{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:20:14Z","timestamp":1793056814220,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Joint Fund Project for \u201cUSTC New Medicine\u201d","award":["YD9110002030"],"award-info":[{"award-number":["YD9110002030"]}]},{"name":"Joint Fund for Medical Artificial Intelligence","award":["MAI2023Q020"],"award-info":[{"award-number":["MAI2023Q020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prognostic significance of lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) remains controversial. Notably, there is evidence suggesting an association between tissue stiffness and the aggressiveness of the disease. We therefore aimed to explore the effect of tissue stiffness on LNM-related invasiveness in PTC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A total of 2492 PTC patients from 3 hospitals were divided into an LNM group and a non-LNM group based on their pathological results. The effects of interior lesion stiffness (E) and peri-cancerous tissue stiffness (Eshell) on the LNM-related recurrence rate and mortality in each patient with PTC subgroup were analyzed. The activation of cancer-associated fibroblasts (CAFs) and extracellular matrix component type 1 collagen (COL-I) in the lesion were compared and analyzed across different subgroups. The underlying biological basis of differences in each subgroup was identified using RNA sequencing (RNA-seq) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Eshell value and Eshell\/E in the LNM group were significantly higher than those in the non-LNM group of patients with PTC (Eshell: 72.72\u2005\u00b1\u20055.63 vs 66.05\u2005\u00b1\u20054.46; Eshell\/E: 1.20\u2005\u00b1\u20051.72 vs 1.09\u2005\u00b1\u20051.10, P\u2005&amp;lt;\u2005.001). When Eshell\/E\u2005&amp;gt;\u20051.412 and LNM were both present, the recurrence rate and mortality were significantly increased compared to those of group of patients with LNM (91.67% and 7.29%, respectively). The CAF activation and COL-I content in the Eshell\/E+ group were significantly higher than those in the Eshell\/E\u2212 group (all P\u2005&amp;lt;\u2005.001), and the RNA-seq results revealed significant extracellular matrix (ECM) remodeling in the LNM-Eshell\/E+ group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stiff peri-cancerous tissue induced CAF activation, COL-I deposition, and ECM remodeling, resulting in a poor prognosis for PTC patients with LNM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyae086","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T19:43:18Z","timestamp":1713555798000},"page":"e1132-e1148","source":"Crossref","is-referenced-by-count":13,"title":["Enhanced stiffness in peri-cancerous tissue: a marker of poor prognosis in papillary thyroid carcinoma with lymph node metastasis"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6871-3547","authenticated-orcid":false,"given":"Lei","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of People\u2019s Republic of China , Hefei, Anhui 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of People\u2019s Republic of China , Hefei, Anhui 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First People\u2019s Hospital of Hefei City, The Third Affiliated Hospital of Anhui Medical University , Hefei 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery, The First Affiliated Hospital of USTC, University of Science and Technology of People\u2019s Republic of China , Hefei, 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoxue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University , Hefei, Anhui 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Affiliated Hospital of Anhui Medical University , Hefei, Anhui 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nianan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of People\u2019s Republic of China , Hefei, Anhui 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifu","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of USTC, University of Science and Technology of People\u2019s Republic of China , Hefei 230001 , People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"issue":"10387","key":"2024090704221444500_CIT0001","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1016\/S0140-6736(23)00020-X","article-title":"Thyroid cancer","volume":"401","author":"Chen","year":"2023","journal-title":"The Lancet"},{"issue":"1","key":"2024090704221444500_CIT0002","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1186\/s12893-020-00974-7","article-title":"Using ultrasound features and radiomics analysis to predict lymph node metastasis in patients with thyroid cancer","volume":"20","author":"Li","year":"2020","journal-title":"BMC Surg"},{"issue":"2021","key":"2024090704221444500_CIT0003","first-page":"713475","article-title":"Preoperatively predicting the central lymph node metastasis for papillary thyroid cancer patients with hashimoto\u2019s 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