Relationship between lymphovascular invasion and clinicopathological features of papillary thyroid carcinoma

  • Atakan Sezer Department of Surgery, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Mehmet Celik Department of Endocrinology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Buket Yilmaz Bulbul Department of Endocrinology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Nuray Can Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Ebru Tastekin Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Semra Ayturk Department of Endocrinology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Funda Ustun Department of Nuclear Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Sibel Guldiken Department of Endocrinology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Necdet Sut Department of Biostatistics, Faculty of Medicine, Trakya University, Edirne, Turkey
Keywords: Papillary thyroid carcinoma, clinicopathological features, lymphovascular, PTC, LVI, lymphovascular invasion, BRAFV600E mutation

Abstract

Lymphovascular invasion (LVI) is an important prognostic factor in various solid tumors, however, data on the association between LVI and thyroid carcinomas are limited. In this study, we evaluated the relationship between LVI and clinicopathological features of papillary thyroid carcinoma (PTC). Six hundred seventy-eight patients diagnosed with PTC between 2012 and 2015 were included into the study. Patients were classified based on the presence or absence of LVI. Gender, age, ultrasonography (US), tumor size and multifocality, BRAFV600E mutation, perineural and capsular invasion, extrathyroid extension (ETE), nodal metastasis, and recurrences were evaluated, and risk analysis was performed for each parameter. The number of patients with LVI [LVI (+)] was 63, while the number of patients without LVI [LVI (-)] was 615. The female/male ratio was 564/114. LVI was present in 18.4% of male patients and in 7.4 % of female patients. In the age group between 17-25 years LVI was detected in 6/13 patients, and this result was statistically significant compared to other age groups (p = 0.004). Suspicious lymph nodes upon US, perineural or capsular invasion, ETE, tumor size, and nodal metastasis were significantly more frequent in LVI (+) group (p < 0.001). The frequency of BRAFV600E mutation was also significantly higher in LVI (+) group (p < 0.001). Overall, the presence of LVI was associated with gender, tumor size, age, lymph node metastasis, pathological lymph nodes, perineural and capsular invasion, ETE, and BRAFV600E mutation. These results suggest that in PTC patients undergoing thyroidectomy, the presence of LVI should be considered as an indicator of aggressive clinicopathological features and those patients should be followed up carefully for recurrences and metastasis.