How do etiological factors can explain the different clinical features of patients with differentiated thyroid cancer an
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ORIGINAL ARTICLE
How do etiological factors can explain the different clinical features of patients with differentiated thyroid cancer and their histopathological findings? Loredana Pagano1 • Chiara Mele1 • Debora Arpaia2 • Maria Teresa Sama`1 • Marina Caputo1 • Serena Ippolito2 • Carmela Peirce2 • Flavia Prodam3 • Guido Valente1 • Giuseppe Ciancia4 • Gianluca Aimaretti1 • Bernadette Biondi2
Received: 26 February 2016 / Accepted: 17 May 2016 Ó Springer Science+Business Media New York 2016
Abstract The aim was to retrospectively analyse the clinical–histopathological characteristics of patients with newly diagnosis of differentiated thyroid cancer (DTC) referred to two Italian centres, one in Northern and the other in Southern Italy, between 2000 and 2013. 1081 patients were included and subdivided into two groups: group A (474 patients from Novara) and group B (607 patients from Naples). The group A came from the industrial area of Novara, while the Group B came from the areas around Vesuvius and Campi Flegrei. The two groups were comparable for iodine levels, body mass index, diagnostic timing and clinical procedures. For all patients, demographic and clinical data were collected. No difference was found in gender, whereas the age at diagnosis was later in the group A (group A 53.1 ± 15.16 years, group B 41.9 ± 14.25 years, p \ 0.001). In both groups, the most frequent histotype was papillary thyroid cancer (PTC) with prevalence of follicular variant in group A (p \ 0.0001) and classical variant in group B (p \ 0.0001). Aggressive histological features were mainly seen in group A (bilaterality p \ 0.0001, multifocality p \ 0.0001 and thyroid capsular invasion p \ 0.0001). Microcarcinomas were more frequent in group A (p \ 0.0001) but mostly & Loredana Pagano [email protected] 1
Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
2
Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
3
Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
4
Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
characterized by bilaterality (p \ 0.001) and multifocality (p \ 0.04). In both groups, tumour-associated thyroiditis showed a significant increase over the years (group A p \ 0.05, group B p \ 0.04). Environmental factors could justify the differences found in our study. These preliminary data should stimulate the need for an Italian Cancer Registry of DTC in order to allow an epidemiological characterization, allowing the identification of specific etiological factors and an improvement in the management of the disease. Keywords Thyroid cancer Tumourigenesis induction Clinical–histopathological features Environmental factors
Introduction The incidence of the differentiated thyroid carcinoma (DTC) has been increasing in many countries over the last 30 years [1–11]. The most recent data about this massive increase in the incidence come from th
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