J Cancer 2022; 13(8):2673-2682. doi:10.7150/jca.71514 This issue

Research Paper

Fasting serum glucose and lymph node metastasis in non-diabetic PTC patients: a 10-Year multicenter retrospective study

Yushu Liu1,2*, Jiantao Gong1,2*, Yanyi Huang1,2*, Shanshan Xing1,2, Ling Chen3, Tao Yi4, Zhiyong Wang5,✉, Yunxia Lv1,✉

1. Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
2. The second clinical medicine college, Medical Department, Nanchang University, Nanchang, Jiangxi, China.
3. Department of General Surgery, The First Affiliated Hospital of Jiangxi Medical College, Shangrao, Jiangxi, China.
4. Department of Otolaryngology, Yichun People's Hospital, Yichun, Jiangxi, China.
5. Department of Otolaryngology, Xinfeng County People's Hospital, Ganzhou, Jiangxi, China.
*Yushu Liu, Jiantao Gong and Yanyi Huang contributed equally to this work.

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Liu Y, Gong J, Huang Y, Xing S, Chen L, Yi T, Wang Z, Lv Y. Fasting serum glucose and lymph node metastasis in non-diabetic PTC patients: a 10-Year multicenter retrospective study. J Cancer 2022; 13(8):2673-2682. doi:10.7150/jca.71514. Available from https://www.jcancer.org/v13p2673.htm

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Graphic abstract

Background: Mostly current studies are limited to the impact of lymph node metastasis(LNM) on the prognosis of papillary thyroid cancer(PTC) or the impact of glucose metabolism on the occurrence of PTC, but no one has paid attention to the connection between fasting serum glucose(FSG) and LNM. The purpose of our study was to explore the relationship between FSG and LNM in non-diabetic PTC patients.

Methods: In this study, we performed a multicenter, retrospective study on 6034 non-diabetic patients with PTC. The associations of FSG with three types of LNM including central lymph node metastasis (CLNM), lateral cervical lymph node metastasis (LLNM) and both were estimated.

Results: Compared with PTC patients without LNM, those with LNM had higher FSG. We also found that FSG was associated with tumor extension, maximum tumor diameter and TSH. In order to further explore the association between FSG and different types of LNM, we analyzed three groups of data separately. Our study reveals that by comparing FSG between patients without LNM and patients with three LNM types, it was statistically different in the PTC patients with CLNM and the PTC patients with CLNM combined with LLNM.

Conclusion: Our study provides evidence for the association of FSG and LNM in non-diabetic PTC patients, with a gradual increase in FSG over the course of the PTC from no lymph node metastasis to CLNM combined with LLNM. Meanwhile, higher FSG is a risk factor for CLNM and CLNM combined with LLNM. In the future, FSG might be used as an indicator for lymph node dissection in PTC patients. However, larger relative studies are needed.

Keywords: Papillary thyroid carcinoma, Fasting serum glucose, Lymph node metastasis