Background: Our study investigated the association between chronic lymphocytic thyroiditis (CLT) and thyroid cancer (TC).Methods: A retrospective review of 1670 patients who underwent thyroid surgery between October 2022 to February 2025 was performed. The clinicopathological characteristics of patients with TC and CLT were collected. CLT was diagnosed histopathologically.Results: Patients with a positive CLT result (60.39%) compared to a negative CLT result (34.12%) had more frequently TC (p< 0.001), predominantly PTC. In univariate analysis, patients with malignancy + CLT-positive compared to malignancy + CLT-negative were found to be younger in age (p< 0.001), female gender (p< 0.001), smaller tumours focus (p= 0. 013), smaller mass of thyroid removed (p< 0.001) and more often Bethesda category V and VI (p= 0.019), true positive fine needle aspiration biopsy (FNAB) for PTC (p= 0.009), and microcarcinoma (p= 0.021). There were no differences in multifocality, the presence of LNM, or the number of LNMs. The location of metastases at neck lymph nodes was at the borderline of significance (p= 0.065). In multivariate analysis, after accounting for Bethesda and age, CLT+ was found to increase the risk of TC by 73% (OR = 1.73; 95%CI, 1.15-2.29), while the risk of PTC increased more than 2-fold (OR = 2.12; 95% CI, 1.45–3.11). CLT had no statistically significant effect on the presence of LNM.Conclusions: We found that CLT is a risk factor for TC. One should be vigilant concerning the coexistence of these two diseases. We suggest that total thyroidectomy should be considered in patients referred for thyroid nodules and suspected CLT. However, this issue requires further research.
背景：本研究旨在探讨慢性淋巴细胞性甲状腺炎（CLT）与甲状腺癌（TC）之间的关联。 方法：回顾性分析了2022年10月至2025年2月期间接受甲状腺手术的1670例患者，收集了合并TC与CLT患者的临床病理特征。CLT通过组织病理学诊断确认。 结果：CLT阳性患者（60.39%）相较于CLT阴性患者（34.12%）更常合并TC（p<0.001），且以甲状腺乳头状癌（PTC）为主。单因素分析显示，与恶性病变合并CLT阴性者相比，恶性病变合并CLT阳性患者年龄更轻（p<0.001）、女性比例更高（p<0.001）、肿瘤病灶更小（p=0.013）、切除甲状腺组织质量更轻（p<0.001），且更常属于Bethesda V类和VI类（p=0.019）、细针穿刺活检（FNAB）对PTC的真阳性率更高（p=0.009）、微小癌比例更高（p=0.021）。两组在多灶性、淋巴结转移（LNM）存在与否及转移淋巴结数量方面无显著差异，颈部淋巴结转移部位差异处于临界显著性水平（p=0.065）。多因素分析显示，在调整Bethesda分类和年龄后，CLT阳性使TC风险增加73%（OR=1.73；95%CI：1.15-2.29），PTC风险增加超过2倍（OR=2.12；95%CI：1.45-3.11）。CLT对淋巴结转移的存在无统计学显著影响。 结论：本研究发现CLT是TC的危险因素，临床应警惕这两种疾病的共存。对于甲状腺结节疑似合并CLT的患者，建议考虑全甲状腺切除术，但该问题仍需进一步研究。
Risk Stratification for Thyroid Malignancies in Chronic Lymphocytic Thyroiditis
肿瘤(癌症)患者之家