{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T06:23:57Z","timestamp":1787207037047,"version":"build-2736575974"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the impact of Hashimoto\u2019s thyroiditis (HT) on central lymph node metastasis (CLNM) patterns and identify independent risk factors for CLNM in patients with papillary thyroid carcinoma (PTC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study enrolled 668 cN0 PTC patients who underwent initial surgery at Huizhou Central People\u2019s Hospital between August 2024 and July 2025. Patients were stratified into an HT-PTC group (n = 117) and a PTC-only group (n = 551) based on postoperative histopathological findings. Clinicopathological features and CLNM characteristics were systematically compared. Multivariable logistic regression was utilized to identify independent risk factors for CLNM in patients with HT-PTC, and the predictive efficacy of the resulting model was validated using ROC curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The HT-PTC group exhibited significantly higher rates of multifocality and central lymph node dissection, alongside lower BMI and serum thyroglobulin (Tg) levels, compared with the PTC-only group (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt;\u00a00.05). While the incidence of CLNM did not differ significantly between groups (35.0% vs. 33.9%,\n                      <jats:italic>P<\/jats:italic>\n                      =\u00a00.819), the metastatic lymph node ratio (LNR) was significantly lower in the HT-PTC group (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt;\u00a00.001). Multivariate analysis identified tumor diameter &amp;gt; 1\u00a0cm as an independent risk factor for CLNM among HT-PTC patients (OR\u00a0=\u00a03.678; 95% CI: 1.587\u20138.520,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.002). The predictive model demonstrated moderate efficacy (AUC\u00a0=\u00a00.649). Notably, the incidence of CLNM in HT-PTC patients with microcarcinoma (\u2264 1\u00a0cm) was only 25.9%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Concomitant HT is associated with a reduced metastatic burden rather than an increased prevalence of CLNM in patients with PTC. Tumor diameter &amp;gt; 1\u00a0cm serves as an independent predictor of CLNM. For HT-PTC patients with tumors \u2264 1\u00a0cm and no other high-risk factors, the necessity of prophylactic central lymph node dissection warrants individualized assessment combining clinical data and intraoperative observations to avoid overtreatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1929155","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:29:16Z","timestamp":1787203756000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Coexistent Hashimoto\u2019s thyroiditis modulates lymph node metastasis burden in papillary thyroid carcinoma: a single-center study in South China"],"prefix":"10.3389","volume":"17","author":[{"given":"Tianyu","family":"Gan","sequence":"first","affiliation":[{"name":"Department of Thyroid Surgery, Huizhou Central People\u2019s Hospital","place":["Huizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyuan","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Dongguan Songshan Lake Central Hospital","place":["Dongguan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guansheng","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Thyroid Surgery, Huizhou Central People\u2019s Hospital","place":["Huizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0333373","article-title":"Trends in the disease burden of thyroid cancer among adolescents and young adults: a comparative study of China and global estimates (1990\u20132021)","volume":"20","author":"Qian","year":"2025","journal-title":"PloS One"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(25)00289-X","article-title":"Thyroid cancer in adolescents and young adults: a population-based study in 185 countries worldwide","volume":"14","author":"Li","year":"2026","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1001\/jama.2017.2719","article-title":"Trends in thyroid cancer incidence and mortality in the United States, 1974-2013","volume":"317","author":"Lim","year":"2017","journal-title":"Jama"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1288527","article-title":"Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study","volume":"14","author":"Du","year":"2023","journal-title":"Front Endocrinol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"121","DOI":"10.20892\/j.issn.2095-3941.2018.0125","article-title":"Risk factors for cervical lymph node metastasis in papillary thyroid microcarcinoma: a study of 1,587 patients","volume":"16","author":"Xiangqian","year":"2019","journal-title":"Cancer Biol Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.819824","article-title":"Risk factors for central lymph node metastases and benefit of prophylactic central lymph node dissection in Middle Eastern patients with cN0 papillary thyroid carcinoma","volume":"11","author":"Parvathareddy","year":"2022","journal-title":"Front Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/medsci13020043","article-title":"A scoping review on the prevalence of Hashimoto\u2019s thyroiditis and the possible associated factors","volume":"13","author":"Vargas-Uricoechea","year":"2025","journal-title":"Med