Is Hashimoto's Thyroiditis a Risk Factor for Papillary Thyroid Cancer?
Is Hashimoto's Thyroiditis a Risk Factor for Papillary Thyroid Cancer?
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DOI：
10.1016/j.jss.2007.09.020
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发表时间：
2008-11-01
影响因子：
2.2
通讯作者：
Chen, Herbert
中科院分区：
文献类型：
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作者：
Repplinger, Daniel;Bargren, Anna;Chen, Herbert
背景。桥本甲状腺炎（HT）是甲状腺功能减退最常见的原因，其特征是逐渐的自身免疫介导的甲状腺功能衰竭，偶尔发生甲状腺肿。女性发生HT的可能性是男性的7倍。甲状腺乳头状癌（PTC）是最常见的甲状腺癌，女性的发病率是男性的2.5倍。鉴于这些疾病的相对较高的患病率和女性发病率的增加，我们分析了本机构的数据，以确定桥本甲状腺炎与女性PTC之间是否存在相关性。从1994年5月到2007年1月，1198名患者在我们的机构接受了甲状腺手术。其中，217名患者被诊断为HT（196名女性，21名男性）。采用spss对患者资料进行统计学分析。217例HT患者中有63例（29%）发生PTC， 981例非HT患者中有230例（23%）发生PTC （P = 0.051）。其中，41例（65%）和158例（69%）患者肿瘤大小为>= 1.0 cm；有HT的196名女性中有56名（29%）合并PTC，无HT的730名女性中有160名（22%）合并PTC （P = 0.03）。在任何类型的甲状腺恶性肿瘤女性中，56/59 (95%)HT患者有PTC，而159/196（81%）无HT患者有PTC （P = 0.006）。此外，有甲状腺肿大的女性HT患者的PTC发生率明显低于无甲状腺肿大的女性（9%对36%，P < 0.001）。这些差异在男性ht患者中没有观察到。这些数据表明，HT与发生PTC的风险增加有关。接受甲状腺切除术的女性HT患者患PTC的可能性增加30%。因此，对于HT患者，尤其是女性患者，可能需要对PTC进行更积极的监测。(c) 2008爱思唯尔公司版权所有。
Background. Hashimoto's thyroiditis (HT) is the most common cause of hypothyroidism and is characterized by gradual autoimmune mediated thyroid failure with occasional goiter development. HT is seven times more likely to occur in women than in men. Papillary thyroid cancer (PTC), the most prevalent form of cancer in the thyroid, is 2.5 times more likely to develop in women than men. Given the relatively high prevalence of these diseases and the increased occurrence in women, we analyzed data from our institution to determine if there is a correlation between Hashimoto's thyroiditis and PTC in women.Methods. From May 1994 to January 2007, 1198 patients underwent thyroid surgery at our institution. Of these, 217 patients were diagnosed with HT (196 women, 21 men). The data from these patients were statistically analyzed using SPSS.Results. PTC occurred in 63 of 217 (29%) HT patients and 230 of 981 (23%) patients without HT (P = 0.051). Of these groups, 41 (65%) and 158 (69%) patients, respectively, had tumor sizes >= 1.0 cm; 56/196 women (29%) with HT had coexistent PTC compared with 160/730 women (22%) without HT (P = 0.03). Among women with any type of thyroid malignancy, 56/59 cases (95%) with HT had PTC compared with 159/196 cases (81%) in women without HT (P = 0.006). Additionally, female HT patients with goiters had a significantly lower rate of PTC (9% versus 36%, P < 0.001) compared with women without goiters. These differences were not observed in men with HT.Conclusions. These data demonstrate that HT is associated with an increased risk of developing PTC. Female patients with HT undergoing thyroidectomy are 30% more likely to have PTC. Thus, more aggressive surveillance for PTC may be indicated in patients with HT, especially in women. (c) 2008 Elsevier Inc. All rights reserved.