The impact of coexistent Hashimoto's thyroiditis on lymph node metastasis and prognosis in papillary thyroid microcarcinoma

Tumour Biol. 2016 Jun;37(6):7685-92. doi: 10.1007/s13277-015-4534-4. Epub 2015 Dec 21.

Abstract

The impact of coexistent Hashimoto's thyroiditis (HT) on lymph node metastasis (LNM) and prognosis in papillary thyroid microcarcinoma (PTMC) remains controversial. We evaluated the association of coexistent HT with clinicopathologic parameters, LNM, and prognosis by retrospectively reviewing a series of consecutive patients treated for PTMC at Fudan University Cancer Center from January 2005 to December 2010. Of all 1,250 patients with complete data for analysis, 364 (29.1 %) had coexistent HT (HT group) and 886 patients (70.9 %) had no evidence of HT (control group). The HT group had higher proportion of female (87.9 vs 70.1 %) patients, higher mean level of thyroid-stimulating hormone (TSH) (2.39 vs 2.00 mIU/L), and lower incidence of extrathyroidal extension (7.4 vs 11.7 %) than those in the control group. However, the incidence of LNM and recurrence was similar between the two groups, and HT was not associated with LNM and recurrence. A series of clinicopathologic factors identified for predicting LNM and recurrence in the control group did not show any prediction in the HT group. In summary, this study suggested that coexistent HT had insignificant protective effect on LNM and prognosis in PTMC, which was inconsistent with prior studies. Further studies aiming to determine novel predictors are recommended in PTMC patients with coexistent HT.

Keywords: Hashimoto’s thyroiditis; Lymph node metastasis; Papillary thyroid microcarcinoma; Prognosis.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autoantibodies / blood
  • Carcinoma, Papillary / epidemiology*
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / surgery
  • China / epidemiology
  • Comorbidity
  • Female
  • Hashimoto Disease / blood
  • Hashimoto Disease / epidemiology*
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Prognosis
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Thyroid Neoplasms / epidemiology*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery
  • Thyroidectomy / methods
  • Thyroxine / therapeutic use
  • Young Adult

Substances

  • Autoantibodies
  • anti-thyroglobulin
  • Thyroxine

Supplementary concepts

  • Papillary Thyroid Microcarcinoma