Sci"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.20452\/pamw.16222","article-title":"Hashimoto thyroiditis: an evidence-based guide: etiology, diagnosis and treatment","volume":"132","author":"Klubo-Gwiezdzinska","year":"2022","journal-title":"Pol Arch Intern Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-012-9703-2","article-title":"The incidence and prevalence of thyroid autoimmunity","volume":"42","author":"McLeod","year":"2012","journal-title":"Endocrine"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2017.00053","article-title":"Association between Hashimoto\u2019s thyroiditis and thyroid cancer in 64,628 patients","volume":"7","author":"Resende De Paiva","year":"2017","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.801925","article-title":"Hashimoto\u2019s thyroiditis: a \u201cdouble-edged sword\u201d in thyroid carcinoma","volume":"13","author":"Xu","year":"2022","journal-title":"Front Endocrinol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.18526","article-title":"Prevalence of Hashimoto thyroiditis in adults with papillary thyroid cancer and its association with cancer recurrence and outcomes","volume":"4","author":"Xu","year":"2021","journal-title":"JAMA Netw Open"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2018.33.4.473","article-title":"Associations between Hashimoto thyroiditis and clinical outcomes of papillary thyroid cancer: a meta-analysis of observational studies","volume":"33","author":"Moon","year":"2018","journal-title":"Endocrinol Metab"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.21037\/gs-24-445","article-title":"Prevalence of Hashimoto\u2019s thyroiditis in papillary thyroid cancer and its association with aggressive characteristics","volume":"14","author":"Xu","year":"2025","journal-title":"Gland Surg"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1155\/jimr\/7192808","article-title":"Research progress on the immunological correlation between papillary thyroid carcinoma and Hashimoto\u2019s thyroiditis","volume":"2025","author":"Fang","year":"2025","journal-title":"J Immunol Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1551271","article-title":"Mechanisms underlying the promotion of papillary thyroid carcinoma occurrence and progression by Hashimoto\u2019s thyroiditis","volume":"16","author":"Xue","year":"2025","journal-title":"Front Endocrinol Lausanne"},{"key":"B18","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3760\/cma.j.cn311282-20221023-00589","article-title":"Guidelines for the diagnosis and management of thyroid nodules and differentiated thyroid cancer (Second edition","volume":"39","year":"2023","journal-title":"Chin J Endocrinol Metab"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1177\/10732748231199647","article-title":"Clinical and pathological characteristics of patients with papillary thyroid carcinoma coexisting with Hashimoto\u2019s thyroiditis: a retrospective cohort study","volume":"30","author":"Yang","year":"2023","journal-title":"Cancer Control"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1420998","article-title":"Correlation analysis of Hashimoto\u2019s thyroiditis with papillary thyroid carcinoma occurrence and its central lymph node metastasis: a single center experience","volume":"15","author":"Sun","year":"2025","journal-title":"Front Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1097\/01.MP.0000066800.44492.1B","article-title":"Estrogen receptors (\u03b1 and \u03b2) and 17\u03b2-hydroxysteroid dehydrogenase type 1 and 2 in thyroid disorders: possible in situ estrogen synthesis and actions","volume":"16","author":"Kawabata","year":"2003","journal-title":"Mod Pathol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2025.103803","article-title":"Research progress on estrogen and estrogen receptors in the occurrence and progression of autoimmune thyroid diseases","volume":"24","author":"Xie","year":"2025","journal-title":"Autoimmun Rev"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3892\/ijo_00000588","article-title":"Estradiol-induced proliferation of papillary and follicular thyroid cancer cells is mediated by estrogen receptors \u03b1 and \u03b2","volume":"36","author":"Klinge","year":"2010","journal-title":"Int J Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23126580","article-title":"Metabolic characteristics of Hashimoto\u2019s thyroiditis patients and the role of microelements and diet in the disease management\u2014an overview","volume":"23","author":"Mikulska","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1211231","article-title":"The interplay of oxidative stress and immune dysfunction in Hashimoto\u2019s thyroiditis and polycystic ovary syndrome: a comprehensive review","volume":"14","author":"Bat\u00f3g","year":"2023","journal-title":"Front Immunol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"393","DOI":"10.14639\/0392-100X-1709","article-title":"Clinical analysis of Hashimoto thyroiditis coexistent with papillary thyroid cancer in 1392 patients","volume":"37","author":"Liang","year":"2017","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1177\/11795549241287085","article-title":"Comparison and analysis of clinical features of papillary thyroid cancer complicated with Hashimoto\u2019s thyroiditis","volume":"18","author":"Zheng","year":"2024","journal-title":"Clin Med Insights Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1159\/000468928","article-title":"Thyroid