Grani Giorgio, Calvanese Anna, Carbotta Giovanni, D'Alessandri Mimma, Nesca Angela, Bianchini Marta, Del Sordo Marianna, Vitale Martina, Fumarola Angela
Department of Experimental Medicine, Unit of Endocrinology, "Sapienza" Università di Roma, Rome, Italy.
Head Neck. 2015 Feb;37(2):260-4. doi: 10.1002/hed.23587. Epub 2014 Apr 3.
Whether the risk of cancer is increased in patients with chronic autoimmune thyroiditis is a controversial issue.
Between May 2005 and October 2012, 3777 fine-needle aspiration cytologies (FNACs) were performed on 2562 patients. Serum FT4, thyroid-stimulating hormone (TSH), anti-thyroglobulin antibody (TgAb), and anti-thyroperoxidase antibody (TPOAb) were determined.
Patients with suspicious cytology were younger and presented smaller maximum lesion diameter. In patients with TgAb positivity, suspicious cytology was detected more frequently (9.4%) than patients without TgAb (5.7%; p = .04). No significant difference was recorded between benign and suspicious cytology in the positive TPOAb rate. Risk factors for suspicious cytology were younger age (odds ratio [OR], 0.94), smaller maximum diameter (0.95), single lesion (1.85), microcalcifications (3.45), and TgAb (1.74). Mixed solid/fluid content resulted as being a protective factor (0.34). According to multivariate logistic regression analysis, age, mixed content, and microcalcification confirmed significance.
Thyroid nodule malignancy in patients with Hashimoto thyroiditis is not more frequent than in patients without thyroiditis.
慢性自身免疫性甲状腺炎患者患癌风险是否增加是一个有争议的问题。
2005年5月至2012年10月期间，对2562例患者进行了3777次细针穿刺细胞学检查（FNAC）。测定血清游离甲状腺素（FT4）、促甲状腺激素（TSH）、抗甲状腺球蛋白抗体（TgAb）和抗甲状腺过氧化物酶抗体（TPOAb）。
细胞学检查可疑的患者更年轻，最大病灶直径更小。在TgAb阳性患者中，可疑细胞学检查的检出率（9.4%）高于无TgAb患者（5.7%；p = 0.04）。TPOAb阳性率在良性和可疑细胞学检查之间无显著差异。可疑细胞学检查的危险因素为年龄较小（比值比[OR]，0.94）、最大直径较小（0.95）、单发病灶（1.85）、微钙化（3.45）和TgAb（1.74）。混合性实性/液性成分是一个保护因素（0.34）。根据多因素逻辑回归分析，年龄、混合成分和微钙化具有统计学意义。
桥本甲状腺炎患者甲状腺结节恶性肿瘤的发生率并不高于无甲状腺炎患者。
