Pathologic Spectrum of Lymphocytic Infiltration and Recurrence of Papillary Thyroid Carcinoma
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to investigate the prognosis of papillary thyroidcarcinoma (PTC) patients according to different pathologic grades of lymphocyticthyroiditis (LT). Materials and Methods: This study included 144 PTC patientswho underwent total thyroidectomy with radioactive iodine remnant ablation therapy. Pathologic grades of LT were separated at two points, chronic lymphocyticthyroiditis (CLT) and Hashimoto thyroiditis (HT). Patients were divided into two groupings according to the presence of the diseases (Grouping 1; patients with CLT or HT and without CLT or HT, Grouping 2; patients with HT and without HT). The groupings were compared according to recurrence, clinicopathologic and ultrasound (US) characteristics, and disease free survival. Results: Of 144 patients, 41 had CLT and 19 had HT. There were 10 patients (6.9%) with tumor recurrence. In both groupings, the presence of calcification was more frequently associated with patients with LT (p=0.041 and 0.047, respectively). In Grouping 2, the mean age at diagnosis was older in patients without HT compared to patients with HT (p=0.032). On multivariate analysis, the presence of LT was not an independent predictor of recurrence in both groupings. For both groupings, pathologic tumor size and taller than wide shape on US were independent predictors of recurrence. The presence of LT in PTC patients did not affect recurrence. Conclusion: There was no relationship between PTC prognosis and different grades of LT. Pathologic tumor size and taller than wide shape on ultrasound were independent predictors of PTC recurrence regardless of concurrent LT.
Abstract
Purpose: The aim of this study was to investigate the prognosis of papillary thyroidcarcinoma (PTC) patients according to different pathologic grades of lymphocyticthyroiditis (LT). Materials and Methods: This study included 144 PTC patientswho underwent total thyroidectomy with radioactive iodine remnant ablation therapy. Pathologic grades of LT were separated at two points, chronic lymphocyticthyroiditis (CLT) and Hashimoto thyroiditis (HT). Patients were divided into two groupings according to the presence of the diseases (Grouping 1; patients with CLT or HT and without CLT or HT, Grouping 2; patients with HT and without HT). The groupings were compared according to recurrence, clinicopathologic and ultrasound (US) characteristics, and disease free survival. Results: Of 144 patients, 41 had CLT and 19 had HT. There were 10 patients (6.9%) with tumor recurrence. In both groupings, the presence of calcification was more frequently associated with patients with LT (p=0.041 and 0.047, respectively). In Grouping 2, the mean age at diagnosis was older in patients without HT compared to patients with HT (p=0.032). On multivariate analysis, the presence of LT was not an independent predictor of recurrence in both groupings. For both groupings, pathologic tumor size and taller than wide shape on US were independent predictors of recurrence. The presence of LT in PTC patients did not affect recurrence. Conclusion: There was no relationship between PTC prognosis and different grades of LT. Pathologic tumor size and taller than wide shape on ultrasound were independent predictors of PTC recurrence regardless of concurrent LT.
참고문헌 (33)
- Dayan CM, "Chronic autoimmune thyroiditis", N Engl J Med, 335, pp.99~107 (1996)
- Singh B, "Coexistent Hashimoto’s thyroiditis with papillary thyroid carcinoma: impact on presentation, management, and outcome", Surgery, 126, pp.1070~1076 (1999)
- Del Rio P, "The association between papillary carcinoma and chronic lymphocytic thyroiditis: does it modify the prognosis of cancer?", Minerva Endocrinol, 33, pp.1~5 (2008)
- Schäffler A, "Coexistent thyroiditis is associated with lower tumour stage in thyroid carcinoma", Eur J Clin Invest, 28, pp.838~844 (1998)
- Mazzaferri EL, "Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer", Am J Med, 97, pp.418~428 (1994)
- Kashima K, "Chronic thyroiditis as a favorable prognostic factor in papillary thyroid carcinoma", Thyroid, 8, pp.197~202 (1998)
- Loh KC, "Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma", J Clin Endocrinol Metab, 84, pp.458~463 (1999)
