Download PDF
Horm Metab Res 2017; 49(10): 732-738
DOI: 10.1055/s-0043-117892
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Hashimoto’s Thyroiditis is an Important Risk Factor of Papillary Thyroid Microcarcinoma in Younger Adults

Yujuan Liu
1   Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
2   Department of Nutrition, Qingdao Women and Children’s Hospital, Qingdao, China
,
Chengqian Li
1   Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
,
Wenjuan Zhao
1   Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
,
Yangang Wang
1   Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
› Author Affiliations
Further Information

Publication History

received 24 February 2017

accepted 24 July 2017

Publication Date:
31 August 2017 (online)

Also available at
    Permissions and Reprints

Abstract

The association between autoimmune thyroid disease and thyroid cancer remains unclear. We performed a matched case-control study to assess the association between Hashimoto’s thyroiditis and papillary thyroid microcarcinoma (PTMC). A total of 927 PTMC cases and 927 age- and gender- matched controls selected from the same population were recruited. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the strength of the association between Hashimoto’s thyroiditis and PTMC. Conditional logistic regression analysis was carried out, and stratified analyses by age, gender and types of thyroid antibodies were also performed. Hashimoto’s thyroiditis was significantly associated with increased risk of PTMC (OR=1.87, 95% CI 1.49–2.34, p<0.001). Stratified analysis by thyroid antibodies also found obvious associations of PTMC risk with TPOAb positivity (OR=1.58, p=0.001) and TGAb positivity (OR=2.35, p<0.001). Stratified analyses by age showed that the association between Hashimoto’s thyroiditis and PTMC risk was more significant in younger adults aged between 18 and 30 years (OR=11.48, p<0.001). Further stratified analyses by thyroid antibodies also found that the associations of PTMC risk with TPOAb positivity or TGAb positivity were more significant in younger adults aged between 18 and 30, and the ORs were 8.27 (p<0.001) and 12.71 (p<0.001), respectively. This study suggests an obvious relationship between Hashimoto’s thyroiditis and PTMC risk, and Hashimoto’s thyroiditis is an important risk of PTMC in younger adults.

