An Analytical Comparison of Papillary Thyroid Carcinoma Patients Manifested with or without Graves' Disease

Objective: There is still no clear relationship between the presence of Graves' disease (GD) and the development of papillary thyroid carcinoma. The aim of this study was to compare the clinicopathologic features of patients diagnosed with papillary thyroid carcinoma (PTC) with thyroid nodules and GD and patients with PTC with thyroid nodules but without autoimmune thyroid disease.
Methods: The study designed as retrospective manner and included a cohort of 239 patients with PTC who underwent total thyroidectomy. Age at diagnosis, disease stage, PTC subtypes, tumor size, radioactive iodine use, nodule ultrasonographic features, and risk of PTC recurrence were compared between patients with and without GD.
Results: Of 239 patients, 99 (41%) had GD, while 140 patients (without autoimmune thyroid disease) had only PTC. The tumor diameter was significantly smaller in the group with PTC + GD (1.45 ± 1.28 cm vs 1.81 ± 1.34 cm, p < 0.05). Significantly lower multifocal involvement rates were observed in the PTC + GD group compared to PTC only group (p < 0.05). The prevalence of the classic papillary thyroid carcinoma subtype was higher in patients without autoimmune thyroid disease (39% vs. 25.7%, p<0.05). Ultrasonographic features of nodules with GD and PTC do not have different characteristics from those of nodules with PTC without GD.
Conclusion: The risk of structural recurrence at the time of diagnosis appears to be similar when PTC is accompanied by GD as compared to PTC alone. Furthermore, the presence of smaller tumor sizes and less multifocality in GD-PTC coexistence may indicate a better prognosis.

Graves Hastalýðý Olan veya Olmayan Papiller Tiroid Karsinomlu Hastalarýnýn Analitik Karþýlaþtýrýlmasý

Amaç: Graves hastalýðý (GH) varlýðý ile papiller tiroid kanseri (PTK) geliþimi arasýnda hala net bir iliþki saptanamamýþtýr. Bu çalýþmanýn amacý tiroid nodülü ve GH olup PTK tanýsý alan hastalar ile tiroid nodülü olan fakat otoimmün tiroid hastalýðý olmayan PTK tanýlý hastalarýn klinik ve patolojik özelliklerini karþýlaþtýrmaktýr.
Yöntem: Çalýþma retrospektif olarak tasarlanmýþtýr ve total tiroidektomi geçiren ve PTK olduðu tespit edilen 239 hastadan oluþan bir kohortu içermektedir. Taný yaþý, hastalýk evresi, PTK alt tipleri, tümör boyutu, radyoaktif iyot kullanýmý, nodül ultrasonografik özellikleri ve PTK nüks riski GH olan ve olmayan hastalar karþýlaþtýrýldý.
Bulgular: 239 hastanýn 99'unda (%41) GH mevcutken, 140 hastada (otoimmün tiroid hastalýðý olmayan) sadece papiller tiroid karsinomu vardý. Papiller tiroid karsinomu ve Graves hastalýðý olan grupta tümör çapý anlamlý olarak daha küçüktü (1,45 ± 1,28 cm vs 1,81 ± 1,34 cm, p <0,05). Graves hastalýðý ve papiller tiroid karsinomu tanýsý alan gruplarda, papiller tiroid karsinomu tanýsý alan gruba kýyasla anlamlý derecede daha düþük multifokal tutulum oranlarý gözlendi (p <0,05). Otoimmün tiroid hastalýðý olmayan hastalarda klasik papiller tiroid karsinomu alt tipi prevalansý daha yüksekti (%39'a karþý %25,7, p<0,05). GH ve PTK içeren nodüllerin ultrasonografik özellikleri, GH içermeyen PTK’lý nodüllerden farklý deðildi.
Sonuç: Taný anýnda yapýsal nüks riski, PTK'ya GH eþlik ettiðinde tek baþýna PTK varlýðý ile benzer görünmektedir. Ayrýca, GH-PTK birlikteliðinde daha küçük tümör boyutlarýnýn ve daha az multifokalitenin varlýðý olumlu bir prognozun habercisi olabilir. (SETB-2024-02-031)