Issa Peter P, Omar Mahmoud, Buti Yusef, Issa Chad P, Chabot Bert, Carnabatu Christopher J, Munshi Ruhul, Hussein Mohammad, Aboueisha Mohamed, Shama Mohamed, Corsetti Ralph L, Toraih Eman, Kandil Emad
School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA.
Biomedicines. 2022 Aug 22;10(8):2051. doi: 10.3390/biomedicines10082051.
Hashimoto's thyroiditis (HT) (autoimmune thyroiditis) is a clinicopathological entity associated with chronic lymphocytic infiltration resulting in hypothyroidism. HT is a double-edged sword that increases the risk of papillary thyroid cancer (PTC), yet it serves as a protective factor for PTC progression. mutation in PTCs is associated with rapid cell growth, aggressive tumor characteristics, and higher mortality rates. Here, we aimed to analyze the influence of HT in patients with PTCs and its effect on lymph node metastasis (LNM) in BRAF mutant tumors. Adults diagnosed with PTC between 2008 and January 2021 were retrospectively included. A total of 427 patients, 128 of whom had underlying HT, were included. The HT group had significantly higher rates of microcarcinoma (49.2% vs. 37.5%, = 0.025) and less lateral LNM (8.6% vs. 17.1%, = 0.024). Interestingly, -mutated PTCs were found to have significantly less overall LNM (20.9% vs. 51%, = 0.001), central LNM (25.6% vs. 45.1%, = 0.040) and lateral LNM (9.3% vs. 29.4%, = 0.010) in patients with HT when compared to those without underlying HT. HT was found to be an independent protective predictor of overall and lateral LNM. Altogether, HT was able to neutralize the effect of mutation and was determined to be an independent protective factor against LNM. Specifically, our work may influence treatment-aggressiveness decision making for endocrinologists, oncologists and surgeons alike.
桥本甲状腺炎（HT）（自身免疫性甲状腺炎）是一种临床病理实体，与慢性淋巴细胞浸润相关，可导致甲状腺功能减退。HT是一把双刃剑，它增加了乳头状甲状腺癌（PTC）的风险，但它也是PTC进展的一个保护因素。PTC中的 突变与细胞快速生长、侵袭性肿瘤特征和更高的死亡率相关。在此，我们旨在分析HT对PTC患者的影响及其对BRAF突变肿瘤淋巴结转移（LNM）的作用。回顾性纳入了2008年至2021年1月期间诊断为PTC的成年人。共纳入427例患者，其中128例有潜在的HT。HT组微癌发生率显著更高（49.2%对37.5%， = 0.025），侧方LNM更少（8.6%对17.1%， = 0.024）。有趣的是，与无潜在HT的患者相比，发现HT患者中 突变的PTC总体LNM（20.9%对51%， = 0.001）、中央LNM（25.6%对45.1%， = 0.040）和侧方LNM（9.3%对29.4%， = 0.010）显著更少。HT被发现是总体和侧方LNM的独立保护预测因子。总之，HT能够抵消 突变的影响，并被确定为抗LNM的独立保护因素。具体而言，我们的工作可能会影响内分泌科医生、肿瘤学家和外科医生在治疗积极性方面的决策。
