Papillary thyroid carcinoma: does the association with Hashimoto's thyroiditis affect the clinicopathological characteristics of the disease?

INTRODUCTION: Papillary carcinoma is the most common malignant thyroid neoplasm. The effect of the concurrent presence of Hashimoto's thyroiditis and papillary thyroid carcinoma remains controversial. OBJECTIVE: To evaluate the association between Hashimoto's thyroiditis and clinicopathological parameters in thyroid papillary carcinoma cases, based on an historical institutional cohort analysis. METHODS: Cross-sectional study obtained from a historical cohort, including all cases submitted to thyroidectomy for papillary thyroid carcinoma in a single institution during an 11-year period study. RESULTS: A total of 417 patients with papillary thyroid carcinoma were enrolled; 148 (35.4%) also had Hashimoto's thyroiditis. A female predominance among cases associated to Hashimoto's thyroiditis was observed. The thyroid tumor, in cases associated with Hashimoto's thyroiditis, had a smaller mean diameter, lower frequency of extra-thyroid extension, and earlier clinicopathological staging. CONCLUSIONS: A high proportion of papillary thyroid carcinoma cases are associated with Hashimoto's thyroiditis. There are associations among these cases with several histopathological factors already recognized for their prognostic value, which by themselves could impact outcomes.

引言：甲状腺乳头状癌（Papillary carcinoma）是最为常见的甲状腺恶性肿瘤。桥本甲状腺炎（Hashimoto's thyroiditis）与甲状腺乳头状癌合并存在的临床意义仍存在争议。
目的：本研究通过回顾性机构队列分析，评估甲状腺乳头状癌患者中桥本甲状腺炎与临床病理参数之间的关联。
方法：本研究为基于回顾性队列的横断面研究，纳入某单一医疗机构在11年研究周期内所有因甲状腺乳头状癌接受甲状腺切除术的病例。
结果：本研究共纳入417例甲状腺乳头状癌患者，其中148例（35.4%）合并桥本甲状腺炎。合并桥本甲状腺炎的患者群体中女性占比更高。相较于未合并者，合并桥本甲状腺炎的甲状腺肿瘤平均直径更小，甲状腺外侵犯发生率更低，临床病理分期更早。
结论：甲状腺乳头状癌病例中合并桥本甲状腺炎的比例较高。此类病例存在多项已被证实具有预后价值的组织病理学特征关联，这些特征本身即可对患者预后结局产生影响。