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Open Access Highly Accessed Research article

The clinical features of papillary thyroid cancer in Hashimoto’s thyroiditis patients from an area with a high prevalence of Hashimoto’s disease

Ling Zhang, Hui Li, Qing-hai Ji*, Yong-xue Zhu, Zhuo-ying Wang, Yu Wang, Cai-ping Huang, Qiang Shen, Duan-shu Li and Yi Wu

Author affiliations

Department of Head & Neck Surgery, Fudan University Cancer Hospital/Center, Department of oncology, Fudan University Shanghai Medical College, 270 Dong An Road, Shanghai, 200032, PR China

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Citation and License

BMC Cancer 2012, 12:610  doi:10.1186/1471-2407-12-610

Published: 21 December 2012

Abstract

Background

The goal of this study was to identify the clinicopathological factors of co-existing papillary thyroid cancer (PTC) in patients with Hashimoto’s thyroiditis (HT) and provide information to aid in the diagnosis of such patients.

Methods

This study included 6109 patients treated in a university-based tertiary care cancer hospital over a 3-year period. All of the patients were categorised based on their final diagnosis. Several clinicopathological factors, such as age, gender, nodular size, invasive status, central compartment lymph node metastasis (CLNM) and serum thyroid-stimulating hormone (TSH) level, were compared between the various groups of patients.

Results

There were 653 patients with a final diagnosis of HT. More PTC was found in those with HT (58.3%; 381 of 653) than those without HT (2416 of 5456; 44.3%; p < 0.05). The HT patients with co-occurring PTC were more likely to be younger, be female, have smaller nodules and have higher TSH levels than those without PTC. A multivariate analysis indicated that the presence of HT and higher TSH levels were risk factors for a diagnosis of PTC. In the PTC patients, the presence of HT or another benign nodule was a protective factor for CLNM, whereas no significant association was found for TSH levels.

Conclusion

PTC and HT have a close relationship in this region of highly prevalent HT disease. Based on the results of our study, we hypothesise that long-term HT leads to elevated serum TSH, which is the real risk factor for thyroid cancer.

Keywords:
Papillary thyroid carcinoma; Thyroid-stimulating hormone; Hashimoto’s thyroiditis