Abstract
OBJECTIVE: Papillary thyroid cancer (PTC) progression is characterized by lymph node metastasis and thyroid capsular invasion. This study aimed to identify high-risk PTC populations for these events based on peripheral blood test parameters and to determine the associated factors. METHODS: This retrospective study analyzed data from 4557 PTC patients. Principal component analysis (PCA) and cluster analysis were performed on 45 peripheral blood test results. High- and low-risk clusters were defined based on metastasis and invasion prevalence. Univariate and multivariate analyses identified parameters significantly differentiating the clusters, examining their association with tumor progression. RESULTS: Preoperative blood tests stratified patients into two distinct clusters. Cluster 0 demonstrated significantly higher rates of metastasis and invasion than Cluster 1, defining it as the high-risk group. PCA identified four principal components significantly differentiating the clusters. Analysis of these components revealed key peripheral blood parameters. Multivariable logistic regression identified six parameters associated with increased risk of Cluster 0: alanine aminotransferase, free triiodothyronine, thrombin time, hemoglobin, hematocrit, and leukocyte count. Conversely, aspartate aminotransferase and neutrophil count were associated with decreased risk. CONCLUSION: These findings suggest that peripheral blood parameters may provide insights into the progression of thyroid tumors and highlight potential avenues for exploring the underlying mechanisms of PTC. However, given the retrospective nature of this study and the potential for selection bias, further prospective studies are necessary to validate these results and confirm their predictive value in clinical practice.