Skip to main content

Advertisement

SpringerLink
Log in

Does papillary thyroid carcinoma have a better prognosis with or without Hashimoto thyroiditis?

  • Original Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

It has been reported that the BRAF V600E mutation is related to a low frequency of background Hashimoto thyroiditis (HT); however, there are not many factors known to be related to the development of HT. The aim of this study was to determine whether patients with both papillary thyroid carcinoma (PTC) and HT show aggressive features, by investigating the clinicopathological features of HT in patients with PTC.

Methods

A database of patients with PTC who underwent thyroidectomy between October 2008 and August 2012 was collected and reviewed. All 2464 patients were offered a thyroidectomy, and DNA was extracted from the atypical cells in the surgical specimens for detection of the BRAF V600E mutation. Clinical and pathological characteristics were also investigated.

Results

Four hundred and fifty-two of 1945 (23.2 %) patients were diagnosed with HT, and of these, 119 (72.1 %) had a BRAF V600E mutation. HT was not significantly associated with the BRAF V600E mutation (P < 0.001) and extrathyroidal extensions (P = 0.005) but was associated with a low stage (P = 0.011) and female predominance (P < 0.001). In a subgroup analysis for gender, HT was associated with a low probability of BRAF V600E mutations in both genders (P < 0.001 for both females and males). Also, recurrence was significantly associated with HT (OR 0.297, CI 0.099–0.890, P = 0.030), lymph node ratio (OR 2.545, CI 1.092–5.931, P = 0.030), and BRAF V600E mutation (OR 2.075, CI 1.021–4.217, P = 0.044). However, there was no relationship with clinicopathological factors or with death.

Conclusions

Our results show that HT in patients with PTC is associated with a low probability of BRAF V600E mutations. Moreover, HT was correlated with some factors that were associated with less aggressive clinical features and inversely related to recurrence. Therefore, these results may be useful to predict whether PTC concurrent with HT exhibits a better prognosis than PTC alone.

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. Sargent R, LiVolsi V, Murphy J et al (2006) BRAF mutation is unusual in chronic lymphocytic thyroiditis-associated papillary thyroid carcinomas and absent in non-neoplastic nuclear atypia of thyroiditis. Endocr Pathol 17(3):235–241

    Article  CAS  PubMed  Google Scholar 

  2. Trovisco V, Vieira de Castro I, Soares P et al (2004) BRAF mutations are associated with some histological types of papillary thyroid carcinoma. J Pathol 202(2):247–251

    Article  CAS  PubMed  Google Scholar 

  3. Puxeddu E, Moretti S, Elisei R et al (2004) BRAF(V599E) mutation is the leading genetic event in adult sporadic papillary thyroid carcinomas. J Clin Endocrinol Metab 89(5):2414–2420

    Article  CAS  PubMed  Google Scholar 

  4. Fugazzola L, Mannavola D, Cirello V et al (2004) BRAF mutations in an Italian cohort of thyroid cancers. Clin Endocrinol 61(2):239–243

    Article  CAS  Google Scholar 

  5. Nikiforov YE (2002) RET/PTC rearrangement in thyroid tumors. Endocr Pathol 13(1):3–16

    Article  CAS  PubMed  Google Scholar 

  6. Kim SK, Song KH, Lim SD et al (2009) Clinical and pathological features and the BRAF(V600E) mutation in patients with papillary thyroid carcinoma with and without concurrent Hashimoto thyroiditis. Thyroid 19(2):137–141

    Article  PubMed  Google Scholar 

  7. Melillo RM, Castellone MD, Guarino V et al (2005) The RET/PTC-RAS-BRAF linear signaling cascade mediates the motile and mitogenic phenotype of thyroid cancer cells. J Clin Invest 115(4):1068–1081

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Chung JH, Hahm JR, Min YK et al (1999) Detection of RET/PTC oncogene rearrangements in Korean papillary thyroid carcinomas. Thyroid 9(12):1237–1243

    Article  CAS  PubMed  Google Scholar 

  9. Park KY, Koh JM, Kim YI et al (1998) Prevalences of Gs alpha, ras, p53 mutations and ret/PTC rearrangement in differentiated thyroid tumours in a Korean population. Clin Endocrinol 49(3):317–323

    Article  CAS  Google Scholar 

  10. Kim TY, Kim WB, Rhee YS et al (2006) The BRAF mutation is useful for prediction of clinical recurrence in low-risk patients with conventional papillary thyroid carcinoma. Clin Endocrinol 65(3):364–368

