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Background <p>Preoperative risk stratification for cervical lymph node metastasis (LNM) is challenging in papillary thyroid carcinoma (PTC), metabolic disturbances may contribute to tumor progression and metastasis. This large retrospective cohort study investigated clinical and metabolic profiles to identify independent metabolic correlates associated with cervical LNM, which may complement preoperative risk assessment.</p> Methods <p>A retrospective cohort analysis of 1,003 PTC patients was performed. Preoperative variables (demographics, clinicopathological features, serum biochemical markers) were profiled; univariate and multivariable logistic regression analyses were utilized to identify independent metabolic factors associated with central (CLNM) and lateral LNM (LLNM).</p> Results <p>Among 1,003 patients, 35.19% and 3.79% presented with CLNM and LLNM, respectively. The LLNM subgroup was small (<i>n</i> = 38), which limited statistical power and generalizability of the corresponding findings. Multivariable analysis identified HDL-C (<i>OR</i> = 0.63, <i>P</i> = 0.040) as a factor independently associated with CLNM, and 25(OH)D (<i>OR</i> = 0.97, <i>P</i> = 0.012) with LLNM. Patients with 25(OH)D deficiency (&lt; 50 nmol/L) had a higher LLNM incidence than those with sufficient levels (5.07% vs. 1.95%, <i>P</i> &lt; 0.05). Tumor size remained a robust risk factor for both compartments, whereas BRAF V600E mutation showed no significant independent association with metastasis in this dataset (<i>P</i> &gt; 0.05).</p> Conclusion <p>Our findings suggest that preoperative serum 25(OH)D and HDL-C are associated with site-specific LNM in PTC. These markers may complement preoperative risk stratification, although current evidence remains inconsistent. Given the retrospective, single-center design and small subgroup sizes, our results are preliminary and hypothesis-generating. Further prospective studies are needed to validate their clinical role.</p>

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Serum 25(OH)D and HDL-C as site-specific metabolic markers of cervical lymph node metastasis in papillary thyroid carcinoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Shanyu Yin,
  • Nannan Lv,
  • Guo Tian,
  • Jianjian Xiang,
  • Danlei Lu,
  • Tian’an Jiang,
  • Ying Hu

摘要

Background

Preoperative risk stratification for cervical lymph node metastasis (LNM) is challenging in papillary thyroid carcinoma (PTC), metabolic disturbances may contribute to tumor progression and metastasis. This large retrospective cohort study investigated clinical and metabolic profiles to identify independent metabolic correlates associated with cervical LNM, which may complement preoperative risk assessment.

Methods

A retrospective cohort analysis of 1,003 PTC patients was performed. Preoperative variables (demographics, clinicopathological features, serum biochemical markers) were profiled; univariate and multivariable logistic regression analyses were utilized to identify independent metabolic factors associated with central (CLNM) and lateral LNM (LLNM).

Results

Among 1,003 patients, 35.19% and 3.79% presented with CLNM and LLNM, respectively. The LLNM subgroup was small (n = 38), which limited statistical power and generalizability of the corresponding findings. Multivariable analysis identified HDL-C (OR = 0.63, P = 0.040) as a factor independently associated with CLNM, and 25(OH)D (OR = 0.97, P = 0.012) with LLNM. Patients with 25(OH)D deficiency (< 50 nmol/L) had a higher LLNM incidence than those with sufficient levels (5.07% vs. 1.95%, P < 0.05). Tumor size remained a robust risk factor for both compartments, whereas BRAF V600E mutation showed no significant independent association with metastasis in this dataset (P > 0.05).

Conclusion

Our findings suggest that preoperative serum 25(OH)D and HDL-C are associated with site-specific LNM in PTC. These markers may complement preoperative risk stratification, although current evidence remains inconsistent. Given the retrospective, single-center design and small subgroup sizes, our results are preliminary and hypothesis-generating. Further prospective studies are needed to validate their clinical role.