesions in papillary thyroid cancer

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 13 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.987906

DOI=10.3389/fendo.2022.987906

ISSN=1664-2392

ABSTRACT=Purpose: Hashimoto's thyroiditis often leads to reactive hyperplasia of the central compartment lymph nodes in PTC patients. However, the effect and clinical significance of HT on ultrasonography evaluation for cervical LNs lesions remain unknown. This study aims to investigate the effect of Hashimoto's thyroiditis on the diagnostic efficacy of preoperative ultrasonography on cervical lymph node lesions in PTC patients.
Patients and methods: This study consecutively enrolled 1874 PTC patients who underwent total thyroidectomy and radical cervical lymph nodes dissection between January 2010 and December 2021. Eligible patients were categorized into HT and without HT. The diagnostic performance of preoperative ultrasonography for cervical LNs lesions (including central LNs and lateral LNs) was evaluated between PTC patients with HT and without HT, respectively.
Results: Among the 1874 PTC patients, 790 (42.1%) had central cN+ and 1610 (85.9%) had lateral cN+. Compared with PTC patients without HT, the preoperative US for central LNs display a higher false positive rate (27.9% vs 12.2%, p <0.001), and lower specificity (72.1% vs 87.8%, p <0.001) in PTC patients with HT. Besides, in PTC patients with HT, the ratio of the absence of fatty hilum in central LNs without metastasis was higher than in PTC patients without HT (13.02% vs 7.46%, p =0.013). However, no such differences were observed in lateral LNs.
Conclusion: HT will interfere with the preoperative US evaluation for central LNs, and increase the incidence of the absence of fatty hilum in central benign LNs. When PTC patients concomitant HT, clinicians should thoroughly evaluate the central LNs, thereby decrease the incidence of misdiagnosis and unnecessary surgery.