Comparative Study On The Clinicopathological Features Of Papillary Thyroid Microcarcinoma With And Without Hashimoto's Thyroiditis

Objective:We aimed to analyze the differences on clinicopathological features of papillary thyroid microcarcinoma?PTMC?with and without Hashimoto's thyroiditis?HT?.And the factors affecting cervical lymph nodes metastasis in PTMC were discussed.Methods:From January 2010 to December 2016,560 patients of PTMC admitted to the First Affiliated Hospital of China Medical University were enrolled in the study randomly.The data were collected,including gender,age,single tumor size,thyroid stimulating hormone?TSH?,free three iodine adenosine?FT₃?,free thyroxine?FT₄?,thyroid peroxidase antibody?TPOAb?,thyroglobulin antibody?TgAb?,smoking,involvement of double lobe,cervical lymph node metastasis,distant metastasis and other clinicopathological features.Telephone follow-up was conducted,including postoperative treatment of iodine-131?I-131?,postoperative treatment of levothyroxine?L-T₄?,recurrence,metastasis,death,and so on.SPSS 22.0 statistical software was used for analysis.U test,Chi square test and Fisher exact test were used to compare the differences in these clinicopathological features.Binary logistic regression was used for multivariate analysis.Results:There were significant differences in the proportion of female?93.9%vs70.7%,P=0.000?,age[44?35,51?years old vs 46?38,54?years old,P=0.005],TSH[2.04?1.34,3.06?mIU/L vs 1.44?0.94,2.09?mIU/L,P=0.000]and FT₄[13.65?12.35,14.64?pmol/L vs 13.89?12.80,15.16?pmol/L,P=0.011]between patients in PTMC with HT and patients in PTMC without HT.There were no significant differences in FT₃,cervical lymph node metastasis,distant metastasis,involvement of double lobe,diameter of single tumor,postoperative treatment of I-131,postoperative treatment of L-T₄,recurrence within the gland or death between patients in PTMC with HT and patients in PTMC without HT.There were significant differences in age[38?31,46?years old vs 47?39,53?years old,P=0.000],diameter of single tumor[5.0?4.0,8.0?mm vs 4.0?3.0,6.0?mm,P=0.023],involvement of double lobe?27.9%vs11.9%,P=0.000?,postoperative treatment of I-131?38.6%vs 9.0%,P=0.000?and recurrence within the gland?2.2%vs 0%,P=0.045?between patients in PTMC with cervical lymph node metastasis and patients in PTMC without cervical lymph node metastasis.There were no significant differences in gender,smoking,TSH,FT₄,FT₃,TPOAb,TgAb,postoperative treatment of L-T₄ or death between patients in PTMC with cervical lymph node metastasis and patients in PTMC without cervical lymph node metastasis.Conclusions:Patients in PTMC with HT had more female,younger age,higher TSH,lower FT₄ compared with patients in PTMC without HT.Patients in PTMC with cervical lymph node metastasis had younger age,larger single tumor,a greater probability of involvement of double lobe,a greater probability of postoperative treatment of I-131 and a higher rate of recurrence within the gland compared with patients in PTMC without cervical lymph node metastasis.