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      Hashimoto’s thyroiditis in papillary thyroid carcinoma: a 22-year study Translated title: Tiroidite di Hashimoto nel carcinoma papillare della tiroide: studio di 22 anni

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          SUMMARY

          Objective

          We retrospectively investigated whether there is a relationship between Hashimoto’s thyroiditis (HT) and papillary thyroid carcinoma and studied the effect of HT on prognostic factors.

          Methods

          1080 patients, who underwent thyroidectomy in our hospital and received a diagnosis of papillary thyroid carcinoma, were included in the study. In histopathological specimens, the diagnosis of papillary thyroid carcinoma was reconfirmed and non-neoplastic areas in the same specimen were evaluated in terms of HT.

          Results

          HT was detected in non-neoplastic areas of specimens in 36.1% (n = 390) of 1080 patients with a diagnosis of papillary thyroid carcinoma whereas HT was not observed in 63.9% (n = 690). There was a significant positive correlation between presence of HT and multifocal location (p < 0.05, χ2 = 38.5). There was no significant relationship between extrathyroidal tissue invasion and HT (p > 0.05).

          Conclusion

          We assume that patients with HT developing papillary thyroid carcinoma have an increased risk of having multifocal tumour, and thus surgical intervention should be tailored according to this risk.

          RIASSUNTO

          Obiettivo

          Ci siamo proposti di indagare retrospettivamente una relazione tra tiroidite di Hashimoto e carcinoma papillare della tiroide e di studiare l’effetto della tiroidite di Hashimoto (HT) sui fattori prognostici.

          Metodi

          Sono stati inclusi nello studio 1080 pazienti, che sono stati sottoposti a tiroidectomia nel nostro ospedale e hanno ricevuto la diagnosi di carcinoma papillare della tiroide. Nei campioni istopatologici dei pazienti è stata riconfermata la diagnosi di carcinoma papillare della tiroide e sono state valutate le aree non neoplastiche dello stesso campione in termini di HT.

          Risultati

          La tiroidite di Hashimoto è stata rilevata in aree non neoplastiche dei campioni nel 36,1% (n = 390) dei pazienti con diagnosi di carcinoma papillare della tiroide mentre la tiroidite di Hashimoto non è stata osservata nel 63,9% (n = 690). L’analisi ha rivelato una correlazione statisticamente significativa tra la presenza della tiroidite di Hashimoto e la localizzazione multifocale (p < 0,05, χ2 = 38,5). Non c’era alcuna relazione statisticamente significativa tra l’invasione del tessuto extratiroideo e la tiroidite di Hashimoto (p > 0,05).

          Conclusioni

          Presumiamo che i pazienti con tiroidite di Hashimoto che sviluppano un carcinoma papillare della tiroide abbiano un aumentato rischio di avere un tumore multifocale, quindi, l’intervento chirurgico dovrebbe essere personalizzato in base a questo rischio.

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          Most cited references23

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          Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland.

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            Thyroid cancer and inflammation.

            Some cancer types are strongly associated with chronic inflammatory or infectious diseases whereas others are not, but an inflammatory component is present in most human neoplastic lesions. This review focuses on various aspects of thyroid cancer and inflammation. The incidence of thyroid cancer, in particular of well-differentiated papillary thyroid carcinomas (PTCs), is increased in autoimmune thyroid diseases such as Hashimoto's thyroiditis. Thyroid cancer often has an inflammatory cell infiltrate, which includes lymphocytes, macrophages, dendritic cells and mast cells, whose role in thyroid cancer is still not completely understood. However, most experimental evidence suggests these cells exert a protumorigenic function. Moreover, oncoproteins typically expressed in human PTCs, such as RET/PTC, RAS, and BRAF, trigger a proinflammatory programme in thyreocytes. These data suggest that inflammatory molecules are promising targets for thyroid cancer therapy. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
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              Infiltration of a mixture of immune cells may be related to good prognosis in patients with differentiated thyroid carcinoma.

              Immune responses against differentiated thyroid carcinomas (DTC) have long been recognized. We aimed to investigate the role of immune cell infiltration in the progression of DTC. We studied 398 patients - 253 with papillary and 13 with follicular thyroid cancers, as well as 132 with nonmalignant tissues. Immune cell infiltration was identified using CD3, CD4, CD8, CD20, CD68 and FoxP3 immunohistochemical markers. In addition, we assessed colocalization of CD4 and IL-17 to identify Th17 lymphocytic infiltration and colocalization of CD33 and CD11b to identify infiltration of myeloid-derived suppressor cells (MDSC). Immune cells infiltrated malignant tissues more often than benign lesions. The presence of chronic lymphocytic thyroiditis (CLT) concurrent to DTC, CD68+, CD4+, CD8+, CD20+, FoxP3+ and Th17 lymphocytes but not MDSCs was associated with clinical and pathological features of lower tumour aggressiveness and a more favourable patient outcome. A log-rank test confirmed an association between concurrent CLT, tumour-associated macrophage infiltration, and CD8+ lymphocytes and an increased in disease-free survival, suggesting that evidence of these immune reactions is associated with a favourable prognosis. Our data suggest that the tumour or peri-tumoural microenvironment may act to modify the observed pattern of immune response. Immune cell infiltration and the presence of concurrent CLT helped characterize specific tumour histotypes associated with favourable prognostic features. © 2012 Blackwell Publishing Ltd.
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                Author and article information

                Journal
                Acta Otorhinolaryngol Ital
                Acta Otorhinolaryngol Ital
                AOI
                Acta Otorhinolaryngologica Italica
                Pacini Editore Srl
                0392-100X
                1827-675X
                14 May 2021
                April 2021
                : 41
                : 2
                : 142-145
                Affiliations
                [1 ] Istanbul Medeniyet University , School of Medicine, Department of Otorhinolaryngology and Head & Neck Surgery, Goztepe Training and Research Hospital, Istanbul, Turkey
                [2 ] Elazıg Health Practices and Research Center , Department of Otorhinolaryngology and Head & Neck Surgery, Elazıg, Turkey
                [3 ] Elazig Fethi Sekin City Hospital , Department of Pathology, Elazig, Turkey
                Author notes
                Correspondence Fatih M. Hanege Istanbul Medeniyet University, School of Medicine, Department of Otorhinolaryngology and Head & Neck Surgery, Goztepe Training and Research Hospital, Istanbul, Turkey Tel. +90 532 502 6239. Fax +90 216 566 6614 E-mail: hanege@ 123456hotmail.com

                Funding

                None.

                Conflict of interest

                The Authors declare no conflict of interest.

                Article
                10.14639/0392-100X-N1081
                8142732
                34028458
                8f01eb80-965d-4ffd-ab58-aaa55f3c8067
                Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy

                This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en

                History
                : 25 August 2020
                : 30 December 2020
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 23, Pages: 4
                Categories
                Thyroid

                Otolaryngology
                hashimoto’s thyroiditis,thyroid cancer,papillary,thyroidectomy,tiroidite di hashimoto,cancro della tiroide,papillare,tiroidectomia

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