Autoimmunity in differentiated thyroid cancer: Significance and related clinical problems

Feldt‐Rasmussen, Ulla; Rasmussen, Åse Krogh

doi:10.14310/horm.2002.1261

Cited by 76 publications

(51 citation statements)

References 65 publications

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“…Coexistence of the two diseases ranges between 0.5 and 58% (2,3,5,6). This wide distribution of coexisting CLT and PTC may at least in part be due to differences in histological examination and criteria of autoimmunity characterization, patient selection or indications for thyroidectomy, population background and, mainly, environmental factors (2).…”

Section: Introductionmentioning

confidence: 99%

Chronic lymphocytic thyroiditis is associated with invasive characteristics of differentiated thyroid carcinoma in children and adolescents

Iliadou

Effraimidis

Konstantinos

et al. 2015

European Journal of Endocrinology

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Background: The association between chronic lymphocytic thyroiditis (CLT) and thyroid cancer is an interesting topic. The aim of the present study was to evaluate if demographic and histological characteristics as well as the long-term outcome of thyroid cancer was different in children and adolescents with and without CLT. Methods: The medical records of children and adolescents (%21 years old) were reviewed. The following data were recorded: gender, year and age at diagnosis, family history of thyroid cancer, history of external radiation therapy, histological type (papillary and variants, follicular and variants), tumour size, multifocality, infiltration of thyroid parenchyma or surrounding soft tissues, vascular invasion, presence of lymph node and distant metastases. Information about the presence of TgAb and TPOAb was also collected. Results: One hundred eight children and adolescents (median age 19.0, interquartile range 4.0 years) were diagnosed with differentiated thyroid carcinoma (DTC); 31 patients (28.7%) presented histological characteristics compatible with CLT. Infiltration of thyroid parenchyma was more frequent in patients with CLT compared to patients without (74.2% vs 48.1% respectively, PZ0.024). Familial papillary thyroid carcinoma (PTC) was more frequent in patients with CLT compared to those without CLT (20.7% vs 2.8% respectively, PZ0.009). There was no better outcome with respect to the presence of CLT or not. Conclusions: Children and adolescents with CLT present more frequently familial PTC as well as thyroid cancer with invasive characteristics.

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Section: Introductionmentioning

confidence: 99%

Chronic lymphocytic thyroiditis is associated with invasive characteristics of differentiated thyroid carcinoma in children and adolescents

Iliadou

Effraimidis

Konstantinos

et al. 2015

European Journal of Endocrinology

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“…Surgery was performed in 76 cases because of different reasons: family history of thyroid carcinoma (two cases), autonomous adenoma (two), cytological diagnosis (45), compressive symptoms and signs (19) and patients' desire (eight) (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…The heterogeneity of the coexistence of DTC and HT in different studies seems to be related to different factors (individual differences in patient selection, indications for thyroidectomy, the level of pathological examination) [17][18][19].…”