    Article  CAS  Google Scholar 

  11. Chung KW, Yang SK, Lee GK et al (2006) Detection of BRAFV600E mutation on fine needle aspiration specimens of thyroid nodule refines cyto-pathology diagnosis, especially in BRAF600E mutation-prevalent area. Clin Endocrinol 65(5):660–666

    Article  CAS  Google Scholar 

  12. Kim KH, Kang DW, Kim SH et al (2004) Mutations of the BRAF gene in papillary thyroid carcinoma in a Korean population. Yonsei Med J 45(5):818–821

    Article  CAS  PubMed  Google Scholar 

  13. Weetman AP (2004) Cellular immune responses in autoimmune thyroid disease. Clin Endocrinol 61(4):405–413

    Article  CAS  Google Scholar 

  14. Guarino V, Castellone MD, Avilla E et al (2010) Thyroid cancer and inflammation. Mol Cell Endocrinol 321(1):94–102

    Article  CAS  PubMed  Google Scholar 

  15. Kim KH, Suh KS, Kang DW et al (2005) Mutations of the BRAF gene in papillary thyroid carcinoma and in Hashimoto’s thyroiditis. Pathol Int 55(9):540–545

    Article  CAS  PubMed  Google Scholar 

  16. Nikiforov YE, Ohori NP, Hodak SP et al (2011) Impact of mutational testing on the diagnosis and management of patients with cytologically indeterminate thyroid nodules: a prospective analysis of 1056 FNA samples. J Clin Endocrinol Metab 96(11):3390–3397

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Nikiforova MN, Kimura ET, Gandhi M et al (2003) BRAF mutations in thyroid tumors are restricted to papillary carcinomas and anaplastic or poorly differentiated carcinomas arising from papillary carcinomas. J Clin Endocrinol Metab 88(11):5399–5404

    Article  CAS  PubMed  Google Scholar 

  18. Salvatore G, Giannini R, Faviana P et al (2004) Analysis of BRAF point mutation and RET/PTC rearrangement refines the fine-needle aspiration diagnosis of papillary thyroid carcinoma. J Clin Endocrinol Metab 89(10):5175–5180

    Article  CAS  PubMed  Google Scholar 

  19. Tetzlaff MT, LiVolsi V, Baloch ZW (2006) Assessing the utility of a mutational assay for B-RAF as an adjunct to conventional fine needle aspiration of the thyroid gland. Adv Anat Pathol 13(5):228–237

    Article  PubMed  Google Scholar 

  20. Xing M, Tufano RP, Tufaro AP et al (2004) Detection of BRAF mutation on fine needle aspiration biopsy specimens: a new diagnostic tool for papillary thyroid cancer. J Clin Endocrinol Metab 89(6):2867–2872

    Article  CAS  PubMed  Google Scholar 

  21. Di Pasquale M, Rothstein JL, Palazzo JP (2001) Pathologic features of Hashimoto’s-associated papillary thyroid carcinomas. Hum Pathol 32(1):24–30

    Article  PubMed  Google Scholar 

  22. Pisanu A, Piu S, Cois A et al (2003) Coexisting Hashimoto’s thyroiditis with differentiated thyroid cancer and benign thyroid diseases: indications for thyroidectomy. Chir Ital 55(3):365–372

    PubMed  Google Scholar 

  23. Sclafani AP, Valdes M, Cho H (1993) Hashimoto’s thyroiditis and carcinoma of the thyroid: optimal management. Laryngoscope 103(8):845–849

    Article  CAS  PubMed  Google Scholar 

  24. Eisenberg BL, Hensley SD (1989) Thyroid cancer with coexistent Hashimoto’s thyroiditis. Clinical assessment and management. Arch Surg 124(9):1045–1047

    Article  CAS  PubMed  Google Scholar 

  25. Ott RA, McCall AR, McHenry C et al (1987) The incidence of thyroid carcinoma in Hashimoto’s thyroiditis. Am Surg 53(8):442–445

    CAS  PubMed  Google Scholar 

  26. Segal K, Ben-Bassat M, Avraham A et al (1985) Hashimoto’s thyroiditis and carcinoma of the thyroid gland. Int Surg 70(3):205–209

    CAS  PubMed  Google Scholar 

  27. Lun Y, Wu X, Xia Q et al (2013) Hashimoto’s thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis. Otolaryngol Head Neck Surg 148:396–402