Key words

Hashimoto’s thyroiditis - papillary thyroid microcarcinoma - risk factor
 

  • References

  • 1 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin 2017; 67: 7-30
    CrossrefPubMedGoogle Scholar
  • 2 Morris LG, Tuttle RM, Davies L. Changing trends in the incidence of thyroid cancer in the united states. JAMA Otolaryngol Head Neck Surg 2016; 142: 709-711
    CrossrefPubMedGoogle Scholar
  • 3 Londero SC, Krogdahl A, Bastholt L, Overgaard J, Trolle W, Pedersen HB, Bentzen J, Schytte S, Christiansen P, Godballe C. Papillary thyroid microcarcinoma in Denmark 1996-2008: A national study of epidemiology and clinical significance. Thyroid 2013; 23: 1159-1164
    CrossrefPubMedGoogle Scholar
  • 4 Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet 2016; 388: 2783-2795
    CrossrefPubMedGoogle Scholar
  • 5 Pacini F. Thyroid microcarcinoma. Best Pract Res Clin Endocrinol Metab 2012; 26: 381-389
    CrossrefPubMedGoogle Scholar
  • 6 Soares P, Celestino R, Gaspar da Rocha A, Sobrinho-Simoes M. Papillary thyroid microcarcinoma: how to diagnose and manage this epidemic?. Int J Surg Pathol 2014; 22: 113-119
    CrossrefPubMedGoogle Scholar
  • 7 Leidig-Bruckner G, Bruckner T, Raue F, Frank-Raue K. long-term follow-up and treatment of postoperative permanent hypoparathyroidism in patients with medullary thyroid carcinoma: Differences in complete and partial disease. Horm Metab Res 2016; 48: 806-813
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Rosario PW, Calsolari MR. Usefulness of serum calcitonin in patients without a suspicious history of medullary thyroid carcinoma and with thyroid nodules without an indication for fine-needle aspiration or with benign cytology. Horm Metab Res 2016; 48: 372-376
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Antonelli A, Ferrari SM, Corrado A, Di Domenicantonio A, Fallahi P. Autoimmune thyroid disorders. Autoimmun Rev 2015; 14: 174-180
    CrossrefPubMedGoogle Scholar
  • 10 McLeod DS, Caturegli P, Cooper DS, Matos PG, Hutfless S. Variation in rates of autoimmune thyroid disease by race/ethnicity in US military personnel. JAMA 2014; 311: 1563-1565
    CrossrefPubMedGoogle Scholar
  • 11 Banga JP, Schott M. Autoimmune Thyroid Diseases. Horm Metab Res 2015; 47: 699-701
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 McLeod DS, Cooper DS. The incidence and prevalence of thyroid autoimmunity. Endocrine 2012; 42: 252-265
    CrossrefPubMedGoogle Scholar
  • 13 Moreno-Reyes R, Glinoer D, Van Oyen H, Vandevijvere S. High prevalence of thyroid disorders in pregnant women in a mildly iodine-deficient country: A population-based study. J Clin Endocrinol Metab 2013; 98: 3694-3701
    CrossrefPubMedGoogle Scholar
  • 14 Ajjan RA, Weetman AP. The pathogenesis of hashimoto's thyroiditis: Further developments in our understanding. Horm Metab Res 2015; 47: 702-710
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Rostamzadeh D, Dabbaghmanesh MH, Shabani M, Hosseini A, Amirghofran Z. Expression Profile of Human Fc Receptor-Like 1, 2, and 4 Molecules in peripheral blood mononuclear cells of patients with Hashimoto's Thyroiditis and Graves' disease. Horm Metab Res 2015; 47: 693-698
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Sarkhail P, Mehran L, Askari S, Tahmasebinejad Z, Tohidi M, Azizi F. Maternal thyroid function and autoimmunity in 3 trimesters of pregnancy and their offspring's thyroid function. Horm Metab Res 2016; 48: 20-26
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Karch A, Thomas SL. Autoimmune thyroiditis as a risk factor for stroke: a historical cohort study. Neurology 2014; 82: 1643-1652
    CrossrefPubMedGoogle Scholar
  • 18 Zoller B, Li X, Sundquist J, Sundquist K. Risk of subsequent coronary heart disease in patients hospitalized for immune-mediated diseases: A nationwide follow-up study from Sweden. PLoS One 2012; 7: e33442
    CrossrefPubMedGoogle Scholar
  • 19 Topaloglu O, Gokay F, Kucukler K, Burnik FS, Mete T, Yavuz HC, Berker D, Guler S. Is autoimmune thyroiditis a risk factor for early atherosclerosis in premenopausal women even if in euthyroid status?. Endocrine 2013; 44: 145-151
    CrossrefPubMedGoogle Scholar
  • 20 Fontenelle LC, Feitosa MM, Severo JS, Freitas TE, Morais JB, Torres-Leal FL, Henriques GS, do Nascimento Marreiro D. Thyroid function in human obesity: Underlying mechanisms. Horm Metab Res 2016; 48: 787-794
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Azizi G, Keller JM, Lewis M, Piper K, Puett D, Rivenbark KM, Malchoff CD. Association of Hashimoto's thyroiditis with thyroid cancer. Endocr Relat Cancer 2014; 21: 845-852
