Clinical analysis of Hashimoto thyroiditis coexistent with papillary thyroid cancer in 1392 patients

摘要

Papillary thyroid carcinoma (PTC) is the most common malignant tumour of the thyroid. The effect of the concurrent presence of Hashimoto’sthyroiditis (HT) and PTC is still under debate. The aim of this study is to investigate the influence of coexistent HT on prognosticoutcomes and the association of coexistent HT with clinicopathological features. The demographic and clinicopathological data of 1,392 patientswho underwent surgery in our hospital from 2007 to 2016 was collected and analysed. Among 1,392 PTC patients, the rate of HT was25.6%. There were significant differences in the mean levels of thyroid stimulating hormone (3.27 vs. 2.41 μIU/L, p < 0.01), thyroperoxidaseantibodies (110.31 vs. 131.2 U/ml, p < 0.01) and thyroglobulin antibodies (131.90 vs. 113.53 ng/ml, p < 0.01) between the two groups. PTCpatients with HT had the following characteristics compared to patients without HT: smaller tumour size (p < 0.01), female predominance(p < 0.01) and higher rate of multifocality (p = 0.024). In addition, patients with HT had a significantly lower rate of lymph node metastasis(LNM) and advanced TNM stage than patients without HT (all p < 0.01). Multivariate analysis found that both age and multifocality weresignificantly associated with central LNM in HT patients (p < 0.01, p = 0.019, respectively). Extrathyroidal invasion and TSH level werealso significant independent factors for lateral LNM in HT patients (p < 0.008, p = 0.04, respectively). HT is associated with a significantlyhigher risk of PTC. The coexistence of HT in PTC patients is associated with favourable clinical outcomes compared to PTC without HT.Total thyroidectomy and prophylactic central compartment lymphadenectomy should be a choice for PTC patients with HT.