    Article  PubMed  Google Scholar 

  28. Howell GM, Nikiforova MN, Carty SE et al (2013) BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer. Ann Surg Oncol 20(1):47–52

    Article  PubMed  Google Scholar 

  29. Kebebew E, Weng J, Bauer J et al (2007) The prevalence and prognostic value of BRAF mutation in thyroid cancer. Ann Surg 246(3):466–470 (discussion 70–1)

    Article  PubMed Central  PubMed  Google Scholar 

  30. Lupi C, Giannini R, Ugolini C et al (2007) Association of BRAF V600E mutation with poor clinicopathological outcomes in 500 consecutive cases of papillary thyroid carcinoma. J Clin Endocrinol Metab 92(11):4085–4090

    Article  CAS  PubMed  Google Scholar 

  31. Xing M, Westra WH, Tufano RP et al (2005) BRAF mutation predicts a poorer clinical prognosis for papillary thyroid cancer. J Clin Endocrinol Metab 90(12):6373–6379

    Article  CAS  PubMed  Google Scholar 

  32. Lang BH, Wong KP, Wan KY et al (2012) Significance of metastatic lymph node ratio on stimulated thyroglobulin levels in papillary thyroid carcinoma after prophylactic unilateral central neck dissection. Ann Surg Oncol 19(4):1257–1263

    Article  PubMed Central  PubMed  Google Scholar 

  33. Yip J, Orlov S, Orlov D et al (2013) Predictive value of metastatic cervical lymph node ratio in papillary thyroid carcinoma recurrence. Head Neck 35(4):592–598

    Article  PubMed  Google Scholar 

  34. Fiore E, Vitti P (2012) Serum TSH and risk of papillary thyroid cancer in nodular thyroid disease. J Clin Endocrinol Metab 97(4):1134–1145

    Article  CAS  PubMed  Google Scholar 

  35. Latrofa F, Ricci D, Vitti P et al (2010) Characterization of thyroglobulin epitopes in Sardinian adults and juveniles with Hashimoto’s thyroiditis: evidence against a major effect of age and genetic background on B-cell epitopes. Clin Endocrinol 73(1):110–113

    CAS  Google Scholar 

  36. Fiore E, Rago T, Latrofa F et al (2011) Hashimoto’s thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine. Endocr Relat Cancer 18(4):429–437

    Article  CAS  PubMed  Google Scholar 

  37. Kim KW, Park YJ, Kim EH et al (2011) Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto’s thyroiditis. Head Neck 33(5):691–695

    Article  PubMed  Google Scholar 

  38. Lee JH, Kim Y, Choi JW et al (2013) The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. Eur J Endocrinol/Eur Fed Endocr Soc 168(3):343–349

    Article  CAS  Google Scholar 

  39. Loh KC, Greenspan FS, Dong F et al (1999) Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J Clin Endocrinol Metab 84(2):458–463

    Article  CAS  PubMed  Google Scholar 

  40. Yoon YH, Kim HJ, Lee JW et al (2012) The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis. Eur Arch Otorhinolaryngol 269(3):1013–1017

    Article  PubMed  Google Scholar 

  41. Marotta V, Guerra A, Zatelli MC et al (2013) BRAF mutation positive papillary thyroid carcinoma is less advanced when Hashimoto’s thyroiditis lymphocytic infiltration is present. Clin Endocrinol 79(5):733–738

    CAS  Google Scholar 

Download references

Acknowledgments

None.

Conflict of interest

The authors have declared no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea

    Hee Yong Kwak

  2. Department of Surgery, Seoul St. Mary’s Hospital, Catholic University of Korea College of Medicine, Seoul, Republic of Korea

    Byung Joo Chae, Yong Hwa Eom, Young Ran Hong, Jae Beom Seo, So Hee Lee, Byung Joo Song, Sang Seol Jung & Ja Seong Bae

Authors
  1. Hee Yong Kwak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Byung Joo Chae
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yong Hwa Eom
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young Ran Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jae Beom Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. So Hee Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Byung Joo Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sang Seol Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ja Seong Bae
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ja Seong Bae.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kwak, H.Y., Chae, B.J., Eom, Y.H. et al. Does papillary thyroid carcinoma have a better prognosis with or without Hashimoto thyroiditis?. Int J Clin Oncol 20, 463–473 (2015). https://doi.org/10.1007/s10147-014-0754-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-014-0754-7

Keywords

Search

Navigation