Objective Using bioinformatics, we analyzed the immune landscape and gene expression patterns associated with CD8+ T-cell subtypes in papillary thyroid carcinoma, constructed a prognostic model, and performed analyses of immune infiltration characteristics. MethodsWe integrated single-cell RNA sequencing and bulk transcriptomic data and, using differential expression analysis, cell differentiation trajectory analysis, consensus clustering, and LASSO-Cox proportional hazards regression, identified CD8+ T-cell subtype-associated prognostic genes. We then developed and evaluated a risk-score prognostic model and used it to analyze immune infiltration and predict responses to immunotherapy. ResultsWe subdivided tumor-infiltrating CD8+ T cells in papillary thyroid carcinoma into 6 subtypes and using pseudotime analysis and differentiation scoring, identified CD8+ T-cells_1 as the putative origin of differentiation. We selected nine prognostic genes (LAIR2, RGS2, DEDD2, HSPA6, KLRB1, DNAJB1, CCL5, CX3CR1, and MT1M) to construct and evaluate a prognostic model. Receiver operating characteristic (ROC) curves for the training, validation, and combined cohorts demonstrated that the model has good predictive performance for 3-, 5-, and 10-year overall survival in patients with papillary thyroid carcinoma. Patients in the high-risk group had significantly shorter overall survival than those in the low-risk group (P=0.021) and exhibited lower levels of immune cell infiltration, while the low-risk group showed a higher response rate to immunotherapy (P<0.05). ConclusionsThis prognostic model can effectively predict the prognosis, immune infiltration characteristics, and response to immunotherapy in patients with papillary thyroid carcinoma, providing a theoretical basis for clinical prognostic assessment and the development of personalized treatment strategies.
ObjectiveTo summarize the clinicopathological characteristics of papillary thyroid cancer (PTC) in adolescents and analyze the risk factors affecting lateral lymph node metastasis and prognosis. MethodsIn retrospectively, 150 adolescent PTC patients admitted to the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2022 and meeting the inclusion and exclusion criterias were collected as the study subjects (adolescent group), and 100 adult PTC patients were selected as adult group. Statistical analysis was performed with SPSS 25.0 software to compare the clinicopathological characteristics of the patients in the two groups, and to explore the risk factors for lateral lymph node metastasis and recurrence in adolescent PTC patients by using logistic regression and Cox proportional hazards regression models, respectively. ResultsAdolescents with PTC were more prone to extrandular invasion [30.0% (45/150) versus 17.0% (17/100), P=0.020], neck lymph node metastasis [79.3% (119/150) versus 48.0% (48/100), P<0.001], central lymph node metastasis [78.7% (118/150) versus 48.0% (48/100), P<0.001], lateral lymph node metastasis [44.0% (66/150) versus 12.0% (12/100), P<0.001]; and had a greater maximum tumor diameter (1.75 cm versus 0.75 cm, P＜0.001) and higher ratio of greater maximum tumor diameter ＞2 cm [45.3% (68/150) versus 8.0% (8/100), P＜0.001] in adolescent PTC patients. In adolescent PTC patients, extraglandular invasion (OR=2.654, P=0.022), multifoci (OR=4.860, P<0.001) and maximum tumor diameter>2 cm (OR=3.845, P=0.001) were risk factors for lateral lymph node metastasis; lateral lymph node metastasis (RR=10.105, P=0.040) and distant metastasis (RR=7.058, P=0.003) were predictors of postoperative recurrence in adolescent PTC patients. ConclusionsCompared with adult PTC patients, adolescent PTC patients have more aggressive tumors. Adolescent PTC with extraglandular invasion, multilesions, and maximum tumor diameter>2 cm should be considered for lateral lymph node dissection; and adolescent PTC patients with lateral lymph node metastasis and distant metastasis should pay close attention to their recurrence status.