    CrossrefPubMedGoogle Scholar
  • 22 Noureldine SI, Tufano RP. Association of Hashimoto's thyroiditis and thyroid cancer. Curr Opin Oncol 2015; 27: 21-25
    CrossrefPubMedGoogle Scholar
  • 23 Benvenga S. On the association between Hashimoto's thyroiditis and papillary thyroid carcinoma: Looking 100 years back and, hopefully, fewer years ahead to sort out this association. Thyroid 2013; 23: 1180-1181
    CrossrefPubMedGoogle Scholar
  • 24 Dvorkin S, Robenshtok E, Hirsch D, Strenov Y, Shimon I, Benbassat CA. Differentiated thyroid cancer is associated with less aggressive disease and better outcome in patients with coexisting Hashimotos thyroiditis. J Clin Endocrinol Metab 2013; 98: 2409-2414
    CrossrefPubMedGoogle Scholar
  • 25 Fukuda A, Hirohata T, Noguchi S, Ikeda M, Matsuo K, Yoshida A. Risks for malignancies in patients with chronic thyroiditis: A long-term follow-up study. Jpn J Cancer Res 1987; 78: 1329-1334
    PubMedGoogle Scholar
  • 26 Liu CL, Cheng SP, Lin HW, Lai YL. Risk of thyroid cancer in patients with thyroiditis: A population-based cohort study. Ann Surg Oncol 2014; 21: 843-849
    CrossrefPubMedGoogle Scholar
  • 27 Holm LE, Blomgren H, Lowhagen T. Cancer risks in patients with chronic lymphocytic thyroiditis. N Engl J Med 1985; 312: 601-604
    CrossrefPubMedGoogle Scholar
  • 28 Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 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 2016; 26: 1-133
    CrossrefPubMedGoogle Scholar
  • 29 Mintziori G, Adamidou F, Kita M. Hashimoto's thyroiditis and papillary thyroid cancer: Polyglandular hints. Trends Endocrinol Metab 2015; 26: 395
    CrossrefPubMedGoogle Scholar
  • 30 Paparodis R, Imam S, Todorova-Koteva K, Staii A, Jaume JC. Hashimoto's thyroiditis pathology and risk for thyroid cancer. Thyroid 2014; 24: 1107-1114
    CrossrefPubMedGoogle Scholar
  • 31 Ehlers M, Schott M. Hashimoto's thyroiditis and papillary thyroid cancer: are they immunologically linked?. Trends Endocrinol Metab 2014; 25: 656-664
    CrossrefPubMedGoogle Scholar
  • 32 Jankovic B, Le KT, Hershman JM. Clinical Review: Hashimoto's thyroiditis and papillary thyroid carcinoma: is there a correlation?. J Clin Endocrinol Metab 2013; 98: 474-482
    CrossrefPubMedGoogle Scholar
  • 33 Anil C, Goksel S, Gursoy A. Hashimoto's thyroiditis is not associated with increased risk of thyroid cancer in patients with thyroid nodules: A single-center prospective study. Thyroid 2010; 20: 601-606
    CrossrefPubMedGoogle Scholar
  • 34 Fiore E, Rago T, Latrofa F, Provenzale MA, Piaggi P, Delitala A, Scutari M, Basolo F, Di Coscio G, Grasso L, Pinchera A, Vitti P. Hashimoto's thyroiditis is associated with papillary thyroid carcinoma: Role of TSH and of treatment with l-thyroxine. Endocr Relat Cancer 2011; 18: 429-437
    CrossrefPubMedGoogle Scholar
  • 35 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: 458-463
    CrossrefPubMedGoogle Scholar
  • 36 Mechler C, Bounacer A, Suarez H, Saint Frison M, Magois C, Aillet G, Gaulier A. Papillary thyroid carcinoma: 6 cases from 2 families with associated lymphocytic thyroiditis harbouring RET/PTC rearrangements. Br J Cancer 2001; 85: 1831-1837
    CrossrefPubMedGoogle Scholar
  • 37 Maceri DR, Sullivan MJ, McClatchney KD. Autoimmune thyroiditis: pathophysiology and relationship to thyroid cancer. Laryngoscope 1986; 96: 82-86
    PubMedGoogle Scholar
  • 38 Koibuchi H, Omoto K, Fukushima N, Toyotsuji T, Taniguchi N, Kawano M. Coexistence of papillary thyroid cancer and Hashimoto thyroiditis in children: report of 3 cases. J Ultrasound Med 2014; 33: 1299-1303
    CrossrefPubMedGoogle Scholar
  • 39 Snyder EM, Nicol KK, Buchan A, Coley BD. Synchronous presentation of Hashimoto thyroiditis and papillary thyroid carcinoma in a 7-year-old girl. J Ultrasound Med 2010; 29: 1007-1010
    CrossrefPubMedGoogle Scholar
  • 40 Okani CO, Otene B, Nyaga T, Ngbea J, Eke A, Edegbe F, Anyiam D. Report of a case of papillary thyroid carcinoma in association with Hashimoto's thyroiditis. Niger Med J 2015; 56: 433-435
    CrossrefPubMedGoogle Scholar
  • 41 Karavanaki K, Karayianni C, Vassiliou I, Tzanela M, Sdogou T, Kakleas K, Tsentidis C, Vakaki M, Soldatou A, Kallinikou D, Kostaki M, Tsitsopoulos S, Papathanasiou A. Multiple autoimmunity, type 1 diabetes (T1DM), autoimmune thyroiditis and thyroid cancer: Is there an association? A case report and literature review. J Pediatr Endocrinol Metab 2014; 27: 1011-1016
    PubMedGoogle Scholar