Clinical Features Of Multifocal Papillary Thyroid Cancer With Hashimoto’s Thyroiditis

Objective: To compare the differences in clinicopathological features between multifocal and unifocal groups of patients with PTC with or without HT,and to further analyze the factors associated with multifocality of PTC with HT.Methods: Patients who underwent surgery at the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2015 to October 2021 and whose pathological findings were confirmed to be papillary thyroid carcinoma were selected.Results:(1)A total of 1149 eligible patients were included,including 763 cases of simple PTC,386 cases of PTC with Hashimoto’s thyroiditis;425 cases of multifocal papillary thyroid carcinoma,and 724 cases of unifocal papillary thyroid carcinoma.(2)The comparative analysis of relevant indicators between the multifocal group of PTC alone(without HT)and the unifocal group showed statistical differences between the two groups in perineural invasion,BRAF gene mutation,cervical lymph node metastasis and maximum tumor diameter.(3)The results of univariate analysis between the multifocal and unifocal groups of PTC with Hashimoto’s thyroiditis showed statistically significant differences(P<0.05)in maximum tumor diameter,BRAF gene mutation,perineural invasion,and cervical lymph node metastasis.Logistic regression analysis showed that BRAF mutation(OR=1.883,95% CI 1.135～3.123,P=0.014),and perineural invasion(OR=1.805,95% CI 1.137～2.867,P=0.012)were independent correlates of Hashimoto’s thyroiditis with multifocal papillary thyroid carcinoma.(4)Among patients with multifocal PTC,there was no statistical difference in clinicopathological characteristics between patients with and without Hashimoto’s thyroiditis(P>0.05),except for gender(P=0.004).Conclusions: The general clinical indicators such as thyroid function,age,BMI,and gender did not correlate significantly with their multifocality in patients with PTC,regardless of whether they had Hashimoto’s thyroiditis in combination.However,BRAF mutation,perineural invasion,and cervical lymph node metastasis are all factors associated with multifocal PTC;In patients with multifocal PTC with Hashimoto’s thyroiditis,BRAF mutation and perineural invasion were independent correlates.