慢性淋巴细胞性甲状腺炎对初治后甲状腺球蛋白抗体升高的乳头状甲状腺癌患者疾病持续和复发风险的影响。
Influence of chronic lymphocytic thyroiditis on the risk of persistent and recurrent disease in patients with papillary thyroid carcinoma and elevated antithyroglobulin antibodies after initial therapy.
作者信息
Côrtes Marina Carvalho S, Rosario Pedro Weslley, Mourão Gabriela Franco, Calsolari Maria Regina
机构信息
Santa Casa de Belo Horizonte, Serviço de Endocrinologia, Belo Horizonte, MG, Brazil.
Santa Casa de Belo Horizonte, Serviço de Endocrinologia, Belo Horizonte, MG, Brazil.
出版信息
Braz J Otorhinolaryngol. 2018 Jul-Aug;84(4):448-452. doi: 10.1016/j.bjorl.2017.05.005. Epub 2017 Jun 2.
INTRODUCTION
In patients with papillary thyroid carcinoma who have negative serum thyroglobulin after initial therapy, the risk of structural disease is higher among those with elevated antithyroglobulin antibodies compared to patients without antithyroglobulin antibodies. Other studies suggest that the presence of chronic lymphocytic thyroiditis is associated with a lower risk of persistence/recurrence of papillary thyroid carcinoma.
OBJECTIVE
This prospective study evaluated the influence of chronic lymphocytic thyroiditis on the risk of persistence and recurrence of papillary thyroid carcinoma in patients with negative thyroglobulin but elevated antithyroglobulin antibodies after initial therapy.
METHODS
This was a prospective study. Patients with clinical examination showing no anomalies, basal Tg<1ng/mL, and elevated antithyroglobulin antibodies 8-12 months after ablation were selected. The patients were divided into two groups: Group A, with chronic lymphocytic thyroiditis on histology; Group B, without histological chronic lymphocytic thyroiditis.
RESULTS
The time of follow-up ranged from 60 to 140 months. Persistent disease was detected in 3 patients of Group A (6.6%) and in 6 of Group B (8.8%) (p=1.0). During follow-up, recurrences were diagnosed in 2 patients of Group A (4.7%) and in 5 of Group B (8%) (p=0.7). Considering both persistent and recurrent disease, structural disease was detected in 5 patients of Group A (11.1%) and in 11 of Group B (16.1%) (p=0.58). There was no case of death related to the disease.
CONCLUSION
Our results do not support the hypothesis that chronic lymphocytic thyroiditis is associated with a lower risk of persistent or recurrent disease, at least in patients with persistently elevated antithyroglobulin antibodies after initial therapy for papillary thyroid carcinoma.
引言
在接受初始治疗后血清甲状腺球蛋白呈阴性的甲状腺乳头状癌患者中，与无抗甲状腺球蛋白抗体的患者相比，抗甲状腺球蛋白抗体升高的患者发生结构性疾病的风险更高。其他研究表明，慢性淋巴细胞性甲状腺炎的存在与甲状腺乳头状癌持续存在/复发的风险较低有关。
目的
本前瞻性研究评估了慢性淋巴细胞性甲状腺炎对初始治疗后甲状腺球蛋白阴性但抗甲状腺球蛋白抗体升高的甲状腺乳头状癌患者持续存在和复发风险的影响。
方法
这是一项前瞻性研究。选择临床检查无异常、基础甲状腺球蛋白<1ng/mL且消融后8-12个月抗甲状腺球蛋白抗体升高的患者。患者分为两组：A组，组织学检查有慢性淋巴细胞性甲状腺炎；B组，无组织学慢性淋巴细胞性甲状腺炎。
结果
随访时间为60至140个月。A组有3例患者（6.6%）检测到持续性疾病，B组有6例患者（8.8%）检测到持续性疾病（p=1.0）。在随访期间，A组有2例患者（4.7%）诊断为复发，B组有5例患者（8%）诊断为复发（p=0.7）。考虑到持续性疾病和复发性疾病，A组有5例患者（11.1%）检测到结构性疾病，B组有11例患者（16.1%）检测到结构性疾病（p=0.58）。没有与疾病相关的死亡病例。
结论
我们的结果不支持慢性淋巴细胞性甲状腺炎与持续性或复发性疾病风险较低相关的假设，至少在甲状腺乳头状癌初始治疗后抗甲状腺球蛋白抗体持续升高的患者中不支持。
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