The Thyroid Autoantibodies And Pathologic Features In Patients Of Hashimoto’s Thyroiditis With Different Thyroid Swelling Extent

BackgroundAutoimmune thyroid diseases(AITD), being regarded as the most common organ specific autoimmune diseases, which were induced on the basis of heredity by stress factors such as infection, spirit wound et al. AITD was attributed to the functional defect of T suppressor lymphocyte(Ts). The frequent AITD were Graves’disease (GD), Hashimoto’s thyroiditis(HT), Silent thyroiditis. thyroid disease related to pregnancy, et al. Hashimoto’s thyroiditis was also called chronic lymphocyte thyroiditis, which was considered as one of the most common autoimmune thyroid diseases and had the highest morbidity in a variety of thyroid diseases. HT had obvious differences in age and crowds, which was mostly turned up in young and middle-aged female.The clinical manifestation of HT was variegated and usually coexisted with other autoimmune diseases, which lacked unitive diagnostic criterion internationally. There were high false negative rate and false positive rate in the practical clinical work. HT was always confused with primary hyperthyroidism, nodular goiter, thyroid carcinoma, thyroid adenoma, et al, which delayed proper diagnoses and exact treatment of HT patients and brought a lot of inconvenience at the same time. The typical manifestation was anthorisma. hard thyroid gland, high level thyroid autoantibodies, such as thyroid peroxidase antidiagnosesbody (TPOAb) and thyroglobulin antibody (TGAb). Part of HT patients had long course of disease, no typical symptoms, dominated with single mass, which were difficult to have definite diagnosis. Therefore combination with ultrasound-guided fine needle aspiration biopsy cytology(UG-FNABC) should be implemented for further detection of special manifestation with HT patients’thyroid gland tissue to make definite diagnosis.HT patients could show different thyroid functionationl state, some represented hyperthyroidism, some euthyroidism and some appeared hypothyroidism. A great quantity of clinical observation suggested that different thyroid functionationl states of HT patients showed different extent of glandanthorisma. Some presented small and tough thyroid gland, some emerged obvious swelling thyroid gland. We investigated HT patients with different thyroid functionationl state, thyroid swelling extent, thyroid lymphocyte infiltration extent, TPOAb, TGAb, and TRAb level, the relationship between them, which could better guide diagnoses and supply appropriate treatment to HT patients.ObjectiveTo investigate the relationship between thyroid swelling extent and thyroid lymphocyte infiltration extent, thyroid autoantibodies levels in patients with Hashimoto’s thyroiditis(HT).Subjects and Methods140patients with Hashimoto’s thyroiditis without other autoimmune diseases had been chosen, who had been diagnosed by four standards from Professor Baiyao of Peking Union Hospital and ultrasound-guided fine needle aspiration biopsy cytology and then been divided into two groups according to their thyroid swelling extent. There were128femals,12males, the sex ratio was1:9.1, the average age was (36.9+13.3) years old, the average course of the disease was (3.5±0.8) year.18cases showed hyperthyroidism(12.9%),72cases displayed euthyroidism(51.4%),50cases manifested hypothyroidism(35.7%). According to criterion of sendemic goiter in Chinese WS276-2007, two groups were divided into:A group, mild and moderate group; B group as severe group. Measured thyroid lymphocyte infiltration extent, serum thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), TSH receptors antibody (TR-Ab) of the two groups respectively. Analysed the relationship between the thyroid swelling extent and thyroid lymphocyte infiltration extent, thyroid autoantibodies in the two groups.Results1. The differences of thyroid functionationl state between the two groups had no statistics significance (P>0.05). 2. The differences of thyroid lymphocyte infiltration extent between the two groups appeared statistics significance (P<0.05).3. The differences of TPOAb, TGAb, TPOAb/TGAb level between the two groups possessed statistics significance (P<0.05).4. Thyroid swelling extent had positive relevance with thyroid lymphocyte infiltration extent, strong positive TPOAb(>1300U/ml) and TGAb(>500U/ml) respectively (r=0.809,p=0.00;r=0.609,p=0.03;r=0.503,p=0.04).5. Thyroid lymphocyte infiltration extent had positive connection with strong positive of TPOAb and TGAb respectively (r=0.992,p=0.00;r=0.901,p=0.04).6. Within the two groups, there existed no linear correlation between different thyroid functionationl state and thyroid lymphocyte infiltration extent, TPOAb, TGAb, TRAb leve1(P>0.05).Conclusions1. The higher thyroid swelling extent in HT patients had higher Thyroid lymphocyte infiltration extent, TPOAb, TGAb and TPOAb/TGAb. Thyroid lymphocyte infiltration extent, Strong positive TPOAb, TGAb had positive correlation with thyroid swelling extent in HT patients.2. Strong positive TPOAb, TGAb had been connected with thyroid lymphocyte infiltration extent. Monitored TPOAb with TGAb could survey the dynamically progressive condition of HT patients.