autoimmunity and thyroid cancer: review focused on cytological studies","volume":"6","author":"Boi","year":"2017","journal-title":"Eur Thyroid J"},{"key":"B29","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1177\/0194599812472426","article-title":"Hashimoto\u2019s thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis","volume":"148","author":"Lun","year":"2013","journal-title":"Otolaryngol Neck Surg"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2019.101367","article-title":"Hashimotos\u2019 thyroiditis: epidemiology, pathogenesis, clinic and therapy","volume":"33","author":"Ragusa","year":"2019","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001475","article-title":"Risk factors of transient and permanent hypoparathyroidism after thyroidectomy: a systematic review and meta-analysis","volume":"110","author":"Ning","year":"2024","journal-title":"Int J Surg"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e26793","article-title":"The impact of coexisting Hashimoto\u2019s thyroiditis on the feasibility of endoscopic thyroidectomy in papillary thyroid carcinoma","volume":"10","author":"Wang","year":"2024","journal-title":"Heliyon"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2020.7013","article-title":"The significance of Hashimoto\u2019s thyroiditis for postoperative complications of thyroid surgery: a systematic review and meta-analysis","volume":"103","author":"Gan","year":"2021","journal-title":"Ann R Coll Surg Engl"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.909205","article-title":"BRAF V600E and RET\/PTC promote the activity of nuclear factor-\u03baB, inflammatory mediators, and lymph node metastasis in papillary thyroid carcinoma: a study of 50 patients in Inner Mongolia","volume":"24","author":"Zhou","year":"2018","journal-title":"Med Sci Monit"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.18620","article-title":"A meta-analysis of Hashimoto\u2019s thyroiditis and papillary thyroid carcinoma risk","volume":"8","author":"Lai","year":"2017","journal-title":"Oncotarget"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-021-00923-2","article-title":"Lymph node metastasis of papillary thyroid carcinoma in the context of Hashimoto\u2019s thyroiditis","volume":"22","author":"Wang","year":"2022","journal-title":"BMC Endocr Disord"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.772071","article-title":"The impact of coexistent Hashimoto\u2019s thyroiditis on central compartment lymph node metastasis in papillary thyroid carcinoma","volume":"12","author":"Liu","year":"2021","journal-title":"Front Endocrinol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S310773","article-title":"Influence factors for lymph node metastasis in papillary thyroid carcinoma: Hashimoto\u2019s thyroiditis has a weak effect on central or lateral lymph node metastasis","volume":"13","author":"Zhou","year":"2021","journal-title":"Cancer Manag Res"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2022.11.014","article-title":"A retrospective study of papillary thyroid carcinoma: Hashimoto\u2019s thyroiditis as a protective biomarker for lymph node metastasis","volume":"49","author":"Wang","year":"2023","journal-title":"Eur J Surg Oncol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1186\/s12957-021-02326-y","article-title":"Predicting factors of central lymph node metastasis and BRAFV600E mutation in Chinese population with papillary thyroid carcinoma","volume":"19","author":"Zhou","year":"2021","journal-title":"World J Surg Oncol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.11.038","article-title":"Vascular invasion predicts advanced tumor characteristics in papillary thyroid carcinoma","volume":"223","author":"Reilly","year":"2022","journal-title":"Am J Surg"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-17-0085","article-title":"Hashimoto\u2019s thyroiditis predicts outcome in intrathyroidal papillary thyroid cancer","volume":"24","author":"Marotta","year":"2017","journal-title":"Endocr Relat Cancer"},{"key":"B43","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12937-021-00676-7","article-title":"Iodine status five years after the adjustment of universal salt iodization: a cross-sectional study in Fujian Province, China","volume":"20","author":"Lin","year":"2021","journal-title":"Nutr J"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-023-03198-6","article-title":"Survey of iodized salt coverage in areas with different water iodine concentrations and the iodine status of local women","volume":"62","author":"Zhang","year":"2023","journal-title":"Eur J Nutr"},{"key":"B45","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1038\/s41598-020-80248-7","article-title":"Geographical influences on thyroid abnormalities in adult population from iodine-replete regions: a cross-sectional study","volume":"11","author":"Wang","year":"2021","journal-title":"Sci Rep"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1929155\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:29:21Z","timestamp":1787203761000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1929155\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":45,"alternative-id":["10.3389\/fendo.2026.1929155"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1929155","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"article-number":"1929155"}}