The impact of coexistent Hashimoto’s thyroiditis on lymph node metastasis and prognosis in papillary thyroid microcarcinoma

Abstract

The impact of coexistent Hashimoto's thyroiditis (HT) on lymph node metastasis (LNM) and prognosis in papillary thyroid microcarcinoma (PTMC) remains controversial. We evaluated the association of coexistent HT with clinicopathologic parameters, LNM, and prognosis by retrospectively reviewing a series of consecutive patients treated for PTMC at Fudan University Cancer Center from January 2005 to December 2010. Of all 1,250 patients with complete data for analysis, 364 (29.1 %) had coexistent HT (HT group) and 886 patients (70.9 %) had no evidence of HT (control group). The HT group had higher proportion of female (87.9 vs 70.1 %) patients, higher mean level of thyroid-stimulating hormone (TSH) (2.39 vs 2.00 mIU/L), and lower incidence of extrathyroidal extension (7.4 vs 11.7 %) than those in the control group. However, the incidence of LNM and recurrence was similar between the two groups, and HT was not associated with LNM and recurrence. A series of clinicopathologic factors identified for predicting LNM and recurrence in the control group did not show any prediction in the HT group. In summary, this study suggested that coexistent HT had insignificant protective effect on LNM and prognosis in PTMC, which was inconsistent with prior studies. Further studies aiming to determine novel predictors are recommended in PTMC patients with coexistent HT.

Influence of coexistent Hashimoto's thyroiditis on the extent of cervical lymph node dissection and prognosis in papillary thyroid carcinoma

“…There are debates regarding the manner in which coexistent HT affects the LN metastasis status of PTC . Our results did not reveal a protective effect of coexistent HT on cervical LN metastasis.…”

Influence of tumor extent on central lymph node metastasis in solitary papillary thyroid microcarcinomas: a retrospective study of 1092 patients

“…This may be explained from the following two aspects [21]: On one hand, the autoimmune response may destroy cancer cells expressing thyroid-specific antigens, thereby preventing cancer progression. On the other hand, if lymphocytic thyroiditis leads to atrophy and fibrosis of the thyroid gland, there may be associated damage to the surrounding lymphatic vessels, which may prevent lymphatic spread and reduce the likelihood of CLNM [20].…”

Correlation Analysis of Papillary Thyroid Carcinoma on Sonographic Features and Cervical Lymph Node Metastasis

“…Meanwhile, TI-RADS was mainly adopted in the differential diagnosis of benign and malignant thyroid neoplasms. The consistent conclusion of the correlation between gender, age and sonographic features and lymph node metastasis was difficult to achieve [15][16][17]. This study only included unifocal PTC and conducted a stratified study to comprehensively evaluate the risks of CLNM in PTC combined with clinical information, ultrasonic measurements and TI-RADS to obtain a more complete and effective result.…”