Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response
Introduction: Differentiated thyroid carcinoma (DTC) is frequently found in conjunction with autoimmune thyroid disorders, particularly Hashimoto’s thyroiditis (HT). This study investigates the impact of coexisting HT on the persistence of an indeterminate response to therapy due to positive anti-th...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/2/166 |
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| author | Alessandra Donnici Maria Mirabelli Stefania Giuliano Roberta Misiti Vera Tocci Marta Greco Vincenzo Aiello Francesco S. Brunetti Eusebio Chiefari Antonio Aversa Daniela P. Foti Antonio Brunetti |
| author_facet | Alessandra Donnici Maria Mirabelli Stefania Giuliano Roberta Misiti Vera Tocci Marta Greco Vincenzo Aiello Francesco S. Brunetti Eusebio Chiefari Antonio Aversa Daniela P. Foti Antonio Brunetti |
| author_sort | Alessandra Donnici |
| collection | DOAJ |
| description | Introduction: Differentiated thyroid carcinoma (DTC) is frequently found in conjunction with autoimmune thyroid disorders, particularly Hashimoto’s thyroiditis (HT). This study investigates the impact of coexisting HT on the persistence of an indeterminate response to therapy due to positive anti-thyroglobulin antibodies (AbTg), measured via competitive immunoassay, in a consecutive patient series from Calabria, Southern Italy. Methods: This retrospective longitudinal study analyzed 259 consecutive DTC patients managed at the Endocrinology Unit of Renato Dulbecco Hospital (Catanzaro, Italy) up to 2023. Patients with medullary and undifferentiated thyroid carcinoma, partial thyroidectomy, less than six months of post-operative monitoring, or missing clinical data were excluded. Demographic information, histological findings, initial tumor stage, and ATA risk category were collected. The response to therapy was assessed based on ATA guidelines. Results: Among the 259 patients, 29% had coexisting HT. Patients with HT exhibited distinct characteristics: a higher proportion of females (87.0% vs. 74.7%), a shorter post-operative monitoring duration (median 3 vs. 5 years), and a higher prevalence of papillary thyroid carcinoma (PTC) (97.4% vs. 86.3%). The tumor size, lymph node involvement, and distant metastasis were similar between the groups, with patients without HT having a higher incidence of extrathyroidal tumor extension. However, the initial TNM stage and ATA risk category did not differ significantly. At the six-month follow-up, HT patients showed a higher rate of indeterminate responses, primarily due to positive AbTg. After 12 months, the response categories aligned, with decreasing AbTg levels in the HT group. After 24 months, most patients with long-term follow-up demonstrated an excellent response to DTC therapy, irrespective of HT coexistence. Conclusions: While HT does not worsen DTC prognosis, it may result in indeterminate responses. AbTg measurements in the peri-operative period should be encouraged to facilitate post-operative monitoring, emphasizing the importance of using standardized assays. Further research in larger populations with extended follow-up is needed to comprehensively understand the HT-DTC relationship. |
| first_indexed | 2024-03-08T10:59:59Z |
| format | Article |
| id | doaj.art-3f235a7283254a12837eea0550436202 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T10:59:59Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-3f235a7283254a12837eea05504362022024-01-26T16:01:28ZengMDPI AGDiagnostics2075-44182024-01-0114216610.3390/diagnostics14020166Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment ResponseAlessandra Donnici0Maria Mirabelli1Stefania Giuliano2Roberta Misiti3Vera Tocci4Marta Greco5Vincenzo Aiello6Francesco S. Brunetti7Eusebio Chiefari8Antonio Aversa9Daniela P. Foti10Antonio Brunetti11Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyEndocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyEndocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyClinical Pathology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyEndocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyClinical Pathology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyRheumatology Clinic ‘Madonna dello Scoglio’ Cotronei, 88900 Crotone, ItalyDepartment of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, ItalyEndocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyEndocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyClinical Pathology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyEndocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, ItalyIntroduction: Differentiated thyroid carcinoma (DTC) is frequently found in conjunction with autoimmune thyroid disorders, particularly Hashimoto’s thyroiditis (HT). This study investigates the impact of coexisting HT on the persistence of an indeterminate response to therapy due to positive anti-thyroglobulin antibodies (AbTg), measured via competitive immunoassay, in a consecutive patient series from Calabria, Southern Italy. Methods: This retrospective longitudinal study analyzed 259 consecutive DTC patients managed at the Endocrinology Unit of Renato Dulbecco Hospital (Catanzaro, Italy) up to 2023. Patients with medullary and undifferentiated thyroid carcinoma, partial thyroidectomy, less than six months of post-operative monitoring, or missing clinical data were excluded. Demographic information, histological findings, initial tumor stage, and ATA risk category were collected. The response to therapy was assessed based on ATA guidelines. Results: Among the 259 patients, 29% had coexisting HT. Patients with HT exhibited distinct characteristics: a higher proportion of females (87.0% vs. 74.7%), a shorter post-operative monitoring duration (median 3 vs. 5 years), and a higher prevalence of papillary thyroid carcinoma (PTC) (97.4% vs. 86.3%). The tumor size, lymph node involvement, and distant metastasis were similar between the groups, with patients without HT having a higher incidence of extrathyroidal tumor extension. However, the initial TNM stage and ATA risk category did not differ significantly. At the six-month follow-up, HT patients showed a higher rate of indeterminate responses, primarily due to positive AbTg. After 12 months, the response categories aligned, with decreasing AbTg levels in the HT group. After 24 months, most patients with long-term follow-up demonstrated an excellent response to DTC therapy, irrespective of HT coexistence. Conclusions: While HT does not worsen DTC prognosis, it may result in indeterminate responses. AbTg measurements in the peri-operative period should be encouraged to facilitate post-operative monitoring, emphasizing the importance of using standardized assays. Further research in larger populations with extended follow-up is needed to comprehensively understand the HT-DTC relationship.https://www.mdpi.com/2075-4418/14/2/166Hashimoto’s thyroiditisthyroid autoimmunitydifferentiated thyroid canceranti-thyroglobulin antibodies |
| spellingShingle | Alessandra Donnici Maria Mirabelli Stefania Giuliano Roberta Misiti Vera Tocci Marta Greco Vincenzo Aiello Francesco S. Brunetti Eusebio Chiefari Antonio Aversa Daniela P. Foti Antonio Brunetti Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response Diagnostics Hashimoto’s thyroiditis thyroid autoimmunity differentiated thyroid cancer anti-thyroglobulin antibodies |
| title | Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response |
| title_full | Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response |
| title_fullStr | Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response |
| title_full_unstemmed | Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response |
| title_short | Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response |
| title_sort | coexistence of hashimoto s thyroiditis in differentiated thyroid cancer post operative monitoring of anti thyroglobulin antibodies and assessment of treatment response |
| topic | Hashimoto’s thyroiditis thyroid autoimmunity differentiated thyroid cancer anti-thyroglobulin antibodies |
| url | https://www.mdpi.com/2075-4418/14/2/166 |
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