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。