PDF(Pubmed)
Abstract：
Hashimoto\'s thyroiditis (HT) is often associated with papillary thyroid carcinoma (PC); it is still a matter of controversy whether the behavior of carcinoma is more aggressive or not. During the follow-up, we retrospectively enrolled 97 patients with PC/HT after thyroidectomy without risk factors at the surgery of the primary tumor, such as multifocality/multicentricity, extrathyroid tumor extension, vascular invasion, neck and distant metastases, and aggressive histological variants. HT diagnosis was confirmed by histology and serum thyroid antibodies. Tumor size was ≤10 mm in 64 cases (microcarcinomas); 206 matched PC patients after thyroidectomy without HT and risk factors were enrolled as controls, totaling 122 microcarcinomas. During follow-up, metastases occurred in 15/97 (15.5%) PC/HT cases, eight microcarcinomas, and in 16/206 (7.8%) without HT, eight microcarcinomas (p = 0.04). Considering both PC/HT and PC patients without HT who developed metastases, univariate analysis showed an increased risk of metastases in patients with HT coexistence, OR: 2.17 (95% CI 1.03-4.60) p = 0.043. Disease-free survival (DFS) was significantly (p = 0.0253) shorter in PC/HT than in the controls. The present study seems to demonstrate that HT is not a cancer protective factor in PC patients given the less favorable outcomes and significantly shorter DFS. HT may also represent an independent recurrence predictor without other risk factors.
摘要：
桥本氏甲状腺炎（HT）常与甲状腺乳头状癌（PC）相关；癌的行为是否更具侵袭性仍存在争议。在后续行动中,我们回顾性纳入了97例甲状腺切除术后PC/HT患者，在原发肿瘤手术中没有危险因素，如多焦点/多中心，甲状腺外肿瘤扩展，血管浸润,颈部和远处转移，和侵袭性组织学变异。HT诊断通过组织学和血清甲状腺抗体证实。64例（微小癌）肿瘤大小≤10mm；206例甲状腺切除术后无HT和危险因素的PC患者作为对照。总共122个微小癌.随访期间,转移发生在15/97(15.5%)PC/HT病例中，八种微癌，在没有HT的16/206（7.8％）中，八个微癌（p=0.04）。考虑到PC/HT和无HT的PC患者发生转移，单因素分析显示HT共存患者的转移风险增加，OR：2.17（95%CI1.03-4.60）p=0.043。PC/HT的无病生存期（DFS）明显短于对照组（p=0.0253）。本研究似乎表明，在预后较差且DFS明显较短的情况下，HT不是PC患者的癌症保护因素。HT也可能是独立的复发预测因子，没有其他危险因素。
