Abstract
Background: The study was aimed at investigating the potential role of chronic lymphocytic thyroiditis (CLT) in papillary thyroid cancer (PTC) prognosis in distinct age groups, as well as the association between CLT and recurrence risk estimation.Methods: A total of 635 adult patients were retrospectively analyzed. On the basis of postoperative pathology examination, 188 patients were diagnosed with coexistent CLT and the remaining 447 were classified as non-CLT. Then the characteristics of CLT-coexisted patients and non-CLT ones were compared respectively when patients were aged ≥55 years or below. The association among postoperative clinicopathological features were also analyzed using multivariate regression. In addition, the prognostic value of several variables relating to high-risk recurrence were estimated within different age groups.Results: When divided in two age groups (55 years as the line), non-CLT group had a remarkable frequency of small size lesion (D max ≤1cm) compared with CLT-coexisted patients (54.6% to 43.0%, p =0.016). In addition, non-CLT patients tended to have intrathyroidal extension as opposed to those with coexistent CLT (20.2% to 28.2%, p =0.05). In multivariate analysis, CLT still significantly acted as an independent risk factor of greater lesion size (D min >1 cm) (OR=1.7, p =0.02) and mildly promoted gross extrathyroidal extension (ETE) (OR=1.4, p =0.06). However, associations didn't emerge in the characteristics mentioned above with CLT when patients were ≥55 years old. The prognostic value of CLT in high-risk recurrence was evident only in patients aged 35-44 years. (OR=2.4, 95%CI:1.2-5.4, p =0.02). Greater lesion size independently promoted gross ETE, no matter patients were aged above 55 years or not. Besides, its prognostic value of high-risk recurrence was significant throughout all age groups. Conclusion: These findings revealed that CLT coexistence might be the unfavorable factor of PTC prognosis in young and middle-aged (<55 years) patients, and its role in recurrence risk stratification was presented only in the specific age (35-44 years).
One-third of an Archivial Series of Papillary Thyroid Cancer (Years 2007–2015) Has Coexistent Chronic Lymphocytic Thyroiditis, Which Is Associated with a More Favorable Tumor-Node-Metastasis Staging
