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Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study
BACKGROUND: An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine a...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276512/ https://www.ncbi.nlm.nih.gov/pubmed/34253203 http://dx.doi.org/10.1186/s12957-021-02302-6 |
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author | Zeng, Ziyang Li, Kang Wang, Xianze Ouyang, Siwen Zhang, Zimu Liu, Zhen Sun, Juan Ye, Xin Kang, Weiming Yu, Jianchun |
author_facet | Zeng, Ziyang Li, Kang Wang, Xianze Ouyang, Siwen Zhang, Zimu Liu, Zhen Sun, Juan Ye, Xin Kang, Weiming Yu, Jianchun |
author_sort | Zeng, Ziyang |
collection | PubMed |
description | BACKGROUND: An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine and clinicopathological features of PTC has not been well-characterized. This study aimed to investigate the associations between iodine intake and the clinicopathological features of PTC patients. METHODS: Three hundred and fifty-nine PTC patients who received surgical treatment in Peking Union Medical College Hospital from May 2015 to November 2020 were retrospectively reviewed. The associations between urinary iodine (UI), urinary iodine/creatinine ratio (UI/U-Cr), and the clinicopathological features of PTC were analyzed. Univariate and multivariate analysis were performed to investigate the relationship between UI level and central lymph node metastasis (CLNM). RESULTS: There were no significant differences in UI in different groups according to the variables studied, except that patients with CLNM had higher UI level than CLNM(−) patients. No associations were found between UI/U-Cr and clinicopathological features except variant subtypes (classic/follicular). After dividing patients into high-iodine group and low-iodine group, more patients were found to have CLNM in the high-iodine group (p = 0.02). In addition, younger age, larger tumor size, and classic variant were positively correlated with CLNM (p < 0.05). Univariate analysis showed that insufficient iodine intake (≤ 99 μg/L) was associated with decreased CLNM risk in PTC. And after defining insufficient iodine intake as ≤ 109 μg/L and above requirements as ≥ 190 μg/L, multivariate analysis showed that lower iodine was associated with CLNM in total population of PTC (OR 0.53, 95% CI 0.31–0.91) and in PTC < 1 cm (papillary thyroid microcarcinoma, PTMC) (OR 0.43, 95% CI 0.21–0.87). CONCLUSIONS: Low iodine was a protective factor for CLNM in papillary thyroid cancer, particularly in those < 1 cm. These results indicated that iodine may not only be an initiator of tumorigenesis, but also a promoter of the development of PTC. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12957-021-02302-6. |
format | Online Article Text |
id | pubmed-8276512 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-82765122021-07-14 Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study Zeng, Ziyang Li, Kang Wang, Xianze Ouyang, Siwen Zhang, Zimu Liu, Zhen Sun, Juan Ye, Xin Kang, Weiming Yu, Jianchun World J Surg Oncol Research BACKGROUND: An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine and clinicopathological features of PTC has not been well-characterized. This study aimed to investigate the associations between iodine intake and the clinicopathological features of PTC patients. METHODS: Three hundred and fifty-nine PTC patients who received surgical treatment in Peking Union Medical College Hospital from May 2015 to November 2020 were retrospectively reviewed. The associations between urinary iodine (UI), urinary iodine/creatinine ratio (UI/U-Cr), and the clinicopathological features of PTC were analyzed. Univariate and multivariate analysis were performed to investigate the relationship between UI level and central lymph node metastasis (CLNM). RESULTS: There were no significant differences in UI in different groups according to the variables studied, except that patients with CLNM had higher UI level than CLNM(−) patients. No associations were found between UI/U-Cr and clinicopathological features except variant subtypes (classic/follicular). After dividing patients into high-iodine group and low-iodine group, more patients were found to have CLNM in the high-iodine group (p = 0.02). In addition, younger age, larger tumor size, and classic variant were positively correlated with CLNM (p < 0.05). Univariate analysis showed that insufficient iodine intake (≤ 99 μg/L) was associated with decreased CLNM risk in PTC. And after defining insufficient iodine intake as ≤ 109 μg/L and above requirements as ≥ 190 μg/L, multivariate analysis showed that lower iodine was associated with CLNM in total population of PTC (OR 0.53, 95% CI 0.31–0.91) and in PTC < 1 cm (papillary thyroid microcarcinoma, PTMC) (OR 0.43, 95% CI 0.21–0.87). CONCLUSIONS: Low iodine was a protective factor for CLNM in papillary thyroid cancer, particularly in those < 1 cm. These results indicated that iodine may not only be an initiator of tumorigenesis, but also a promoter of the development of PTC. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12957-021-02302-6. BioMed Central 2021-07-12 /pmc/articles/PMC8276512/ /pubmed/34253203 http://dx.doi.org/10.1186/s12957-021-02302-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Zeng, Ziyang Li, Kang Wang, Xianze Ouyang, Siwen Zhang, Zimu Liu, Zhen Sun, Juan Ye, Xin Kang, Weiming Yu, Jianchun Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study |
title | Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study |
title_full | Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study |
title_fullStr | Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study |
title_full_unstemmed | Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study |
title_short | Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study |
title_sort | low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276512/ https://www.ncbi.nlm.nih.gov/pubmed/34253203 http://dx.doi.org/10.1186/s12957-021-02302-6 |
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