Liu Yujuan, Li Chengqian, Zhao Wenjuan, Wang Yangang
Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Nutrition, Qingdao Women and Children's Hospital, Qingdao, China.
Horm Metab Res. 2017 Oct;49(10):732-738. doi: 10.1055/s-0043-117892. Epub 2017 Aug 31.
The association between autoimmune thyroid disease and thyroid cancer remains unclear. We performed a matched case-control study to assess the association between Hashimoto's thyroiditis and papillary thyroid microcarcinoma (PTMC). A total of 927 PTMC cases and 927 age- and gender- matched controls selected from the same population were recruited. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the strength of the association between Hashimoto's thyroiditis and PTMC. Conditional logistic regression analysis was carried out, and stratified analyses by age, gender and types of thyroid antibodies were also performed. Hashimoto's thyroiditis was significantly associated with increased risk of PTMC (OR=1.87, 95% CI 1.49-2.34, p<0.001). Stratified analysis by thyroid antibodies also found obvious associations of PTMC risk with TPOAb positivity (OR=1.58, p=0.001) and TGAb positivity (OR=2.35, p<0.001). Stratified analyses by age showed that the association between Hashimoto's thyroiditis and PTMC risk was more significant in younger adults aged between 18 and 30 years (OR=11.48, p<0.001). Further stratified analyses by thyroid antibodies also found that the associations of PTMC risk with TPOAb positivity or TGAb positivity were more significant in younger adults aged between 18 and 30, and the ORs were 8.27 (p<0.001) and 12.71 (p<0.001), respectively. This study suggests an obvious relationship between Hashimoto's thyroiditis and PTMC risk, and Hashimoto's thyroiditis is an important risk of PTMC in younger adults.
自身免疫性甲状腺疾病与甲状腺癌之间的关联仍不明确。我们开展了一项配对病例对照研究,以评估桥本甲状腺炎与甲状腺微小乳头状癌(PTMC)之间的关联。共招募了927例PTMC病例以及从同一人群中选取的927名年龄和性别匹配的对照。采用比值比(OR)及95%置信区间(95%CI)来评估桥本甲状腺炎与PTMC之间关联的强度。进行了条件逻辑回归分析,还按年龄、性别和甲状腺抗体类型进行了分层分析。桥本甲状腺炎与PTMC风险增加显著相关(OR = 1.87,95%CI 1.49 - 2.34,p < 0.001)。按甲状腺抗体进行的分层分析也发现,PTMC风险与甲状腺过氧化物酶抗体(TPOAb)阳性(OR = 1.58,p = 0.001)及甲状腺球蛋白抗体(TGAb)阳性(OR = 2.35,p < 0.001)存在明显关联。按年龄进行的分层分析显示,桥本甲状腺炎与PTMC风险之间的关联在18至30岁的年轻成年人中更为显著(OR = 11.48,p < 0.001)。进一步按甲状腺抗体进行的分层分析还发现,PTMC风险与TPOAb阳性或TGAb阳性之间的关联在18至30岁的年轻成年人中更为显著,OR分别为8.27(p < 0.001)和12.71(p < 0.001)。本研究表明桥本甲状腺炎与PTMC风险之间存在明显关联,且桥本甲状腺炎是年轻成年人发生PTMC的重要风险因素。