Section: Prace Oryginalnementioning

confidence: 99%

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

Zosin¹,

Balaş²

2013

Endokrynologia Polska

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Intriduction: The reported prevalence of chronic autoimmune thyroiditis associated with differentiated thyroid cancer (DTC) is heterogeneous. The aim of this study was to evaluate some epidemiological, clinical, sonographical and histological features of operated thyroid nodules with background diffuse autoimmune thyroiditis. Material and methods:The study included 411 cases with Hashimoto's thyroiditis (HT), of which 118 presented thyroid nodular disease (TND). Thyroidectomy was performed in 76 cases. Of these patients, 24 presented histologically confirmed DTC and 52 benign lesions. DTC types were as follows: papillary thyroid cancer (PTC) (n = 6), follicular variant of PTC (FVPTC) (n = 6), papillary microcarcinomas (n = 8), follicular thyroid carcinoma (n = 1) and the mixed form (classic PTC and FVPTC) (n = 3). The benign nodules were dominated by: follicular adenoma (48%), and colloid goitre (40.3%). Results:The sonographic features with predictive risk for malignancy in cases with HT associated with TND were represented by: solid composition, hypoechogenicity and microcalcifications. The characters of margins, the nodular shape and the type of vascularity do not seem to be as useful for identification of malignant nodules in HT. Fine needle-aspiration biopsy (FNAB) showed in DTC cases different cytological smears: malignant (ten), indeterminate (eight), benign (two), and non-diagnostic (four). In the group of benign nodules, the indeterminate smears represented also a significant percentage (n = 12). Conclusions: The incidence of TND associated with HT was 28.7%. Among 76 operated cases, 31.5% presented DTC. The accuracy of FNAB in the preoperative diagnosis showed higher sensitivity (90.0%) and specificity (61.5%) compared to sonographic criteria. StreszczenieWstęp: Podawane w literaturze dane na temat rozpowszechnienia przewlekłego autoimmunologicznego zapalenia tarczycy związanego ze zróżnicowanym rakiem tarczycy (DTC, differentiated thyroid cancer) cechuje duża rozpiętość. Celem badania była ocena wybranych cech epidemiologicznych, klinicznych, ultrasonograficznych i histopatologicznych operowanych guzków tarczycy u pacjentów z rozlanym autoimmunologicznym zapaleniem tarczycy. Materiał i metody: Do badania włączono 411 przypadków choroby Hashimoto (HT, Hashimoto thyroiditis), z czego 118 pacjentów zgłosiło się do lekarza z powodu choroby guzkowej tarczycy (TND, thyroid nodular disease). Tyroidektomię wykonano u 76 pacjentów, przy czym u 24 pacjentów badanie histopatologiczne wykazało DTC, a u pozostałych 52 -zmiany łagodne. Postacie DTC były następujące: rak brodawkowaty tarczycy (PTC, papillary thyroid cancer) (n = 6), wariant pęcherzykowy PTC (FVPTC, follicular variant of papillary thyroid cancer) (n = 6), mikroraki brodawkowate (n = 8), rak pęcherzykowy tarczycy (n = 1) i postać mieszana (klasyczny PTC i FVPTC) (n = 3). Większość guzków łagodnych stanowiły gruczolaki pęcherzykowe (48%) i wole koloidalne (40,3%). Wyniki: Cechy ultrasonograficzne związane z ryzykiem rozpoznania nowotworu złośl...

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“…Depending on the population studied, the assay used and the definition of a positive test result, up to 25%-30% of patients with DTC have a positive test for TgAb at the time of diagnosis [16,42]. Some authors proposed to measure serum Tg by RIA and IMA on the same sample as discordant result suggest TgAb interference [16,43].…”

Section: Interferencesmentioning

confidence: 99%

Thyroglobulin measurement by highly sensitive assays: focus on laboratory challenges

Giovanella

Feldt‐Rasmussen

Verburg

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Differentiated thyroid cancer (DTC) is the most common endocrine cancer and its incidence has increased in recent decades. The initial treatment consists of total thyroidectomy followed by ablation of thyroid remnants by radioiodine in most cases. As thyroid cells are the only source of thyroglobulin (Tg), circulating Tg serves as a biochemical marker of persistent or recurrent disease in the follow-up of DTC. Due to the suboptimal clinical detection rate of older Tg assays endogenous or exogenous thyrotropin (TSH) stimulations are recommended for unmasking occult disease. However, the development of new Tg assays with improved analytical sensitivity and precision at low concentrations now allows detection of very low Tg concentrations, reflecting minimal amounts of thyroid tissue, even without the need for TSH stimulation. Even if the use of these assays still has not found its way in current clinical guidelines, such assays are now increasingly used in clinical practice. As serum Tg measurement is a technically challenging assay and criteria to define a 'highly sensitive' assay may be different, a good knowledge of the technical difficulties and interpretation criteria is of paramount importance for both clinical thyroidologists, laboratory physicians and scientists involved in the care of DTC patients.

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Autoimmunity in differentiated thyroid cancer: Significance and related clinical problems

Cited by 76 publications

References 65 publications

Chronic lymphocytic thyroiditis is associated with invasive characteristics of differentiated thyroid carcinoma in children and adolescents

Chronic lymphocytic thyroiditis is associated with invasive characteristics of differentiated thyroid carcinoma in children and adolescents

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

Thyroglobulin measurement by highly sensitive assays: focus on laboratory challenges

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