Clinical features of thyroid autoimmunity are associated with thyroiditis on histology and are not predictive of malignancy in 570 patients with indeterminate nodules on cytology who had a thyroidectomy.

Abstract

BACKGROUND:

The relationship between thyroid autoimmunity and cancer is still uncertain.

PATIENTS:

We approached this issue in 570 consecutive patients submitted to thyroidectomy for an indeterminate nodule on cytology. Thyroid autoimmunity was defined as positivity of circulating thyroid autoantibodies (TAb), autoimmune hypo- or hyperthyroidism, thyroid hypoechogenicity on ultrasound, and lymphocytic infiltration on histology.

RESULTS:

TAb were found in 122/570 (21.4%), hypoechogenicity in 115/570 (20.1%), and lymphocytic infiltration in 117/570 (20.5%) of patients. The three features of thyroid autoimmunity were highly concordant: hypoechogenicity was observed in 71/448 (15.8%) patients with negative TAb and in 44/122 (36%) with positive TAb (P < 0.0001); lymphocytic infiltration was found in 53/448 (11.8%) patients with negative TAb and in 64/122 (52.4%) with positive TAb (P < 0.0001); hypoechogenicity on ultrasound was observed in 73/453 (16.1%) patients without, and in 42/117 (35.9%) with lymphocytic infiltration (P < 0.0001). None of these parameters was associated with malignancy. TAb were found in 32/135 (23.7%) patients with carcinoma and in 90/435 (20.6%) with a benign lesion (P = NS); hypoechogenicity was observed in 26/135 (19.2%) patients with carcinoma and in 89/435 (20.4%) patients with benign lesions (P = NS); lymphocytic infiltration was present in 28/135 (20.7%) patients with carcinoma and in 89/435 (20.4%) with benign lesions (P = NS). The frequency of cancer in 11 patients with clinically overt thyroid autoimmune disease did not differ from that observed in the whole study group.

CONCLUSION:

In this group of patients with indeterminate thyroid nodules at cytology, clinical and pathological criteria of thyroid autoimmunity were strongly concordant and not associated with malignancy.

• Authors: T Rago, G Di Coscio, C Ugolini, M Scutari, F Basolo, F Latrofa, R Romani, P Berti, L Grasso, L E Braverman, A Pinchera, P Vitti
• Journal: Clinical endocrinology (Clin Endocrinol (Oxf)) Vol. 67 Issue 3 Pg. 363-9 (Sep 2007) ISSN: 0300-0664 [Print] England
• PMID: 17555501 (Publication Type: Journal Article)

Chemical References

• Autoantibodies

Topics

• Adenoma (immunology, pathology, surgery)
• Adenoma, Oxyphilic (immunology, pathology, surgery)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Autoantibodies (blood)
• Female
• Humans
• Lymphocytes (pathology)
• Male
• Middle Aged
• Predictive Value of Tests
• Thyroid Neoplasms (immunology, pathology, surgery)
• Thyroid Nodule (immunology, pathology, surgery)
• Thyroidectomy
• Thyroiditis, Autoimmune (immunology, pathology, surgery)
• Young Adult