, Volume 55, Issue 3, pp 954–958 | Cite as

Chronic lymphocytic thyroiditis does not influence the risk of recurrence in patients with papillary thyroid carcinoma and excellent response to initial therapy

  • Marina S. Carvalho
  • Pedro W. Rosario
  • Gabriela F. Mourão
  • Maria R. Calsolari
Original Article



This study evaluated the recurrence in patients with papillary thyroid cancer and an excellent response to initial therapy, comparing those with and without chronic lymphocytic thyroiditis.


This was a prospective study. Patients who met the following criteria were selected: diagnosis of papillary thyroid cancer; submitted to total thyroidectomy followed or not by ablation with 131I; and neck ultrasonography without abnormalities, nonstimulated thyroglobulina (Tg) ≤0.2 ng/ml, and undetectable antithyroglobulin antibodies (TgAb) 12–18 months after initial therapy. The patients were divided into two groups: group A, with chronic lymphocytic thyroiditis on histology; group B, without chronic lymphocytic thyroiditis on histology.


Groups A and B were similar in terms of sex and age of the patients, characteristics of the tumor, tumor-node-metastase stage and risk category. The time of follow-up ranged from 24 to 120 months (median 66 months). During follow-up, 5 patients of group A (2.6 %) and 9 patients of group B (2 %) developed recurrence (p = 0.77). Patients with chronic lymphocytic thyroiditis were more likely to progress to persistently borderline TgAb. No patient had positive TgAb (above the reference value) during follow-up. Recurrences occurred in 12/588 patients (2 %) with undetectable TgAb in all measurements, in 1/32 (3.1 %) with detectable TgAb on some occasion but that returned to undetectable spontaneously, and in 1/13 (7.7 %) with persistently borderline TgAb. These rates did not differ significantly (p = 0.25).


The results of the present study showed the absence of an association between chronic lymphocytic thyroiditis and recurrence risk at least in patients with an excellent response to initial therapy.


Papillary thyroid cancer Chronic lymphocytic thyroiditis Excellent response to therapy Recurrence 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Informed consent

The study was approved by the local Research Ethics Committee and the subjects gave written informed consent.