- Kim EY, "Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma", CLINICAL ENDOCRINOLOGY, 71(4), pp.581~586 (2009), BLACKWELL PUBLISHING
- 정준수, "Coexistence of Chronic Lymphocytic Thyroiditis with Papillary Thyroid Carcinoma: Clinical Manifestation and Prognostic Outcome", Journal of Korean Medical Science, 27(8), pp.883~889 (2012), 대한의학회[DOI]
- Lee JH, "The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis", Eur J Endocrinol, 168, pp.343~349 (2013)
- Matsubayashi S, "The correlation between papillary thyroid carcinoma and lymphocytic infiltration in the thyroid gland", J Clin Endocrinol Metab, 80, pp.3421~3424 (1995)
- Rho MH, "Diagnostic value of antithyroid peroxidase antibody for incidental autoimmune thyroiditis based on histopathologic results", ENDOCRINE, 42, pp.647~652 (2012), HUMANA PRESS INC
- Thomson AD, "The pathology of Hashimoto’s disease", Proc R Soc Med, 50, pp.950~952 (1957)
- 손유미, "Mixed Echoic Thyroid Nodules on Ultrasound: Approach to Management", Yonsei Medical Journal, 53(4), pp.812~819 (2012), 연세대학교의과대학[DOI]
- LiVolsi VA, "The pathology of autoimmune thyroid disease: a review", Thyroid, 4, pp.333~339 (1994)
- Bhatia A, "Lymphocytic thyroiditis--is cytological grading significant? A correlation of grades with clinical, biochemical, ultrasonographic and radionuclide parameters", Cytojournal, 4, pp.10~ (2007)
- Kebebew E, "Coexisting chronic lymphocytic thyroiditis and papillary thyroid cancer revisited", World J Surg, 25, pp.632~637 (2001)
- Kumar N, "Aspiration cytology of Hashimoto’s thyroiditis in an endemic area", Cytopathology, 13, pp.31~39 (2002)
- Herh SJ, "Heterogeneous echogenicity of the thyroid parenchyma does not influence the detection of multi-focality in papillary thyroid carcinoma on preoperative ultrasound staging", ULTRASOUND IN MEDICINE AND BIOLOGY, 40(5), pp.884~889 (2014), ELSEVIER SCIENCE INC
- 김인중, "Diagnostic Role of Conventional Ultrasonography and Shearwave Elastography in Asymptomatic Patients with Diffuse Thyroid Disease: Initial Experience with 57 Patients", Yonsei Medical Journal, 55(1), pp.247~253 (2014), 연세대학교의과대학
- Park M, "Heterogeneous echogenicity of the underlying thyroid parenchyma: How does this affect the analysis of a thyroid nodule?", BMC CANCER, 13(1), pp.550(1)~550(9) (2013), BIOMED CENTRAL LTD
- Kim HS, "Features of papillary thyroid microcarcinoma in the presence and absence of lymphocytic thyroiditis", Endocrine Pathology, 21(3), pp.149~153 (2010), Humana Press
- Wirtschafter A, "Expression of the RET", PTC fusion gene as a marker for papillary carcinoma in Hashimoto’s thyroiditis, 1997, pp.107, 95~100
- Okayasu I, "Enhanced cellular proliferative activity and cell death in chronic thyroiditis and thyroid papillary carcinoma", J Cancer Res Clin Oncol, 121, pp.746~752 (1995)
- Repplinger D, "Is Hashimoto’s thyroiditis a risk factor for papillary thyroid cancer?", J Surg Res, 150, pp.49~52 (2008)
- Tamimi DM, "The association between chronic lymphocytic thyroiditis and thyroid tumors", Int J Surg Pathol, 10, pp.141~146 (2002)
- Kim SS, "Coexistence of Hashimoto’s thyroiditis with papillary thyroid carcinoma: the influence of lymph node metastasis", Head Neck, 33, pp.1272~1277 (2011)
- Simpson WJ, "Papillary and follicular thyroid cancer. Prognostic factors in 1,578 patients", Am J Med, 83, pp.479~488 (1987)
- Moon HJ, "Minimal extrathyroidal extension in patients with papillary thyroid microcarcinoma: is it a real prognostic factor?", Ann Surg Oncol, 18, pp.1916~1923 (2011)
- Nam SY, "Preoperative Ultrasonographic Features of Papillary Thyroid Carcinoma Predict Biological Behavior", JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 98, pp.1476~1482 (2013), ENDOCRINE SOC
- Kwak JY, "Papillary Microcarcinoma of the Thyroid: Predicting Factors of Lateral Neck Node Metastasis", Annals Of Surgical Oncology, 16(5), pp.1348~1355 (2009), springer
- Ito Y, "Preoperative ultrasonographic examination for lymph node metastasis: usefulness when designing lymph node dissection for papillary microcarcinoma of the thyroid", World J Surg, 28, pp.498~501 (2004)
- Kim SS, "Preoperative ultrasonographic tumor characteristics as a predictive factor of tumor stage in papillary thyroid carcinoma", Head Neck, 33, pp.1719~1726 (2011)
