Skip to main content

Advertisement

SpringerLink
Log in

The impact of coexistent Hashimoto’s thyroiditis on lymph node metastasis and prognosis in papillary thyroid microcarcinoma

  • Research Article
  • Published:
Tumor Biology

Abstract

The impact of coexistent Hashimoto’s thyroiditis (HT) on lymph node metastasis (LNM) and prognosis in papillary thyroid microcarcinoma (PTMC) remains controversial. We evaluated the association of coexistent HT with clinicopathologic parameters, LNM, and prognosis by retrospectively reviewing a series of consecutive patients treated for PTMC at Fudan University Cancer Center from January 2005 to December 2010. Of all 1,250 patients with complete data for analysis, 364 (29.1 %) had coexistent HT (HT group) and 886 patients (70.9 %) had no evidence of HT (control group). The HT group had higher proportion of female (87.9 vs 70.1 %) patients, higher mean level of thyroid-stimulating hormone (TSH) (2.39 vs 2.00 mIU/L), and lower incidence of extrathyroidal extension (7.4 vs 11.7 %) than those in the control group. However, the incidence of LNM and recurrence was similar between the two groups, and HT was not associated with LNM and recurrence. A series of clinicopathologic factors identified for predicting LNM and recurrence in the control group did not show any prediction in the HT group. In summary, this study suggested that coexistent HT had insignificant protective effect on LNM and prognosis in PTMC, which was inconsistent with prior studies. Further studies aiming to determine novel predictors are recommended in PTMC patients with coexistent HT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McLeod DS, Sawka AM, Cooper DS. Controversies in primary treatment of low-risk papillary thyroid cancer. Lancet. 2013;381:1046–57.

    Article  PubMed  Google Scholar 

  2. Malandrino PPG, Attard M. Papillary thyroid microcarcinomas: a comparative study of the characteristics and risk factors at presentation in two cancer registries. J Clin Endocrinol Metab. 2013;2013(98):1427–34.

    Article  CAS  Google Scholar 

  3. Lee J, Park JH, Lee CR, Chung WY, Park CS. Long-term outcomes of total thyroidectomy versus thyroid lobectomy for papillary thyroid microcarcinoma: comparative analysis after propensity score matching. Thyroid. 2013;23:1408–15.

    Article  PubMed  Google Scholar 

  4. Zhang L, Wei WJ, Ji QH, Zhu YX, Wang ZY, Wang Y, et al. Risk factors for neck nodal metastasis in papillary thyroid microcarcinoma: a study of 1066 patients. J Clin Endocrinol Metab. 2012;97:1250–7.

    Article  CAS  PubMed  Google Scholar 

  5. Wada N, Duh QY, Sugino K, Iwasaki H, Kameyama K, Mimura T, et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg. 2003;237:399–407.

    PubMed  PubMed Central  Google Scholar 

  6. Tamimi DM. The association between chronic lymphocytic thyroiditis and thyroid tumors. Int J Surg Pathol. 2002;10:141–6.

    Article  PubMed  Google Scholar 

  7. Kebebew E, Treseler PA, Ituarte PH, Clark OH. Coexisting chronic lymphocytic thyroiditis and papillary thyroid cancer revisited. World J Surg. 2001;25:632–7.

    Article  CAS  PubMed  Google Scholar 

  8. Zhang L, Li H, Ji QH, Zhu YX, Wang ZY, Wang Y, et al. The clinical features of papillary thyroid cancer in Hashimoto’s thyroiditis patients from an area with a high prevalence of Hashimoto’s disease. BMC Cancer. 2012;12:610.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Zeppa P, Cozzolino I, Peluso AL, Troncone G, Lucariello A, Picardi M, et al. Cytologic, flow cytometry, and molecular assessment of lymphoid infiltrate in fine-needle cytology samples of hashimoto thyroiditis. Cancer. 2009;117:174–84.

    CAS  PubMed  Google Scholar 

  10. Muzza M, Degl’Innocenti D, Colombo C, Perrino M, Ravasi E, Rossi S, et al. The tight relationship between papillary thyroid cancer, autoimmunity and inflammation: clinical and molecular studies. Clin Endocrinol (Oxf). 2010;72:702–8.

    Article  CAS  Google Scholar 

  11. Jara SM, Carson KA, Pai SI, Agrawal N, Richmon JD, Prescott JD, et al. The relationship between chronic lymphocytic thyroiditis and central neck lymph node metastasis in North American patients with papillary thyroid carcinoma. Surgery. 2013;154:1272–80. discussion 1280–1272.

    Article  PubMed  Google Scholar 

  12. Sciuto R, Romano L, Rea S, Marandino F, Sperduti I, Maini CL. Natural history and clinical outcome of differentiated thyroid carcinoma: a retrospective analysis of 1503 patients treated at a single institution. Ann Oncol. 2009;20:1728–35.

    Article  CAS  PubMed  Google Scholar 

  13. Sobin LHGM, Wittekind CH. UICC: TNM classification of malignant tumors. 7th ed. New York: Wiley-Liss; 2009.

    Google Scholar 

  14. Lee J, Park JH, Lee CR, Chung WY, Park CS. Long-term outcomes of total thyroidectomy versus thyroid lobectomy for papillary thyroid microcarcinoma: comparative analysis after propensity score matching. Thyroid. 2013;1408–15. doi:10.1089/thy.2012.0463.

