Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Head Neck. 2011 May;33(5):691-5. doi: 10.1002/hed.21518. Epub 2010 Nov 10.
Hashimoto's thyroiditis (HT) and higher levels of thyroid-stimulating hormone (TSH) have been proposed as risk factors for papillary thyroid cancer (PTC), but this issue is still being debated. The purpose of this study was whether HT was related to the risk of PTC over TSH.
We enrolled 1329 patients (1028 with PTC, 52 with follicular thyroid cancer, and 249 with benign disease) of 1490 patients who underwent thyroidectomy.
The TSH concentration was not different among patients with PTC or benign disease. Our study showed that men (odds ratio [OR] = 1.54; p = .049) and the presence of HT (OR = 2.96; p <.001) increased the risk of PTC. Moreover, HT was associated with multifocal cancer (p = .005) and smaller tumor size (p = .031), but it did not influence the extrathyroidal invasion or nodal metastasis.
Clinicians who deal with thyroid nodules should pay particular attention to HT because it is a stronger predictor for PTC than other risk factors.
桥本甲状腺炎（HT）和较高的促甲状腺激素（TSH）水平被认为是甲状腺乳头状癌（PTC）的危险因素，但这一问题仍存在争议。本研究旨在探讨 HT 是否与 PTC 的发生风险有关，而不是与 TSH 有关。
我们纳入了 1329 例患者（1028 例 PTC、52 例滤泡状甲状腺癌和 249 例良性疾病），这些患者均接受了甲状腺切除术。
PTC 患者和良性疾病患者的 TSH 浓度没有差异。我们的研究表明，男性（比值比[OR] = 1.54；p =.049）和 HT 的存在（OR = 2.96；p <.001）增加了 PTC 的风险。此外，HT 与多灶性癌（p =.005）和较小的肿瘤大小（p =.031）有关，但与甲状腺外侵犯或淋巴结转移无关。
处理甲状腺结节的临床医生应特别注意 HT，因为它是比其他危险因素更强的 PTC 预测因子。
