Clinicopathologic Study Of Thyroid Papillary Carcinoma With Hashimoto's Thyroiditis

Objective: This article analyzes the clinicopathological data of patients who get PTC(Papillary thyroid carcinoma)with or without HT(Hashimoto's thyroiditis),then explore the relationship between PTC and HT,and concludes the clinicopathological features that PTC with HT or not,for providing guidance for the treatment of PTC patients with HT.Methods: A retrospective analysis of the basic data of patients who had undergone surgical treatment and had a clear pathological diagnosis from January 1,2015 to January 1,2016 in Fujian Provincial Hospital,a total of 536 cases.According to preoperative serum antibody test and postoperative pathological results,they were divided into papillary thyroid carcinoma with Hashimoto's thyroiditis group(PCT-HT group)and simple papillary thyroid carcinoma group(PCT group).Among them,there were 156 patients in the PCT-HT group and 380 patients in the PCT group.The thyroid gland in all patients were treated surgically for the first time in our hospital,who had complete clinical and pathological data and excluded other thyroid diseases or autoimmune diseases.Collecting the patient's age,gender,preoperative TSH,TGAb,TPOAb,postoperative pathological results such as the size of the carcinoma,number,encroachment of the capsule,lymph node metastasis in the central and lateral cervical regions,immunohistochemical results such as BRAF gene,CK19,Galectin-3,MC,etc.,and based on the above data to draw each patient's AJCC differentiated thyroid cancer staging(2017 8th edition).The collected data was imported into SPSS 17.0 statistical software for analysis.Results: By comparing the clinical and pathological data of the PTC-HT and PTC groups,the following results were obtained: The proportion of women in the PTC-HT group was significantly higher than that of the PTC group(89.1% vs 68.7%),and the preoperative TSH was higher(3.90±13.523 mIU/L vs 2.07±1.433 mIU/L),with higher preoperative serum antibody such as TGAb(502.20±818.242 IU/mL vs 22.36±15.882 IU/mL)and TPOAb(200.36±224.784 IU/mL vs 113.24±11.242 IU /mL),PTC-HT group had a higher proportion of multifocal tumors(65.4% vs 33.4%),a more number of central lymph nodes(7.48±4.622 vs 4.77±3.427),and a low rate of lymph node metastasis in the central region(19.01%±28.177% vs.31.00%±36.468%),and the mutation rate of BRAF gene was lower(76.9% vs 88.0%),all the difference was statistically significant(p<0.05).There was no significant difference between the two groups in terms of age,capsule invasion,maximal diameter of tumor,positive rates of central and lateral cervical lymph nodes,CK19,Galectin-3,MC,and AJCC pathological stages(p>0.05).Conclusion: 1.PTC and HT affect each other,HT may be a precancerous lesion of PCT,PTC can also lead to the occurrence and development of HT;2.PTC patients with HT have better pathological types,better prognosis than PCT alone,and treatment methods should not be excessive;3.The treatment for PTC with HT is still based on surgery,the high TSH level of HT determines the importance of preoperative and postoperative monitoring and suppression of TSH.