The Journal of Practical Medicine ›› 2023, Vol. 39 ›› Issue (13): 1641-1646.doi: 10.3969/j.issn.1006⁃5725.2023.13.008

• Clinical Research • Previous Articles     Next Articles

Clinical characteristics of papillary thyroid carcinoma with concomitant Hashimoto′ s thyroiditis 

SUN Kang,WANG Xiaoming,WANG Jianguo.   

  1. Department of General Surgery,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China 
  • Online:2023-07-10 Published:2023-07-10

Abstract:

Objective The incidence rate of papillary thyroid carcinoma(PTC)and Hashimoto′s thyroiditis (HT)are on the rise. The objective of this article is to explore the clinicopathological features of PTC with concomi⁃ tant HT,and further discuss the relationship between them. Methods A retrospective analysis was conducted of 347 patients who underwent thyroid cancer surgery in the Second Department of General Surgery of the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2016 to November 2022 and were patho⁃ logically diagnosed as papillary thyroid cancer after surgery. The clinicopathological characteristics of patients with or without HT were compared. Results Among 347 PTC patients,98(28.24%)were accompanied by HT. Univariate analysis showed that when compared with those in PTC group alone,higher proportion of women (85.7% vs. 74.3%);higher proportion of patients with aspect ratio > 1 higher(57.1% vs. 41.8%);lower proportion of invasive patients(16.3% vs. 27.7%);greater total number of lymph nodes in the central area[(7.31 ± 6.132) vs.(3.98 ± 3.592)];lower positive rate of lymph nodes in the central area[(14.55 ± 28.99)% vs.(25.93 ± 35.91)%], higher level of thyroid ⁃ stimulating hormone(TSH)[(2.70 ± 1.99)mIU/L vs.(1.99 ± 1.36)mIU/L],significantly higher level of thyroid peroxidase antibody(TPOAb)[(185.48 ± 264.77)IU/mL vs.(18.17 ± 89.57)IU/mL],and that of thyroglobulin antibodies(TgAb)[(150.88 ± 235.23)IU/mL vs.(21.59 ± 86.44)IU/mL]were observed in the PTC combined with HT group,showing statistical significance(all P < 0.05). Multiple linear regression analysis showed that the positive rate of lymph nodes in the central region of PTC was markedly affected by the presence of microcarcinoma,age,sex,and the presence of HT(all P < 0.05). Conclusion Female PTC patients are more likely to be accompanied by HT,and the combination of HT will increase blood TSH,TPOAb and TgAb of PTC patients,but reduce the invasion of PTC and the risk of central lymph node metastasis. PTC patients with concomitant HT are prone to having node with longitudinal growth,and increased risk of PTC. The impact of HT on PTC pa⁃ tients is a“double⁃edged sword”. In addition,microcarcinoma,age,sex and HT are independent risk factors for central lymph node metastasis of PTC. 

Key words: papillary thyroid carcinoma, Hashimoto′ s thyroiditis, thyroid stimulating hormone, central lymph nodes, clinical pathology