Coagulation and thyroiditis are factors associated with adverse pathological features in differentiated thyroid cancer: a retrospective cohort study.

Objective: Lymph node metastasis (LNM) and thyroid capsular invasion (CI) are the main pathological features leading to poor prognosis of differentiated thyroid cancer (DTC), and there is a lack of effective diagnostic methods before surgery. Therefore, this study was designed to analyze a large number of preoperative clinical features of DTC and identify factors closely related to those two pathological features.

Methods: 4557 patients with DTC, postoperative pathological results showed LNM in 2146 cases and CI in 2783 cases were retrospectively included. The preoperative blood, urine, serum laboratory test and ultrasound of thyroid were performed for data collection. A total of 74 clinical features were analyzed by the methods of principal component analysis (PCA), and key principal components were extracted for regression analysis of LNM and CI as well as subgroup analysis.

Results: 11 key clinical features were used for principal component analysis, and 6 principal components PC0-PC5 were finally obtained. PC0 is mainly composed of prothrombin time and international normalized ratio, and the score represents better coagulation function and has a protective effect on LNM. PC1 is mainly composed of thyroid peroxidase antibody and thyroid texture, and the score represents the severity of thyroiditis and has a protective effect on LNM and CI.

Conclusion: Thyroiditis and coagulation function were identified by principal component analysis as protective and risk factors for adverse pathology of DTC, meaning they were closely related to tumor metastasis and invasion.