  1. 1.
    K. Kashima, S. Yokoyama, S. Noguchi, N. Murakami, H. Yamashita, S. Watanabe, S. Uchino, M. Toda, A. Sasaki, T. Daa, I. Nakayama, I. Chronic thyroiditis as a favorable prognostic factor in papillary thyroid carcinoma. Thyroid 8, 197–202 (1998)CrossRefPubMedGoogle Scholar
  2. 2.
    K.C. Loh, F.S. Greenspan, F. Dong, T.R. Miller, P.P. Yeo, Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J. Clin. Endocrinol. Metab. 84, 458–463 (1999)CrossRefPubMedGoogle Scholar
  3. 3.
    E. Kebebew, P.A. Treseler, P.H. Ituarte, O.H. Clark, Coexisting chronic lymphocytic thyroiditis and papillary thyroid cancer revisited. World. J. Surg. 25, 632–637 (2001)CrossRefPubMedGoogle Scholar
  4. 4.
    E.Y. Kim, W.G. Kim, W.B. Kim, T.Y. Kim, J.M. Kim, J.S. Ryu, S.J. Hong, G. Gong, Y.K. Shong, Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin. Endocrinol. (Oxf) 71, 581–586 (2009)CrossRefGoogle Scholar
  5. 5.
    B.Y. Huang, C. Hseuh, T.C. Chao, K.J. Lin, J.D. Lin, Well-differentiated thyroid carcinoma with concomitant Hashimoto’s thyroiditis present with less aggressive clinical stage and low recurrence. Endocr. Pathol. 22, 144–149 (2011)CrossRefPubMedGoogle Scholar
  6. 6.
    J.S. Jeong, H.K. Kim, C.R. Lee, S. Park, J.H. Park, S.W. Kang, J.J. Jeong, K.H. Nam, W.Y. Chung, C.S. Park, Coexistence of chronic lymphocytic thyroiditis with papillary thyroid carcinoma: clinical manifestation and prognostic outcome. J. Korean Med. Sci. 27, 883–889 (2012)CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    R.M. Tuttle, H. Tala, J. Shah, R. Leboeuf, R. Ghossein, M. Gonen, M. Brokhin, G. Omry, J.A. Fagin, A. Shaha, Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid 20, 1341–1349 (2010)CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    M.G. Castagna, F. Maino, C. Cipri, V. Belardini, A. Theodoropoulou, G. Cevenini, F. Pacini, Delayed risk stratification, to include the response to initial treatment (surgery and radioiodine ablation), has better outcome predictivity in differentiated thyroid cancer patients. Eur. J. Endocrinol. 165, 441–446 (2011)CrossRefPubMedGoogle Scholar
  9. 9.
    F. Vaisman, D. Momesso, D.A. Bulzico, C.H. Pessoa, F. Dias, R. Corbo, M. Vaisman, R.M. Tuttle, Spontaneous remission in thyroid cancer patients after biochemical incomplete response to initial therapy. Clin Endocrinol. (Oxf). 77, 132–138 (2012)CrossRefPubMedGoogle Scholar
  10. 10.
    M.J. Jeon, W.G. Kim, W.R. Park, J.M. Han, T.Y. Kim, D.E. Song, K.W. Chung, J.S. Ryu, S.J. Hong, Y.K. Shong, W.B. Kim, Modified dynamic risk stratification for predicting recurrence using the response to initial therapy in patients with differentiated thyroid carcinoma. Eur. J. Endocrinol. 170, 23–30 (2013)CrossRefPubMedGoogle Scholar
  11. 11.
    F. Pitoia, F. Bueno, C. Urciuoli, E. Abelleira, G. Cross, R.M. Tuttle, Outcomes of patients with differentiated thyroid cancer risk-stratified according to the American thyroid association and Latin American thyroid society risk of recurrence classification systems. Thyroid 23, 1401–1407 (2013)CrossRefPubMedGoogle Scholar
  12. 12.
    R.S. Scheffel, A.B. Zanella, D. Antunes, J.M. Dora, A.L. Maia, Low recurrence rates in a cohort of differentiated thyroid carcinoma patients: a referral center experience. Thyroid 25, 883–889 (2015)CrossRefPubMedGoogle Scholar
  13. 13.
    L. Giovanella, G. Treglia, R. Sadeghi, P. Trimboli, L. Ceriani, F.A. Verburg FA., Unstimulated highly sensitive thyroglobulin in follow-up of differentiated thyroid cancer patients: a meta-analysis. J. Clin. Endocrinol. Metab. 99, 440–447 (2014)CrossRefPubMedGoogle Scholar
  14. 14.
    M. Brassard, I. Borget, A. Edet-Sanson, A.L. Giraudet, O. Mundler, M. Toubeau, F. Bonichon, F. Borson-Chazot, L. Leenhardt, C. Schvartz, C. Dejax, I. Brenot-Rossi, M.E. Toubert, M. Torlontano, E. Benhamou, M. Schlumberger, Long-term follow-up of patients with papillary and follicular thyroid cancer: a prospective study on 715 patients. J. Clin. Endocrinol. Metab. 96, 1352–1359 (2011)CrossRefPubMedGoogle Scholar
  15. 15.