  15. Loh KC, Greenspan FS, Dong F, Miller TR, Yeo PP. Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J Clin Endocrinol Metab. 1999;84:458–63.

    Article  CAS  PubMed  Google Scholar 

  16. Kashima K, Yokoyama S, Noguchi S, Murakami N, Yamashita H, Watanabe S, et al. Chronic thyroiditis as a favorable prognostic factor in papillary thyroid carcinoma. Thyroid. 1998;8:197–202.

    Article  CAS  PubMed  Google Scholar 

  17. Matsubayashi S, Kawai K, Matsumoto Y, Mukuta T, Morita T, Hirai K, et al. The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland. J Clin Endocrinol Metab. 1995;80:3421–4.

    CAS  PubMed  Google Scholar 

  18. Kim EY, Kim WG, Kim WB, Kim TY, Kim JM, Ryu JS, et al. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf). 2009;71:581–6.

    Article  Google Scholar 

  19. Yoon YH, Kim HJ, Lee JW, Kim JM, Koo BS. The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis. Eur Arch Otorhinolaryngol. 2012;269:1013–7.

    Article  PubMed  Google Scholar 

  20. Singh B, Shaha AR, Trivedi H, Carew JF, Poluri A, Shah JP. Coexistent Hashimoto’s thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome. Surgery. 1999;126:1070–6. discussion 1076–1077.

    Article  CAS  PubMed  Google Scholar 

  21. Kim SS, Lee BJ, Lee JC, Kim SJ, Jeon YK, Kim MR, et al. Coexistence of Hashimoto’s thyroiditis with papillary thyroid carcinoma: the influence of lymph node metastasis. Head Neck. 2011;33:1272–7.

    Article  PubMed  Google Scholar 

  22. Schaffler A, Palitzsch KD, Seiffarth C, Hohne HM, Riedhammer FJ, Hofstadter F, et al. Coexistent thyroiditis is associated with lower tumour stage in thyroid carcinoma. Eur J Clin Investig. 1998;28:838–44.

    Article  CAS  Google Scholar 

  23. Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med. 1996;335:99–107.

    Article  CAS  PubMed  Google Scholar 

  24. Kim YS, Choi HJ, Kim ES. Papillary thyroid carcinoma with thyroiditis: lymph node metastasis, complications. J Korean Surg Soc. 2013;85:20–4.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zheng X, Wei S, Han Y, Li Y, Yu Y, Yun X, et al. Papillary microcarcinoma of the thyroid: Clinical characteristics and BRAF(V600E) mutational status of 977 cases. Ann Surg Oncol. 2013;20:2266–73.

    Article  PubMed  Google Scholar 

  26. Hyun SM, Song HY, Kim SY, Nam SY, Roh JL, Han MW, et al. Impact of combined prophylactic unilateral central neck dissection and hemithyroidectomy in patients with papillary thyroid microcarcinoma. Ann Surg Oncol. 2012;19:591–6.

    Article  PubMed  Google Scholar 

  27. Vayisoglu Y, Ozcan C. Involvement of level IIb lymph node metastasis and dissection in thyroid cancer. Gland Surg. 2013;2:180–5.

    PubMed  PubMed Central  Google Scholar 

  28. Haymart MR, Repplinger DJ, Leverson GE, Elson DF, Sippel RS, Jaume JC, et al. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab. 2008;93:809–14.

    Article  CAS  PubMed  Google Scholar 

  29. Kim SK, Song KH, Lim SD, Lim YC, Yoo YB, Kim JS, et al. Clinical and pathological features and the BRAF(V600E) mutation in patients with papillary thyroid carcinoma with and without concurrent hashimoto thyroiditis. Thyroid. 2009;19:137–41.

    Article  CAS  PubMed  Google Scholar 

  30. Crawford S, Belajic D, Wei J, Riley JP, Dunford PJ, Bembenek S, et al. A novel B-RAF inhibitor blocks interleukin-8 (IL-8) synthesis in human melanoma xenografts, revealing IL-8 as a potential pharmacodynamic biomarker. Mol Cancer Ther. 2008;7:492–9.

    Article  CAS  PubMed  Google Scholar 

  31. Puxeddu E, Moretti S, Elisei R, Romei C, Pascucci R, Martinelli M, et al. BRAF(V599E) mutation is the leading genetic event in adult sporadic papillary thyroid carcinomas. J Clin Endocrinol Metab. 2004;89:2414–20.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This research is supported by grants from the Key Project of Science and Technology Commission of Shanghai Municipality (11DJ1400200).

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Ning Qu, Ling Zhang, Qing-hai Ji, Yong-xue Zhu & Yu Wang

  2. Department of Oncology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Dao-zhe Lin

Authors
  1. Ning Qu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ling Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dao-zhe Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qing-hai Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yong-xue Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qing-hai Ji.

Additional information

Ning Qu, Ling Zhang, and Dao-zhe Lin contributed equally to the paper.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Qu, N., Zhang, L., Lin, Dz. et al. The impact of coexistent Hashimoto’s thyroiditis on lymph node metastasis and prognosis in papillary thyroid microcarcinoma. Tumor Biol. 37, 7685–7692 (2016). https://doi.org/10.1007/s13277-015-4534-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13277-015-4534-4

Keywords

Search

Navigation