Role of chronic lymphocytic thyroiditis in central node metastasis of papillary thyroid carcinoma

Lorien M. Paulson, Maisie Shindo, Kathryn Schuff

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective. (1) To investigate the role of chronic lymphocytic thyroiditis (CLT) in central node metastasis of papillary thyroid carcinoma (PTC) and (2) to evaluate the presence of chronic lymphocytic thyroiditis according to PTC-specific molecular markers. Study Design. Historical cohort study. Setting. Academic medical center. Subjects and Methods. All patients who underwent total thyroidectomy with central neck dissection for PTC at Oregon Health & Science University between 2005 and 2010 were screened for the presence of CLT and reviewed for clinical prognostic factors. Patients with inadequate central neck dissections were excluded. Molecular markers for PTC were analyzed on archived tumor samples. Results. A total of 139 patients met selection criteria. The rate of CLT was 43.8%. The rate of central node positivity was 63%. Presence of CLT was associated with a significantly lower proportion of central node metastases (49% vs 74%, P = .003) and angiolymphatic invasion (31% vs 15%, P = .03). There was no significant difference in mean age, tumor size, and extracapsular extension. Molecular genotyping did not reveal a significant difference in the types of mutations found in both groups. Conclusion. The data indicate a lower incidence of central compartment lymph node metastasis in those with CLT in this patient population, suggesting a potential protective role in tumor spread. The equal distribution of tumor mutations between the carcinomas with and without evidence of CLT argues against a mutation-specific antigen as the immunologic stimulus. Further research is needed to characterize the role of autoimmunity in thyroid cancer.

Original languageEnglish (US)
Pages (from-to)444-449
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume147
Issue number3
DOIs
StatePublished - Sep 2012

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Hashimoto Disease
Neoplasm Metastasis
Neck Dissection
Patient Selection
Mutation
Neoplasms
Thyroidectomy
Papillary Thyroid cancer
Autoimmunity
Thyroid Neoplasms
Cohort Studies
Lymph Nodes
Carcinoma
Antigens
Incidence
Health
Research
Population

Keywords

  • BRAF
  • central lymph node metastasis
  • chronic lymphocytic thyroiditis
  • Hashimoto's thyroiditis
  • molecular markers
  • papillary thyroid carcinoma
  • RET-PTC

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

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title = "Role of chronic lymphocytic thyroiditis in central node metastasis of papillary thyroid carcinoma",
abstract = "Objective. (1) To investigate the role of chronic lymphocytic thyroiditis (CLT) in central node metastasis of papillary thyroid carcinoma (PTC) and (2) to evaluate the presence of chronic lymphocytic thyroiditis according to PTC-specific molecular markers. Study Design. Historical cohort study. Setting. Academic medical center. Subjects and Methods. All patients who underwent total thyroidectomy with central neck dissection for PTC at Oregon Health & Science University between 2005 and 2010 were screened for the presence of CLT and reviewed for clinical prognostic factors. Patients with inadequate central neck dissections were excluded. Molecular markers for PTC were analyzed on archived tumor samples. Results. A total of 139 patients met selection criteria. The rate of CLT was 43.8{\%}. The rate of central node positivity was 63{\%}. Presence of CLT was associated with a significantly lower proportion of central node metastases (49{\%} vs 74{\%}, P = .003) and angiolymphatic invasion (31{\%} vs 15{\%}, P = .03). There was no significant difference in mean age, tumor size, and extracapsular extension. Molecular genotyping did not reveal a significant difference in the types of mutations found in both groups. Conclusion. The data indicate a lower incidence of central compartment lymph node metastasis in those with CLT in this patient population, suggesting a potential protective role in tumor spread. The equal distribution of tumor mutations between the carcinomas with and without evidence of CLT argues against a mutation-specific antigen as the immunologic stimulus. Further research is needed to characterize the role of autoimmunity in thyroid cancer.",
keywords = "BRAF, central lymph node metastasis, chronic lymphocytic thyroiditis, Hashimoto's thyroiditis, molecular markers, papillary thyroid carcinoma, RET-PTC",
author = "Paulson, {Lorien M.} and Maisie Shindo and Kathryn Schuff",
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language = "English (US)",
volume = "147",
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AU - Paulson, Lorien M.

AU - Shindo, Maisie

AU - Schuff, Kathryn

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N2 - Objective. (1) To investigate the role of chronic lymphocytic thyroiditis (CLT) in central node metastasis of papillary thyroid carcinoma (PTC) and (2) to evaluate the presence of chronic lymphocytic thyroiditis according to PTC-specific molecular markers. Study Design. Historical cohort study. Setting. Academic medical center. Subjects and Methods. All patients who underwent total thyroidectomy with central neck dissection for PTC at Oregon Health & Science University between 2005 and 2010 were screened for the presence of CLT and reviewed for clinical prognostic factors. Patients with inadequate central neck dissections were excluded. Molecular markers for PTC were analyzed on archived tumor samples. Results. A total of 139 patients met selection criteria. The rate of CLT was 43.8%. The rate of central node positivity was 63%. Presence of CLT was associated with a significantly lower proportion of central node metastases (49% vs 74%, P = .003) and angiolymphatic invasion (31% vs 15%, P = .03). There was no significant difference in mean age, tumor size, and extracapsular extension. Molecular genotyping did not reveal a significant difference in the types of mutations found in both groups. Conclusion. The data indicate a lower incidence of central compartment lymph node metastasis in those with CLT in this patient population, suggesting a potential protective role in tumor spread. The equal distribution of tumor mutations between the carcinomas with and without evidence of CLT argues against a mutation-specific antigen as the immunologic stimulus. Further research is needed to characterize the role of autoimmunity in thyroid cancer.

AB - Objective. (1) To investigate the role of chronic lymphocytic thyroiditis (CLT) in central node metastasis of papillary thyroid carcinoma (PTC) and (2) to evaluate the presence of chronic lymphocytic thyroiditis according to PTC-specific molecular markers. Study Design. Historical cohort study. Setting. Academic medical center. Subjects and Methods. All patients who underwent total thyroidectomy with central neck dissection for PTC at Oregon Health & Science University between 2005 and 2010 were screened for the presence of CLT and reviewed for clinical prognostic factors. Patients with inadequate central neck dissections were excluded. Molecular markers for PTC were analyzed on archived tumor samples. Results. A total of 139 patients met selection criteria. The rate of CLT was 43.8%. The rate of central node positivity was 63%. Presence of CLT was associated with a significantly lower proportion of central node metastases (49% vs 74%, P = .003) and angiolymphatic invasion (31% vs 15%, P = .03). There was no significant difference in mean age, tumor size, and extracapsular extension. Molecular genotyping did not reveal a significant difference in the types of mutations found in both groups. Conclusion. The data indicate a lower incidence of central compartment lymph node metastasis in those with CLT in this patient population, suggesting a potential protective role in tumor spread. The equal distribution of tumor mutations between the carcinomas with and without evidence of CLT argues against a mutation-specific antigen as the immunologic stimulus. Further research is needed to characterize the role of autoimmunity in thyroid cancer.

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KW - central lymph node metastasis

KW - chronic lymphocytic thyroiditis

KW - Hashimoto's thyroiditis

KW - molecular markers

KW - papillary thyroid carcinoma

KW - RET-PTC

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