Hashimoto’s Thyroiditis Minimizes Lymph Node Metastasis in BRAF Mutant Papillary Thyroid Carcinomas

Hashimoto’s thyroiditis (HT) (autoimmune thyroiditis) is a clinicopathological entity associated with chronic lymphocytic infiltration resulting in hypothyroidism. HT is a double-edged sword that increases the risk of papillary thyroid cancer (PTC), yet it serves as a protective factor for PTC progr...

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Bibliographic Details
Published in:Biomedicines 2022-08, Vol.10 (8), p.2051
Main Authors: Issa, Peter P., Omar, Mahmoud, Buti, Yusef, Issa, Chad P., Chabot, Bert, Carnabatu, Christopher J., Munshi, Ruhul, Hussein, Mohammad, Aboueisha, Mohamed, Shama, Mohamed, Corsetti, Ralph L., Toraih, Eman, Kandil, Emad
Format: Article
Language:English
Subjects:
Biopsy
Decision making
Hashimoto’s thyroiditis
Hypothyroidism
lymph node metastasis
Lymph nodes
Lymphatic system
Medical prognosis
Metastases
Metastasis
Mutants
Mutation
Papillary thyroid cancer
Papillary thyroid carcinoma
Patients
protective factor
risk factor
Thyroid cancer
Thyroidectomy
Thyroiditis
Tumors
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Summary:Hashimoto’s thyroiditis (HT) (autoimmune thyroiditis) is a clinicopathological entity associated with chronic lymphocytic infiltration resulting in hypothyroidism. HT is a double-edged sword that increases the risk of papillary thyroid cancer (PTC), yet it serves as a protective factor for PTC progression. BRAF mutation in PTCs is associated with rapid cell growth, aggressive tumor characteristics, and higher mortality rates. Here, we aimed to analyze the influence of HT in patients with PTCs and its effect on lymph node metastasis (LNM) in BRAF mutant tumors. Adults diagnosed with PTC between 2008 and January 2021 were retrospectively included. A total of 427 patients, 128 of whom had underlying HT, were included. The HT group had significantly higher rates of microcarcinoma (49.2% vs. 37.5%, p = 0.025) and less lateral LNM (8.6% vs. 17.1%, p = 0.024). Interestingly, BRAF-mutated PTCs were found to have significantly less overall LNM (20.9% vs. 51%, p = 0.001), central LNM (25.6% vs. 45.1%, p = 0.040) and lateral LNM (9.3% vs. 29.4%, p = 0.010) in patients with HT when compared to those without underlying HT. HT was found to be an independent protective predictor of overall and lateral LNM. Altogether, HT was able to neutralize the effect of BRAF mutation and was determined to be an independent protective factor against LNM. Specifically, our work may influence treatment-aggressiveness decision making for endocrinologists, oncologists and surgeons alike.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines10082051