甲状腺乳头状癌（PTC）术后复发可能性较高，术后治疗多采用促甲状腺激素（TSH）抑制和放射性碘（131I）治疗。本研究探讨淋巴结转移（LNM）的潜在机制，旨在为PTC制定差异化治疗方案。本研究通过分析2073例PTC的临床资料，探讨PTC淋巴结转移的危险因素。对甲状腺癌癌症基因组图谱（TCGA-THCA）和基因表达综合数据库（GEO）的基因表达进行分析，以确定基因表达与表型之间的相互关系。分析临床数据，我们发现男性、年龄较小、肿瘤较大大小、甲状腺外延伸（ETE）是淋巴结转移的显着危险因素（P<0.05）。相反，TSH、FT3、FT4、TSH/FT3、TSH/FT4等甲状腺功能参数与LNM无相关性(P>0.05)，且女性TSH水平较高(P<0.05)。基因表达分析显示，SLC5A5在男性、年轻个体和有淋巴结转移的个体中表达下调，且较低水平的SLC5A5与较差的无病生存率相关（P<0.05）。此外，我们对单细胞 RNA 测序 (scRNA-seq) 数据的检查表明，肿瘤和淋巴结转移样本中 SLC5A5 表达降低，与 TSHR 的表达呈正相关。 TSH 对 PTC 行为的影响仍不清楚，而依赖于 SLC5A5 的 131I 吸收能力在不同性别和年龄之间表现出差异。我们得出结论，PTC术后治疗应考虑性别和年龄引起的差异。版权所有©2024 Yan，Sun，He和Jia。

Thyroid papillary carcinoma (PTC) had a high possibility of recurrence after surgery, and thyroid stimulating hormone (TSH) suppression and radioactive iodine (131I) were used for postoperative therapy. This study explored the potential mechanism of lymph node metastasis (LNM) and aimed to develop differentiated treatments for PTC.This study explored the risk factors of lymph node metastasis in PTC by analyzing the clinical information of 2073 cases. The Cancer Genome Atlas Thyroid Cancer (TCGA-THCA) and the Gene Expression Omnibus (GEO) databases of gene expression were analyzed to identify the interrelationships between gene expression to phenotype.Analyzing clinical data, we found that male gender, younger age, larger tumor size, and extra-thyroidal extension (ETE) were risk significant risk factors for lymph node metastasis(P<0.05). Conversely, thyroid function parameters such as TSH, FT3, FT4, TSH/FT3, and TSH/FT4 didn't correlate with LNM(P>0.05), and TSH levels were observed to be higher in females(P<0.05). Gene expression analysis revealed that SLC5A5 was down-regulated in males, younger individuals, and those with lymph node metastasis, and a lower level of SLC5A5 was associated with a worse disease-free survival(P<0.05). Additionally, our examination of single-cell RNA sequencing (scRNA-seq) data indicated that SLC5A5 expression was reduced in tumors and lymph node metastasis samples, correlating positively with the expression of TSHR.The impact of TSH on PTC behavior remained unclear, while the capacity for absorbing 131I in dependence on SLC5A5 showed variations across different genders and ages. We conclude that postoperative treatment of PTC should take into account the differences caused by gender and age.Copyright © 2024 Yan, Sun, He and Jia.