{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:14:18Z","timestamp":1781777658072,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T00:00:00Z","timestamp":1529625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diffuse lymphocytic infiltration (DLI) is frequently found with papillary thyroid cancer (PTC), so there has been long interest in how it affects the characteristics of PTC. This purpose of this study was to define the association between DLI and PTC aggressiveness according to thyroperoxidase antibody (TPOAb) and B\u2010type Raf (BRAF)<jats:sup>V600E<\/jats:sup> mutation positivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>There were 1879 patients with PTC who underwent surgery and were enrolled in this study. Clinicopathologic characteristics were compared between groups according to the presence of DLI and TPOAb. Multiple logistic regression analysis was conducted to assess odds ratio (OR) for each dependent variable (BRAF<jats:sup>V600E<\/jats:sup> mutation, tumor size &gt;1.0 cm, multifocality, extrathyroidal extension, and lymph node metastasis) of each group according to the presence of DLI and TPOAb, with the group with neither DLI or TPOAb (DLI\u2010negative TPOAb\u2010negative PTC) as the reference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The DLI\u2010positive PTC showed more frequent multifocality and less frequent BRAF<jats:sup>V600E<\/jats:sup> mutation than DLI\u2010negative PTC. Among patients with DLI\u2010positive PTC, extrathyroidal extension and BRAF<jats:sup>V600E<\/jats:sup> mutation was less frequent when serum TPOAb was positive. In multiple logistic regressions, DLI\u2010positive TPOAb\u2010positive PTC showed a high OR for multifocality (1.410; <jats:italic>P<\/jats:italic> = .017), but low ORs for BRAF<jats:sup>V600E<\/jats:sup> mutation (0.521; <jats:italic>P<\/jats:italic> &lt; .001) and extrathyroidal extension (0.691; <jats:italic>P<\/jats:italic> = .008). The patients with DLI\u2010positive TPOAb\u2010positive PTCs showed a high OR for multifocality (1.588; <jats:italic>P<\/jats:italic> = .002), and high ORs for tumor size &gt;1.0 cm (2.205; <jats:italic>P<\/jats:italic> = .019) and lymph node metastasis (2.005; <jats:italic>P<\/jats:italic> = .032) in subgroup analyses of PTC with wild\u2010type BRAF. The DLI\u2010negative TPOAb\u2010positive group was not associated with any tumor aggressiveness\u2010related variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although DLI was associated with multifocality regardless of TPOAb positivity, it was associated with an indolent feature when TPOAb was positive but with aggressive features in PTC with wild\u2010type BRAF when TPOAb was negative. The TPOAb and BRAF status may help to define the clinical implication of lymphocytic infiltration found with PTC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.25327","type":"journal-article","created":{"date-parts":[[2018,6,23]],"date-time":"2018-06-23T06:45:56Z","timestamp":1529736356000},"page":"2271-2279","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAF<sup>V600E<\/sup> mutation"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0330-7684","authenticated-orcid":false,"given":"Young Ki","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of 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Yeob","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kee Hyun","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Surgery Yonsei University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woong Youn","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Surgery Yonsei University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Jig","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of 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