A Prospective Multicenter Study Examining the Relationship Between Thyroid Cancer Treatment Outcomes and the Presence of Autoimmune Thyroiditis

被引：11

作者：

De Leo, Simone ^{[1
]}

D'Elia, Silvia ^{[2
]}

Grani, Giorgio ^{[3
]}

Dondi, Francesco ^{[4
,5
]}

Bertagna, Francesco ^{[4
,5
]}

Puxeddu, Efisio ^{[6
]}

Morelli, Silvia ^{[6
]}

Piovesan, Alessandro ^{[7
]}

Nervo, Alice ^{[7
]}

Zatelli, Maria Chiara ^{[8
]}

Gagliardi, Irene ^{[8
]}

Sama, Maria Teresa ^{[9
]}

Aimaretti, Gianluca ^{[9
]}

Crocetti, Umberto ^{[10
]}

Massa, Michela ^{[10
]}

Deandrea, Maurilio ^{[11
]}

Retta, Francesca ^{[11
]}

Pagano, Loredana ^{[12
]}

Rossi, Mattia ^{[12
]}

Solaroli, Erica ^{[13
]}

Pezzullo, Luciano ^{[14
]}

Chiofalo, Maria Grazia ^{[14
]}

Pontecorvi, Alfredo ^{[15
,16
]}

Lombardi, Celestino Pio ^{[15
,16
,17
]}

Antonelli, Alessandro ^{[18
]}

Patrizio, Armando ^{[18
]}

Messuti, Ilaria ^{[19
]}

Magri, Flavia ^{[20
,21
]}

Spiazzi, Giovanna ^{[22
]}

Ceresini, Graziano ^{[23
]}

Bruno, Rocco ^{[24
]}

Sparano, Clotilde ^{[25
]}

Centanni, Marco ^{[26
,27
]}

Crescenzi, Anna ^{[28
]}

Tallini, Giovanni ^{[29
,30
]}

Marotta, Vincenzo ^{[31
]}

Madeo, Bruno ^{[32
]}

Mian, Caterina ^{[33
]}

Filetti, Sebastiano ^{[34
]}

Durante, Cosimo ^{[3
]}

Fugazzola, Laura ^{[1
,35
,36
]}

机构：

[1] IRCCS Ist Auxol Italiano, Dept Endocrine & Metab Dis, Endocrine Oncol Unit, Milan, Italy

[2] Sapienza Univ Rome, Dept Stat Sci, Rome, Italy

[3] Sapienza Univ Rome, Dept Translat & Precis Med, Rome, Italy

[4] Univ Brescia, Nucl Med Dept, Brescia, Italy

[5] ASST Spedali Civili, Brescia, Italy

[6] Univ Perugia, Dept Med & Surg, Perugia, Italy

[7] Citta Salute & Sci Hosp, Oncol Endocrinol Unit, Turin, Italy

[8] Univ Ferrara, Dept Med Sci, Sect Endocrinol Geriatr & Internal Med, Ferrara, Italy

[9] Univ Piemonte Orientale, Maggiore Car Univ Hosp, Dept Translat Med, Div Endocrinol, Novara, Italy

[10] Fdn IRCCS Casa Sollievo Sofferenza, Dept Med Sci, San Giovanni Rotondo, Italy

[11] AO Ordine Mauriziano Torino, UO Endocrinol Diabetol & Malattie Metab, Turin, Italy

[12] Univ Turin, AOU Citta Salute & Sci Torino, Dept Med Sci, Div Endocrinol Diabetol & Metab, Turin, Italy

[13] AUSL Bologna, Dept Med, Unit Endocrinol, Bologna, Italy

[14] Ist Nazl Tumori IRCCS Fdn G Pascale, Thyroid Oncol Surg Unit, Naples, Italy

[15] Univ Cattolica Sacro Cuore, Dept Translat Med & Surg, Rome, Italy

[16] Fdn Policlin Univ A Gemelli IRCCS, Rome, Italy

[17] Unicamillus St Camillus Int Univ Hlth Sci, Div Endocrine Surg, Rome, Italy

[18] Univ Pisa, Dept Surg Med & Mol Pathol & Crit Area, Pisa, Italy

[19] Humanitas Gradenigo, Dept Endocrinol & Androl, Turin, Italy

[20] Univ Pavia &, Dept Internal Med & Therapeut, Unit Internal Med & Endocrinol, Pavia, Italy

