Endocrine Unit, Alexandra General Hospital, Athens, Greece.
Medical Diagnostic Group, Athens, Greece.
Arch Endocrinol Metab. 2022;66(4):446-451. doi: 10.20945/2359-3997000000483. Epub 2022 Jun 2.
The prevalence of autoimmune thyroiditis (AT) in papillary thyroid carcinoma (PTC) is still controversial. The aim of this study was to investigate the frequency of coexistence of PTC with AT versus that of the coexistence of benign nodules with AT.
This was a cross-sectional retrospective study including patients operated on for thyroid nodules from January 2011, to April 2021. The frequency of papillary carcinomas cooccurring with AT was compared to that of benign nodules cooccurring with AT, which was assessed based on cytopathological diagnosis after thyroidectomy.
The study included 668 cases of benign nodules and 420 cases with PTC. No statistically significant difference was observed between cases of benign and PTC nodules regarding the presence of AT (25% 28%, respectively, p = 0.177). The size of the PTC compared to that of the benign predominant nodules was significantly smaller both in the absence (0.96 ± 1.09 cm 2.19 ± 1.06 cm, p < 0.05) and in the presence (0.77 ± 0.76 cm 1.67 ± 1.08 cm, p < 0.01) of AT. In the binary logistic regression analysis of the PTC, the only variable associated with AT was multifocality (odds ratio: 1.750, 95% confidence intervals: 1.131-2.706, p = 0.013). The incidences of lymph node involvement and advanced stage PTC were very low both in the presence and absence of AT.
The nodules present with PTC were not more likely to coexist with AT than benign nodules were. The small incidence of advanced PTC indicates a significant improvement in early-stage diagnosis.
甲状腺癌(PTC)合并自身免疫性甲状腺炎(AT)的发病率仍存在争议。本研究旨在比较 PTC 与 AT 共存与良性结节与 AT 共存的频率。
这是一项回顾性的横断面研究,纳入了 2011 年 1 月至 2021 年 4 月间因甲状腺结节手术的患者。通过甲状腺切除术后的细胞病理学诊断,评估 PTC 与 AT 共存的频率,并与良性结节与 AT 共存的频率进行比较。
本研究纳入了 668 例良性结节和 420 例 PTC 患者。在 AT 的存在方面,良性和 PTC 结节之间没有观察到统计学上的显著差异(分别为 25%和 28%,p = 0.177)。在 AT 存在或不存在的情况下,PTC 的大小与良性优势结节相比均显著较小(分别为 0.96 ± 1.09 cm 和 2.19 ± 1.06 cm,p < 0.05 和 0.77 ± 0.76 cm 和 1.67 ± 1.08 cm,p < 0.01)。在 PTC 的二元逻辑回归分析中,与 AT 相关的唯一变量是多灶性(比值比:1.750,95%置信区间:1.131-2.706,p = 0.013)。在 AT 存在或不存在的情况下,淋巴结受累和晚期 PTC 的发生率都非常低。
与良性结节相比,PTC 结节与 AT 共存的可能性并不更大。晚期 PTC 的低发生率表明早期诊断有了显著的改善。