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Hashimoto's thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine.
Endocr Relat Cancer 2011; 18(4):429-37ER

Abstract

The possible association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) is a still debated issue. We analyzed the frequency of PTC, TSH levels and thyroid autoantibodies (TAb) in 13 738 patients (9824 untreated and 3914 under l-thyroxine, l-T(4)). Patients with nodular-HT (n=1593) had high titer of TAb and/or hypothyroidism. Patients with nodular goiter (NG) were subdivided in TAb-NG (n=8812) with undetectable TAb and TAb+NG (n=3395) with positive TAb. Among untreated patients, those with nodular-HT showed higher frequency of PTC (9.4%) compared with both TAb-NG (6.4%; P=0.002) and TAb+NG (6.5%; P=0.009) and presented also higher serum TSH (median 1.30 vs 0.71 μU/ml, P<0.001 and 0.70 μU/ml, P<0.001 respectively). Independently of clinical diagnosis, patients with high titer of TAb showed a higher frequency of PTC (9.3%) compared to patients with low titer (6.8%, P<0.001) or negative TAb (6.3%, P<0.001) and presented also higher serum TSH (median 1.16 vs 0.75 μU/ml, P<0.001 and 0.72 μU/ml, P<0.001 respectively). PTC frequency was strongly related with serum TSH (odds ratio (OR)=1.111), slightly related with anti-thyroglobulin antibodies (OR=1.001), and unrelated with anti-thyroperoxidase antibodies. In the l-T(4)-treated group, when only patients with serum TSH levels below the median value (0.90 μU/ml) were considered, no significant difference in PTC frequency was found between nodular-HT, TAb-NG and TAb+NG. In conclusion, the frequency of PTC is significantly higher in nodular-HT than in NG and is associated with increased levels of serum TSH. Treatment with l-T(4) reduces TSH levels and decreases the occurrence of clinically detectable PTC.

Authors+Show Affiliations

Department of Endocrinology, Department of Surgery, University of Pisa, Italy. e.fiore@ao-pisa.toscana.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21565972

Citation

Fiore, E, et al. "Hashimoto's Thyroiditis Is Associated With Papillary Thyroid Carcinoma: Role of TSH and of Treatment With L-thyroxine." Endocrine-related Cancer, vol. 18, no. 4, 2011, pp. 429-37.
Fiore E, Rago T, Latrofa F, et al. Hashimoto's thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine. Endocr Relat Cancer. 2011;18(4):429-37.
Fiore, E., Rago, T., Latrofa, F., Provenzale, M. A., Piaggi, P., Delitala, A., ... Vitti, P. (2011). Hashimoto's thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine. Endocrine-related Cancer, 18(4), pp. 429-37. doi:10.1530/ERC-11-002.
Fiore E, et al. Hashimoto's Thyroiditis Is Associated With Papillary Thyroid Carcinoma: Role of TSH and of Treatment With L-thyroxine. Endocr Relat Cancer. 2011;18(4):429-37. PubMed PMID: 21565972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hashimoto's thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine. AU - Fiore,E, AU - Rago,T, AU - Latrofa,F, AU - Provenzale,M A, AU - Piaggi,P, AU - Delitala,A, AU - Scutari,M, AU - Basolo,F, AU - Di Coscio,G, AU - Grasso,L, AU - Pinchera,A, AU - Vitti,P, Y1 - 2011/07/01/ PY - 2011/5/14/entrez PY - 2011/5/14/pubmed PY - 2011/10/26/medline SP - 429 EP - 37 JF - Endocrine-related cancer JO - Endocr. Relat. Cancer VL - 18 IS - 4 N2 - The possible association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) is a still debated issue. We analyzed the frequency of PTC, TSH levels and thyroid autoantibodies (TAb) in 13 738 patients (9824 untreated and 3914 under l-thyroxine, l-T(4)). Patients with nodular-HT (n=1593) had high titer of TAb and/or hypothyroidism. Patients with nodular goiter (NG) were subdivided in TAb-NG (n=8812) with undetectable TAb and TAb+NG (n=3395) with positive TAb. Among untreated patients, those with nodular-HT showed higher frequency of PTC (9.4%) compared with both TAb-NG (6.4%; P=0.002) and TAb+NG (6.5%; P=0.009) and presented also higher serum TSH (median 1.30 vs 0.71 μU/ml, P<0.001 and 0.70 μU/ml, P<0.001 respectively). Independently of clinical diagnosis, patients with high titer of TAb showed a higher frequency of PTC (9.3%) compared to patients with low titer (6.8%, P<0.001) or negative TAb (6.3%, P<0.001) and presented also higher serum TSH (median 1.16 vs 0.75 μU/ml, P<0.001 and 0.72 μU/ml, P<0.001 respectively). PTC frequency was strongly related with serum TSH (odds ratio (OR)=1.111), slightly related with anti-thyroglobulin antibodies (OR=1.001), and unrelated with anti-thyroperoxidase antibodies. In the l-T(4)-treated group, when only patients with serum TSH levels below the median value (0.90 μU/ml) were considered, no significant difference in PTC frequency was found between nodular-HT, TAb-NG and TAb+NG. In conclusion, the frequency of PTC is significantly higher in nodular-HT than in NG and is associated with increased levels of serum TSH. Treatment with l-T(4) reduces TSH levels and decreases the occurrence of clinically detectable PTC. SN - 1479-6821 UR - https://www.unboundmedicine.com/medline/citation/21565972/Hashimoto's_thyroiditis_is_associated_with_papillary_thyroid_carcinoma:_role_of_TSH_and_of_treatment_with_L_thyroxine_ L2 - https://erc.bioscientifica.com/doi/10.1530/ERC-11-0028 DB - PRIME DP - Unbound Medicine ER -