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M.D., M.D., M.D., and M.D.: Is Hashimoto's Thyroiditis Associated with the Prognostic Factors of Papillary Thyroid Carcinoma?
Review Article

Korean J Endocrine Surg 2010;10(1):29-33.

Published online: 18 March 2010

DOI: https://doi.org/10.16956/kjes.2010.10.1.29

Is Hashimoto's Thyroiditis Associated with the Prognostic Factors of Papillary Thyroid Carcinoma?

Min Joo Lee M.D., Byoung Kil Lee M.D., Hyun Jo Yang M.D., Hoo Jung M.D.

Department of Surgery, Chonbuk National University College of Medicine, Jeonju, Korea

Copyright © 2010 Korean Journal of Endocrine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

In recent studies, the presence of lymphocytic infiltration in patients with papillary thyroid carcinoma (PTC) was reported to be associated with a favorable prognosis. The prognostic significance of Hashimoto's thyroiditis (HT) in patients with PTC remains unclear. The aim of our study was to determine the frequency and prognostic significance of HT in patients with PTC.

Methods:

From January 2005 to December 2007, 367 patients who underwent thyroid surgery for PTC were included in this study. They were divided into two groups: Group A (n=71; 19.4%) included the patients diagnosed as having PTC with HT and Group B (n=296; 80.6%) included the patients who had PTC without HT. The clinicopathologic features between Groups A and B were retrospectively reviewed via the medical records.

Results:

Lymph node metastasis was less frequent in Group A than that in Group B (25.5% versus 41.0%, respectively, P=0.033). However, both groups had similar clinicopathologic features in terms of age, gender, the tumor size, multifocality, extrathyroidal invasion, the TNM stage and the AMES and MACIS scores. Also, the operative method did not differ significantly between the two groups.

Conclusion:

These results suggest that the presence of HT is not associated with the prognostic factors of PTC. (Korean J Endocrine Surg 2010;10:29-33)

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Keywords: Papillary thyroid carcinoma, Hashimoto's thyroiditis, Prognostic factor

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Table 1.
Clinicopathologic characteristics
  Group A (%) Group B (%) P value
Age (years) 23∼71 16∼87 0.520
Mean 45.7 46.7  
Gender     0.384
Female 66 (93.0) 265 (89.5)  
Male 5 (7.0) 31 (10.5)  
Operative method     0.428
Lobectomy 24 (33.8) 91 (30.7)  
Sub or near total thyroidectomy 6 (8.5) 20 (6.8)  
Total thyroidectom my 41 (57.7) 179 (60.5) )
Completion thyroid dectomy 0 (0) 6 (2.0)  
Lymph node dissecti ion   0.274
Central LND∗ 46 (64.8) 166 (56.1)  
Lateral LND∗ 5 (7.0) 22 (7.4)  
No 20 (28.2) 108 (36.5)  
Size (cm)     0.231
Mean 1.03 1.19  
≤1.0 45 (63.4) 164 (55.4)  
1.1∼2.0 22 (31.0) 101 (34.1)  
2.1∼3.0 2 (2.8) 21 (7.1)  
3.1≤ 2 (2.8) 10 (3.4)  
Multifocality     0.176
(−) 62 (87.3) 240 (81.1)  
(＋) 9 (12.7) 56 (18.9)  
Extrathyroidal invasio on   0.647
(−) 63 (88.7) 268 (90.5)  
(＋) 8 (11.3) 28 (9.5)  
Lymph node metasta asis   0.033
(−) 38 (74.5) 111 (59.0)  
(＋) 13 (25.5) 77 (41.0)  
TNM stage     0.128
I 43 (84.3) 139 (73.9)  
II 0 (0) 8 (4.3)  
III 8 (15.7) 37 (19.7)  
IV 0 (0) 4 (2.1)  
MACIS     0.111
Low 69 (97.2) 276 (93.2)  
High 2 (2.8) 20 (6.8)  
AMES     0.846
Low 63 (88.7) 265 (89.5)  
High 8 (11.3) 31 (10.5)  

∗ LND = lymph node dissection.

Table 2.
Diagnostic efficacy for Hashimoto's thyroiditis of thyroid ultrasound
  Hashimoto's thyroiditis Total
  (+) (-)
Ultrasound      
(＋) 12 5 17
(−) 59 291 350
Total 71 296 367

Sensitivity = 16.9% (12/71); Specificity = 98.3% (291/296); False positive rate = 1.7% (5/296); False negative rate = 83.1% (59/71); Diagnostic accuracy = 76.5% (303/367).

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