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The features of autoimmune thyroid disease are usually concordant in patients with thyroid nodules, and do not predict the presence of thyroid cancer

The background of the study.  Chronic autoimmune (Hashimoto’s) thyroiditis is defined by high serum antithyroid antibody values, the appearance of the thyroid on  ultrasound, and pathologic findings. In this study, the relationships between these findings were evaluated in patients who underwent thyroidectomy for thyroid nodules, and the findings were correlated with the presence of thyroid cancer.

How the study was done.  The study subjects were 570 patients who had a thyroid nodule, with a biopsy diagnosis of follicular tumor. Serum antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-Tg) antibodies were measured, thyroid echogenicity was determined, and lymphocytic infiltration of the nodule and the extranodular tissue was evaluated after surgery.

The results of the study.  Serum anti-TPO antibody or anti-Tg antibody concentrations were high in 21 percent of the patients, and both were high in 10 percent. Diffuse thyroid echogenicity was present in 20 percent, and infiltration of the thyroid by lymphocytes was present in 20 percent. There was concordance between these three features of thyroid autoimmune disease. For example, 36 percent of the patients with high serum antithyroid antibody concentrations had thyroid hypoechogenicity, as compared with 16 percent of the patients with normal concentrations.

The thyroid nodule was a cancer in 135 patients (24 percent); 81 percent were papillary cancers. Among the 435 patients with benign nodules (76 percent), 90 percent were follicular adenomas or hyperplastic nodules. None of the three features of thyroid autoimmune disease was associated with nodule pathology.

The conclusions of the study.  Among patients with thyroid nodules, the features of thyroid autoimmune disease are often concordant, and the frequency of these features is similar in patients with thyroid cancer and those with benign nodules.

The original article.  Rago T, Di Coscio G, Ugolini C, Scutari M, Basolo F, Latrofa F, Romani R, Berti P, Grasso L, Braverman LE, Pinchera A, Vitti P. 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. Clin Endocrinol (Oxf) 2007;67:363-9.

 

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Thyroid Digest Index	|	November 2007 Thyroid Digest