慢性淋巴细胞性甲状腺炎患者分化型甲状腺癌分期降低。
Decreased staging of differentiated thyroid cancer in patients with chronic lymphocytic thyroiditis.
机构信息
Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, 49, Przybyszewskiego Street, 60-355, Poznan, Poland.
Department of Clinical Immunology, Poznan University of Medical Sciences, 5D, Rokietnicka Street, 60-806, Poznan, Poland.
出版信息
J Endocrinol Invest. 2019 Jan;42(1):45-52. doi: 10.1007/s40618-018-0882-4. Epub 2018 Apr 4.
PURPOSE
The biological association between chronic lymphocytic thyroiditis (CLT) and differentiated thyroid cancer (DTC) has not been elucidated yet. The aim of the study was to assess whether the presence of CLT exerts any influence on clinical or histological presentation of DTC.
METHODS
Nine hundred and seven consecutive patients with DTC treated in the years 1998-2016 were divided into two groups according to the presence or absence of concomitant CLT. The statistical differences were analysed.
RESULTS
Out of 907 patients included in the study, 331 were diagnosed with DTC and CLT (studied group), while 576 patients with DTC but without CLT constituted a control group. The distribution of papillary and follicular thyroid cancer did not differ. In CLT group, the prevalence of pT1 was greater than for pT2-pT4 DTC (P = 0.0003; OR = 1.69, 95% CI 1.27-2.24) compared to controls (68.3 vs. 56.1%, respectively). The presence of multifocal lesions was similar. The thyroid capsule infiltration without extrathyroidal invasion (P < 0.0001; OR = 0.21, 95% CI 0.14-0.31) was more frequent in the studied group, unlike extracapsular invasion, which was significantly more often present in patients with DTC but without CLT (P = 0.004; OR = 1.66; 95% CI 1.17-2.34) as well as nodal involvement (P = 0.048; OR = 0.65, 95% CI 0.42-0.99).
CONCLUSIONS
The collected data indicate a protective role of CLT in preventing the spread of the DTC. The presence of CLT might limit tumour growth to the primary site.
目的
慢性淋巴细胞性甲状腺炎（CLT）与分化型甲状腺癌（DTC）之间的生物学关联尚未阐明。本研究旨在评估 CLT 的存在是否对 DTC 的临床或组织学表现产生任何影响。
方法
将 1998 年至 2016 年间收治的 907 例连续 DTC 患者根据是否同时存在 CLT 分为两组。分析了两组间的统计学差异。
结果
在纳入本研究的 907 例患者中，331 例被诊断为 DTC 和 CLT（研究组），而 576 例仅患有 DTC 但无 CLT 的患者为对照组。乳头状和滤泡状甲状腺癌的分布无差异。在 CLT 组中，pT1 的患病率大于 pT2-pT4 DTC（P=0.0003；OR=1.69，95%CI 1.27-2.24），与对照组相比（分别为 68.3%和 56.1%）。多灶性病变的存在相似。甲状腺包膜浸润而无甲状腺外侵犯（P<0.0001；OR=0.21，95%CI 0.14-0.31）在研究组中更为常见，而与包膜外侵犯相反，在 DTC 但无 CLT 的患者中更为常见（P=0.004；OR=1.66；95%CI 1.17-2.34），且淋巴结受累的情况也更为常见（P=0.048；OR=0.65，95%CI 0.42-0.99）。
结论
所收集的数据表明 CLT 在防止 DTC 扩散方面具有保护作用。CLT 的存在可能会限制肿瘤生长至原发部位。
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