[21] Ist Clin Sci Maugeri IRCCS, Pavia, Italy

[22] Azienda Osped Univ Verona, Dept Med, Endocrinol & Diabetol Unit, Verona, Italy

[23] Univ Hosp Parma, Dept Med & Surg, Parma, Italy

[24] Tinchi Hosp ASM, Endocrine Unit, Matera, Italy

[25] Univ Florence, Dept Expt & Clin Biomed Sci Mario Serio, Endocrinol Unit, Florence, Italy

[26] Sapienza Univ Rome, Dept Med Surg Sci & Biotechnol, Latina, Italy

[27] AUSL Latina, UOC Endocrinol, Latina, Italy

[28] Fdn Policlin Univ Campus Biomed, Unit Endocrine Organs & Neuromuscolar Pathol, Rome, Italy

[29] Univ Bologna, Med Ctr, Dept Med & Surg Sci DIMEC, Bologna, Italy

[30] IRCCS Azienda Osped Univ Bologna, Bologna, Italy

[31] AOU San Giovanni Dio & Ruggi Aragona, UOC Clin Endocrinol & Diabetol, Salerno, Italy

[32] Azienda Osped Univ Policlin Modena, Osped Civile Baggiovara, Dept Med Specialties, Unit Endocrinol, Modena, Italy

[33] Univ Padua, Dept Med DIMED, Unit Endocrinol, Padua, Italy

[34] UNITELMA Sapienza Univ Rome, Sch Hlth, Rome, Italy

[35] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[36] Univ Milan, Dept Pathophysiol & Transplantat, P le Brescia 20, I-20149 Milan, Italy

来源：

THYROID | 2023年 / 33卷 / 11期

关键词：

thyroiditis; prospective; thyroid cancer; outcome; radioiodine; MUTATIONS;

D O I：

10.1089/thy.2023.0052

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: There is some controversy on the potential relationship between autoimmune processes and clinicopathologic features as well as prognosis of differentiated thyroid cancer (DTC), and the evidence is limited by its largely retrospective nature. We examined the relationship between the presence of autoimmune thyroiditis (AT) and 1-year thyroid cancer treatment outcomes in a large multicenter study using prospectively collected data.Methods: We included data from consecutive DTC patients enrolled in the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339). We divided the groups according to the presence (AT) or absence (no autoimmune thyroiditis [noAT]) of associated AT. We used propensity score matching to compare the clinical features and outcomes between the two groups at 1-year follow-up.Results: We included data from 4233 DTC patients, including 3172 (75%) females. The American Thyroid Association (ATA) risk levels were as follows: 51% (2160/4233) low risk, 41.3% (1750/4233) intermediate risk, and 7.6% (323/4233) high risk. There were 1552 patients (36.7%) who had AT. Before propensity score matching, AT patients were significantly younger and had a smaller and bilateral tumor (p < 0.0001). Patients with AT more frequently fell into the low- and intermediate-risk categories, while the ATA high risk was more frequent among noAT patients (p = 0.004). After propensity score matching, patients with AT more frequently showed evidence of disease (structural/biochemical incomplete response) versus excellent/indeterminate response, compared with patients without AT (7.3% vs. 4.5%, p = 0.001), with an odds ratio of 1.86 ([confidence interval: 1.3-2.6], p = 0.0001). However, when considering only structural persistence as the outcome, no statistically significant differences were observed between patients with or without AT (3.4% vs. 2.7%, p = 0.35). The elevated risk associated with the ATA intermediate and high risk at diagnosis remained consistently statistically significant.Conclusions: In this large prospective series, biochemical persistence was more frequent, at 1-year follow-up, in AT patients. However, there was no significant association between the presence of AT and structural persistence of disease. These findings may be explained by the presence of a residual thyroid tissue.

引用

页码：1318 / 1326

页数：9

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