The association between papillary thyroid carcinoma and histologically proven Hashimoto's thyroiditis: a meta-analysis

• Published in: European journal of endocrinology Vol. 168; no. 3; pp. 343 - 349
• Main Authors: Lee, Ju-Han, Kim, Younghye, Choi, Jung-Woo, Kim, Young-Sik
• Format: Journal Article
• Language: English
• Published: Bristol BioScientifica 01.03.2013
• Subjects: Biological and medical sciences; Carcinoma - complications; Carcinoma - physiopathology; Carcinoma, Papillary; Case-Control Studies; Clinical Study; Endocrinopathies; Female; Fundamental and applied biological sciences. Psychology; Hashimoto Disease - complications; Hashimoto Disease - epidemiology; Hashimoto Disease - etiology; Hashimoto Disease - physiopathology; Humans; Incidence; Male; Malignant tumors; Medical sciences; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Sex Factors; Survival Analysis; Thyroid Cancer, Papillary; Thyroid Neoplasms - complications; Thyroid Neoplasms - physiopathology; Thyroid. Thyroid axis (diseases); Vertebrates: endocrinology; Endocrinopathy; Immunopathology; Association; Hashimoto thyroiditis; Thyroid diseases; Autoimmune disease; Malignant tumor; Papillary thyroid carcinoma; Endocrinology; Cancer; Metaanalysis
• ISSN: 0804-4643; 1479-683X
• DOI: 10.1530/EJE-12-0903

ObjectiveNo consensus exists on the association between papillary thyroid carcinoma (PTC) and Hashimoto's thyroiditis (HT). To resolve this controversy, this study aimed to evaluate the relationship between the two conditions using a meta-analysis.MethodsWe searched relevant published studies using citation databases including PubMed, Embase, and ISI Web of Science. The effect sizes of clinicopathologic parameters were calculated by odds ratio (OR), weighted mean difference, or hazard ratio (HR). The effect sizes were combined using a random-effects model.ResultsThirty-eight eligible studies including 10 648 PTC cases were selected. Histologically proven HT was identified in 2471 (23.2%) PTCs. HT was more frequently observed in PTCs than in benign thyroid diseases and other carcinomas (OR=2.8 and 2.4; P<0.001). PTCs with coexisting HT were significantly related to female patients (OR=2.7; P<0.001), multifocal involvement (OR=1.5; P=0.010), no extrathyroidal extension (OR=1.3; P=0.002), and no lymph node metastasis (OR=1.3; P=0.041). Moreover, PTCs with HT were significantly associated with long recurrence-free survival (HR=0.6; P=0.001).ConclusionsOur meta-analysis showed that PTC is significantly associated with pathologically confirmed HT. PTC patients with HT have favorable clinicopathologic characteristics compared with PTCs without HT. However, patients with HT need to be carefully monitored for the development of PTC.