Krátký Jan, Ježková Jana, Kosák Mikuláš, Vítková Hana, Bartáková Jana, Mráz Miloš, Lukáš Jindřich, Límanová Zdenka, Jiskra Jan
3rd Department of Medicine-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 1, 128 08 Praha 2, Czech Republic.
Dialectology Center, Institute of Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Praha 4, Czech Republic.
Int J Endocrinol. 2018 Sep 6;2018:9793850. doi: 10.1155/2018/9793850. eCollection 2018.
The relationship between Hashimoto's thyroiditis (HT) and thyroid cancer (TC) is a controversial topic; it remains unclear if HT acts as a risk factor of TC. The aim of our study was to compare the presence of HT and thyroid function in patients with TC and benign nodules. We analyzed 2571 patients after fine needle aspiration biopsy of thyroid nodule. Totally, 91 patients with primary TC and 182 sex- and age-matched controls were included. Positive antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-Tg) antibodies were associated with TC (anti-TPO 44% in TC vs. 27% in controls, = 0.005, anti-TG 35% in TC group vs. 21% in controls, = 0.018), and the TC group had significantly higher TSH (median 1.88 mIU/l vs. 1.21 mIU/l, < 0.001). Using multiple logistic regression, positive anti-TPO was identified as an independent risk factor (OR 2.21, = 0.018), while spontaneously suppressed TSH < 0.5 mIU/l was a protective factor (OR 0.3, = 0.01) against TC. In conclusion, nodules in subjects with positive antithyroid antibodies could be considered to have a higher risk of malignancy. However, based on our results, it is not possible to declare that TC is triggered by HT.
桥本甲状腺炎（HT）与甲状腺癌（TC）之间的关系是一个存在争议的话题；HT是否为TC的危险因素仍不明确。我们研究的目的是比较TC患者和良性结节患者中HT的存在情况及甲状腺功能。我们对2571例甲状腺结节细针穿刺活检后的患者进行了分析。总共纳入了91例原发性TC患者和182例年龄及性别匹配的对照。抗甲状腺过氧化物酶（抗-TPO）和抗甲状腺球蛋白（抗-Tg）抗体阳性与TC相关（TC组抗-TPO阳性率为44%，对照组为27%，P = 0.005；TC组抗-TG阳性率为35%，对照组为21%，P = 0.018），且TC组促甲状腺激素（TSH）显著更高（中位数1.88 mIU/l对1.21 mIU/l，P < 0.001）。采用多因素logistic回归分析，抗-TPO抗体阳性被确定为独立危险因素（比值比[OR] 2.21，P = 0.018），而自发性TSH < 0.5 mIU/l是预防TC的保护因素（OR 0.3，P = 0.01）。总之，抗甲状腺抗体阳性患者的结节可能被认为具有更高的恶性风险。然而，根据我们的结果，无法宣称TC是由HT引发的。
