Endocrinol Metab.  2018 Dec;33(4):473-484. 10.3803/EnM.2018.33.4.473.

Associations between Hashimoto Thyroiditis and Clinical Outcomes of Papillary Thyroid Cancer: A Meta-Analysis of Observational Studies

• Moon S
• Chung HS
• Yu JM
• Yoo HJ
• Park JH
• Kim DS
• Park YJ

• KMID: 2427443
• DOI: http://doi.org/10.3803/EnM.2018.33.4.473

Abstract

BACKGROUND
Epidemiological studies have suggested an association between Hashimoto thyroiditis (HT) and papillary thyroid cancer (PTC) development. Other studies, however, have reported a protective role of HT against PTC progression. Through this updated meta-analysis, we aimed to clarify the effects of HT on the progression of PTC.
METHODS
We searched citation databases, including PubMed and Embase, for relevant studies from inception to September 2017. From these studies, we calculated the pooled odds ratios (ORs) of clinicopathologic features and the relative risk (RR) of PTC recurrence with 95% confidence intervals (CIs) using the Mantel-Haenszel method. Additionally, the Higgins I 2 statistic was used to test for heterogeneity.
RESULTS
The meta-analysis included 71 published studies with 44,034 participants, among whom 11,132 had HT. We observed negative associations between PTC with comorbid HT and extrathyroidal extension (OR, 0.74; 95% CI, 0.68 to 0.81), lymph node metastasis (OR, 0.82; 95% CI, 0.72 to 0.94), distant metastasis (OR, 0.49; 95% CI, 0.32 to 0.76), and recurrence (RR, 0.50; 95% CI, 0.41 to 0.61).
CONCLUSION
In this meta-analysis, PTC patients with HT appeared to exhibit more favorable clinicopathologic characteristics and a better prognosis than those without HT.

Keyword

Hashimoto disease; Thyroid cancer, papillary; Prognosis

MeSH Terms

Epidemiologic Studies
Hashimoto Disease*
Humans
Lymph Nodes
Methods
Neoplasm Metastasis
Odds Ratio
Population Characteristics
Prognosis
Recurrence
Thyroid Gland*
Thyroid Neoplasms*

Figure

• 

  Fig. 1 Schema of the search strategy.

• 

  Fig. 2 Forest plots summarizing the risk ratio of the association between Hashimoto thyroiditis and recurrence of papillary thyroid cancer. RR, relative risk; CI, confidence interval.

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