Characteristics, staging and outcomes of differentiated thyroid cancer in patients with and without Graves' disease.
Characteristics, staging and outcomes of differentiated thyroid cancer in patients with and without Graves' disease.
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DOI：
10.1016/j.jcte.2023.100321
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发表时间：
2023-09
影响因子：
3
通讯作者：
Choudhary, Chitra
中科院分区：
文献类型：
--
作者：
Gopinath, Chaitra;Crow, Hanna;Panthi, Sujata;Bantis, Leonidas;Burman, Kenneth D.;Choudhary, Chitra
格雷夫斯病与分化型甲状腺癌的风险增加有关。癌症和侵袭性风险增加的发病机制仍存在争议。我们的研究发现，GD患者的肿瘤体积较小，肿瘤分期较早。过去三十年中，甲状腺癌的发病率有所增加，研究表明，与毒性多结节性甲状腺肿相比，格雷夫斯病 (GD) 患者的甲状腺癌发病率更高。1我们进行了一项回顾性研究，以进一步调查甲状腺癌合并 GD 患者的特征和结果。我们回顾性分析了 62 名诊断为分化型甲状腺癌 (DTC) 的患者。我们比较了 GD 患者和非 GD 患者的诊断年龄、肿瘤类型、肿瘤大小、放射性碘 (RAI) 使用情况以及 DTC 复发情况。我们使用卡方检验名义水平为 0.05 的分类变量之间的独立性；比较基于 t 检验。在 62 名患者中，29 名患者患有 GD 和 DTC (47%)。 94% 患有乳头状甲状腺癌。与没有 GD 的患者（平均 53 岁）相比，GD 患者被诊断出 DTC 的年龄更小（平均 46 岁）。 DTC 的类型没有差异。与没有 GD 的患者相比，GD 患者的肿瘤尺寸明显更小（平均大小 1.035 cm；p 值 = 0.002），更多的是 1 期和 2 期肿瘤（p 值 = 0.009）。两组患者在随访和 RAI 使用方面的复发率相似。我们发现，与没有 GD 的患者相比，GD 患者的肿瘤较小，DTC 处于早期阶段，并且预后可能良好。需要更多数据来了解这是否是由于 Graves 抗体促进肿瘤形成等发病机制，还是仅仅是 GD 中 DTC 的早期检测所致。
Graves disease has been associated with increased risk of Differentiated Thyroid Cancer. Pathogenesis for increased risk of cancer and aggressiveness remains controversial. Our study found that patients with GD had smaller tumor size and earlier tumor stage. The incidence of thyroid cancer has increased over the last three decades with studies showing incidence of thyroid cancer is higher among patients with Graves’ Disease (GD) when compared to Toxic multinodular goiter.1 We conducted a retrospective study to further investigate characteristics and outcomes in patients with thyroid cancer and GD. We retrospectively reviewed 62 patients with a diagnosis of Differentiated Thyroid Cancer (DTC). We compared age at diagnosis, type, size of tumor, radioactive iodine (RAI) use, and DTC recurrence amongst patients with GD, non-GD patients. We used Chi-square to test for independence among categorical variables at a nominal level of 0.05; comparison was based on t-test. Out of 62 patients, 29 patients had GD and DTC (47%). 94% had papillary thyroid cancer. Patients with GD were diagnosed with DTC at a younger age (mean 46 years) in comparison to patients without GD (mean 53 years). There was no difference in the type of DTC. Patients with GD had significantly smaller tumor size (mean size 1.035 cm; p value = 0.002), more Stage 1 and 2 compared to patients without GD (p-value = 0.009). Both groups of patients had similar rates of recurrence on follow up and RAI use. We found patients with GD had smaller tumor size, early-stage DTC when compared to patients without GD and potentially favorable prognosis. More data is needed to understand whether this is due to pathogenesis like Graves antibodies promoting tumor formation or merely earlier detection of DTC in GD.
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影响因子：
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作者：
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