The Clinicopathological Features Of Papillary Thyroid Cancer In Hashimoto’s Thyroiditis Patients

Objective:To identify the clinicopathological factors of co-existing papillary thyroid cancer (PTC) in patients with Hashimoto’s thyroiditis (HT) and provide information to aid in the diagnosis and treatment of such patients.Methods:This study included6109patients treated in a university-based tertiary care cancer hospital over a3-year period. All the patients were categorized based on their final diagnosis. Several clinicopathological factors, such as age, gender, nodular size, invasive status, central compartment lymph node metastasis (CLNM) and serum TSH level, were compared between the various groups of patients.Results:In sum, there were653patients with a final diagnosis of HT. More PTC were found in those with HT (381out of653or58.3%) than in those without HT (2440out of5456or44.7%, p<0.05). The HT patients with co-occurring PTC were more likely to be younger, female, had smaller nodules and had higher TSH levels than those without PTC. A univariate analysis demonstrated that the presence of HT and higher TSH levels were risk factors for a diagnosis of PTC, while a multivariate analysis suggested that the presence of higher TSH levels was risk factors for a diagnosis of PTC, while the presence of HT had a protective role against PTC. In the PTC patients, moreover, the presence of HT or other benign nodule was a protective factor for CLNM, while the TSH level had no significant associations.Conclusion:PTC and HT have a close relationship, and have similar epidemiological characteristics. The HT patients with co-occurring PTC are more likely to be younger, female, smaller nodules and higher TSH levels than those without PTC, and also they have lower rates of invasion of the primary tumor and lymph node metastasis. From the results of our study, we hypothesize that HT is the risk factor for the transformation of thyroid cancer. And the elevated serum TSH caused by long-term HT may be the real risk factor for the formation and progress of thyroid cancer. Furthermore, the disease’s invasiveness and metastasis in patients suffering from both PTC and HT could be used as a model in research investigating inflammation and cancer progression.