    B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M. Sawka, M. Schlumberger, K.G. Schuff, S.I. Sherman, J.A. Sosa, D.L. Steward, R.M. Tuttle, L. Wartofsky, 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26, 1–133 (2016)CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    P.W. Rosario, G.C. Penna, M.R. Calsolari, Noninvasive encapsulated follicular variant of papillary thyroid carcinoma: is lobectomy sufficient for tumours ≥1 cm? Clin Endocrinol. (Oxf) 81, 630–632 (2014)CrossRefGoogle Scholar
  17. 17.
    P.W. Rosario, S. de Faria, L. Bicalho, M.F. Alves, M.A. Borges, S. Purisch, E.L. Padrão, L.L. Rezende, A.L. Barroso, Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma. J. Ultrasound. Med. 24, 1385–1389 (2005)CrossRefPubMedGoogle Scholar
  18. 18.
    P.W. Rosario, W.C. Tavares, M.A. Borges, J.B. Santos, M.R. Calsolari, Ultrasonographic differentiation of cervical lymph nodes in patients with papillary thyroid carcinoma after thyroidectomy and radioiodine ablation: a prospective study. Endocr. Pract. 20, 293–298 (2014)CrossRefPubMedGoogle Scholar
  19. 19.
    C. Durante, T. Montesano, M. Torlontano, M. Attard, F. Monzani, S. Tumino, G. Costante, D. Meringolo, R. Bruno, F. Trulli, M. Massa, A. Maniglia, R. D’Apollo, L. Giacomelli, G. Ronga, S. Filetti, Papillary thyroid cancer: time course of recurrences during postsurgery surveillance. J. Clin. Endocrinol. Metab. 98, 636–642 (2013)CrossRefPubMedGoogle Scholar
  20. 20.
    F. Latrofa, D. Ricci, L. Montanelli, R. Rocchi, P. Piaggi, E. Sisti, L. Grasso, F. Basolo, C. Ugolini, A. Pinchera, P. Vitti, Lymphocytic thyroiditis on histology correlates with serum thyroglobulin autoantibodies in patients with papillary thyroid carcinoma: impact on detection of serum thyroglobulin. J. Clin. Endocrinol. Metab. 97, 2380–2387 (2012)CrossRefPubMedGoogle Scholar
  21. 21.
    J.K. Chung, Y.J. Park, T.Y. Kim, Y. So, S.K. Kim, D.J. Park, D.S. Lee, M.C. Lee, B.Y. Cho, Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clin Endocrinol (Oxf) 57, 215–221 (2002)CrossRefGoogle Scholar
  22. 22.
    W.G. Kim, J.H. Yoon, W.B. Kim, T.Y. Kim, E.Y. Kim, J.M. Kim, J.S. Ryu, G. Gong, S.J. Hong, Y.K. Shong, Change of serum antithyroglobulin antibody levels is useful for prediction of clinical recurrence in thyroglobulin-negative patients with differentiated thyroid carcinoma. J. Clin. Endocrinol. Metab. 93, 4683–4689 (2008)CrossRefPubMedGoogle Scholar
  23. 23.
    C.J. Hsieh, P.W. Wang, Sequential changes of serum antithyroglobulin antibody levels are a good predictor of disease activity in thyroglobulin-negative patients with papillary thyroid carcinoma. Thyroid 24, 488–493 (2014)CrossRefPubMedGoogle Scholar
  24. 24.
    C. Durante, S. Tognini, T. Montesano, F. Orlandi, M. Torlontano, E. Puxeddu, M. Attard, G. Costante, S. Tumino, D. Meringolo, R. Bruno, F. Trulli, M. Toteda, A. Redler, G. Ronga, S. Filetti, F. Monzani, Clinical aggressiveness and long-term outcome in patients with papillary thyroid cancer and circulating anti-thyroglobulin autoantibodies. Thyroid 24, 1139–1145 (2014)CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    P.W. Rosario, M. Carvalho, G.F. Mourão, M.R. Calsolari, Comparison of antithyroglobulin antibody concentrations before and after ablation with 131I as a predictor of structural disease in differentiated thyroid carcinoma patients with undetectable basal thyroglobulin and negative neck ultrasonography. Thyroid 26, 525–531 (2016)CrossRefPubMedGoogle Scholar
  26. 26.
    L.L. Cunha, M.A. Marcello, S. Nonogaki, E.C. Morari, F.A. Soares, J. Vassallo, L.S. Ward, CD8+ tumour-infiltrating lymphocytes and COX2 expression may predict relapse in differentiated thyroid cancer. Clin. Endocrinol. (Oxf) 83, 246–253 (2015)CrossRefGoogle Scholar
  27. 27.
    J.H. Lee, Y. Kim, J.W. Choi, Y.S. Kim, The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. Eur. J. Endocrinol. 168, 343–349 (2013)CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Marina S. Carvalho
    • 1
  • Pedro W. Rosario
    • 1
  • Gabriela F. Mourão
    • 1
  • Maria R. Calsolari
    • 1
  1. 1.Instituto de Ensino e Pesquisa da Santa Casa de Belo Horizonte, Rua Domingos Vieira, 590, Santa EfigêniaBelo HorizonteBrazil

Personalised recommendations