Thyroid autoimmune antibodies in patients with papillary thyroid carcinoma: a double-edged sword?
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ORIGINAL ARTICLE
Thyroid autoimmune antibodies in patients with papillary thyroid carcinoma: a double-edged sword? Chen-Tian Shen1 Xin-Yun Zhang1 Zhong-Ling Qiu1 Zhen-Kui Sun1 Wei-Jun Wei1 Hong-Jun Song1 Quan-Yong Luo 1 ●
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Received: 4 July 2017 / Accepted: 19 August 2017 © Springer Science+Business Media, LLC 2017
Abstract Purpose The relationship between thyroid autoimmunity and thyroid cancer remains controversial. The objective of this study is to comprehensively analyze the association between thyroid autoimmune antibodies and disease statuses of papillary thyroid carcinoma (PTC). Methods Patients were divided into different groups according to their final diagnoses after radioiodine therapy as well as their serum anti-thyroglobulin antibody (TgAb) and anti-thyroidperoxidase antibody (TPOAb) titers. Clinicopathologic characteristics were then compared between groups. Results In all, 1126 PTC patients met the inclusion criteria. When compared with thyroid autoimmune antibody negative group, patients in positive group were young female predominant. After age and gender adjusted, patients in thyroid autoimmune antibody positive group had much more cervical metastatic node count and this effect was limited to the central compartment but not to the lateral compartment. Antibody positivity rate was much lower in patients with distant metastasis and multivariable logistic regression analysis showed positive status of antibody was a protective factor of distant metastasis of PTC with an OR
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12020-017-1401-7) contains supplementary material, which is available to authorized users. Chen-Tian Shen and Xin-Yun Zhang contributed equally to this work. * Quan-Yong Luo [email protected] 1
Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, People’s Republic of China
value of 0.403 (95% CI 0.216–0.622, p < 0.001). Additionally, subgroup analysis demonstrated single TgAb positivity and combined positivity of TgAb and TPOAb were shown to be related to less distant metastatic disease. Conclusions Positive thyroid auto-antibody status could be a risk factor of more metastatic cervical lymph nodes while a protective factor of distant metastatic disease in PTC patients. The association between thyroid autoimmunity and thyroid cancer can be patient and antibody specific. A systemic immunosupression status may exist in PTC patients with distant metastasis. Keywords Thyroid autoimmunity Papillary thyroid carcinoma Metastasis Radioiodine ●
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Introduction Chronic inflammation considered as a pre-cancer condition was first proposed by Virchow in 1863 and the relationship between inflammation and cancer has been verified by lots of clinical and epidemiological evidence [1–3]. In the development of papillary thyroid carcinoma (PTC), autoimmune thyroid disease/chronic thyroiditis is frequently found to be related [3]. Although this association has been suggested since the 1
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