Abidin Sayiner Zeynel, Yatkin Keles Yagmur, Ozturk Sadettin, Akarsu Ersin
Department of Endocrinology and Metabolism, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye.
Department of Internal Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye.
Sisli Etfal Hastan Tip Bul. 2024 Sep 30;58(3):354-358. doi: 10.14744/SEMB.2024.86300. eCollection 2024.
There is still no clear relationship between the presence of Graves' disease (GD) and the development of papillary thyroid carcinoma. The aim of this study was to compare the clinicopathologic features of patients diagnosed with papillary thyroid carcinoma (PTC) with thyroid nodules and GD and patients with PTC with thyroid nodules but without autoimmune thyroid disease.
The study was designed in a retrospective manner and included a cohort of 239 patients with PTC who underwent total thyroidectomy. Age at diagnosis, disease stage, PTC subtypes, tumor size, radioactive iodine use, nodule ultrasonographic features, and risk of PTC recurrence were compared between patients with and without GD.
Of 239 patients, 99 (41%) had GD, while 140 patients (without autoimmune thyroid disease) had only PTC. The tumor diameter was significantly smaller in the group with PTC + GD (1.45±1.28 cm vs. 1.81±1.34 cm, p<0.05). Significantly lower multifocal involvement rates were observed in the PTC + GD group compared to PTC-only group (p<0.05). The prevalence of the classic papillary thyroid carcinoma subtype was higher in patients without autoimmune thyroid disease (39% vs. 25.7%, p<0.05). Ultrasonographic features of nodules with GD and PTC do not have different characteristics from those of nodules with PTC without GD.
The risk of structural recurrence at the time of diagnosis appears to be similar when PTC is accompanied by GD as compared to PTC alone. Furthermore, the presence of smaller tumor sizes and less multifocality in GD-PTC coexistence may indicate a better prognosis.
格雷夫斯病（GD）的存在与甲状腺乳头状癌的发生之间仍没有明确的关系。本研究的目的是比较诊断为甲状腺乳头状癌（PTC）合并甲状腺结节及GD的患者与诊断为PTC合并甲状腺结节但无自身免疫性甲状腺疾病的患者的临床病理特征。
本研究采用回顾性设计，纳入了239例行甲状腺全切除术的PTC患者队列。比较了有和没有GD的患者在诊断时的年龄、疾病分期、PTC亚型、肿瘤大小、放射性碘的使用、结节超声特征以及PTC复发风险。
在239例患者中，99例（41%）患有GD，而140例患者（无自身免疫性甲状腺疾病）仅患有PTC。PTC + GD组的肿瘤直径明显较小（1.45±1.28 cm对1.81±1.34 cm，p<0.05）。与仅PTC组相比，PTC + GD组的多灶性累及率明显更低（p<0.05）。无自身免疫性甲状腺疾病的患者中经典型甲状腺乳头状癌亚型的患病率更高（39%对25.7%，p<0.05）。GD合并PTC的结节的超声特征与无GD的PTC结节的超声特征没有不同。
与单独的PTC相比，PTC伴有GD时诊断时结构复发的风险似乎相似。此外，GD-PTC共存时肿瘤较小且多灶性较少可能表明预后较好。
