Baser Husniye, Ozdemir Didem, Cuhaci Neslihan, Aydin Cevdet, Ersoy Reyhan, Kilicarslan Aydan, Cakir Bekir
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ovecler, 1297 Sokak, No: 1/22, 06460, Ankara, Turkey.
Department of Endocrinology and Metabolism, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
Endocr Pathol. 2015 Dec;26(4):356-64. doi: 10.1007/s12022-015-9401-8.
The association between papillary thyroid carcinoma (PTC) and Hashimoto's thyroiditis (HT) is controversial. In this study, we aimed to compare preoperative thyroid functions, ultrasonography (US) features, fine-needle aspiration biopsy (FNAB) results, and histopathological characteristics of PTC in patients with and without HT. Data of 919 PTC patients were reviewed retrospectively. The diagnosis of HT was based on histopathological examination and patients were grouped as HT and non-HT. There were 1321 PTC lesions in 919 patients among which 317 (34.5 %) had coexistent HT. There were no significant differences in nodule volume, longitudinal diameter, texture, echogenicity, marginal regularity, presence of microcalcification and hypoechoic halo, and peripheral vascularization in patients with and without HT (p > 0.05, for all parameters). Macrocalcification was observed more frequently in the non-HT group (p = 0.021). FNAB results were similar in the two groups (p = 0.105). Distribution of variants, capsule invasion, vascular invasion, and extrathyroidal extension were observed with similar rates in the HT and non-HT groups. Lymph node metastasis was significantly higher in patients without HT (p = 0.012). Of the carcinomas, 66.1 % (n = 874) were papillary thyroid microcarcinoma (PTMC). Tumor size was lower in PTMC lesions coexistent with HT (p = 0.026). We observed lower rates of capsule invasion, extrathyroidal extension, and lymph node metastases in PTMC with HT compared to without HT (p = 0.007, p = 0.003, and p = 0.015, respectively). This study showed that US features, FNAB results, and histopathological findings of PTC lesions are not influenced by the presence of HT. However, PTMC seems to be related with less aggressive histopathological behavior in HT.
甲状腺乳头状癌(PTC)与桥本甲状腺炎(HT)之间的关联存在争议。在本研究中,我们旨在比较合并HT和未合并HT的PTC患者的术前甲状腺功能、超声(US)特征、细针穿刺活检(FNAB)结果以及组织病理学特征。回顾性分析了919例PTC患者的数据。HT的诊断基于组织病理学检查,患者被分为HT组和非HT组。919例患者中共有1321个PTC病灶,其中317个(34.5%)合并HT。合并HT和未合并HT的患者在结节体积、纵径、质地、回声、边缘规整性、微钙化和低回声晕的存在以及周边血管化方面均无显著差异(所有参数p>0.05)。非HT组中粗大钙化的观察频率更高(p=0.021)。两组的FNAB结果相似(p=*0.105)。HT组和非HT组在变异型分布、包膜侵犯、血管侵犯和甲状腺外侵犯方面的发生率相似。未合并HT的患者淋巴结转移显著更高(p=0.012)。在这些癌中,66.1%(n=874)为甲状腺微小乳头状癌(PTMC)。合并HT的PTMC病灶的肿瘤大小更小(p=0.026)。我们观察到,与未合并HT的PTMC相比,合并HT的PTMC的包膜侵犯、甲状腺外侵犯和淋巴结转移率更低(分别为p=0.007、p=0.003和p=0.015)。本研究表明,PTC病灶的US特征、FNAB结果和组织病理学发现不受HT存在的影响。然而,PTMC似乎与HT中侵袭性较小的组织病理学行为相关。