Turkiye Klinikleri Journal of Internal Medicine

.: ORIGINAL RESEARCH
Kronik Lenfositik Tiroidit ve Papiller Tiroid Karsinomu Birlikteliğinde Klinik Sonuçları Etkileyen Faktörler
Factors Influencing Clinical Outcomes in Coexistence of Chronic Lymphocytic Thyroiditis with Papillary Thyroid Carcinoma
Derya ÇAYIRa, Bahadır KÜLAHb, Mehmet BOZKURTa, Tuğba TAŞKIN TÜRKMENOĞLUc
aSağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Nükleer Tıp Bölümü, Ankara, TÜRKİYE
bA Life Park International Academic Hospital, Genel Cerrahi Bölümü, Ankara, TÜRKİYE
cSağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Patoloji Kliniği, Ankara, TÜRKİYE
Turkiye Klinikleri J Intern Med. 2020;5(1):8-14
doi: 10.5336/intermed.2019-70935
Article Language: TR
Full Text
ÖZET
 Amaç: Kronik lenfositik tiroidit (KLT) zemininde gelişen papiller tiroid karsinom (PTK) hastalarında, birçok parametre üzerinden KLT varlığının, prognoz üzerine olumlu etkileri olduğu ileri sürülmektedir. Ancak literatürde aksi görüşler de mevcuttur. Çalışmamızda, KLT ve PTK birlikteliğinin klinik prognoz üzerine etkisini araştırdık. Gereç ve Yöntemler: Ocak 2014-Ağustos 2018 tarihleri arasında tiroidektomi geçirmiş 259 (232 K, 27 E) hasta, PTK tanısı (144 papiller mikrokarsinom) almıştı. 170 (%65) hastada PTK yanında histopatolojik olarak KLT tanısı mevcuttu. Yaş, cinsiyet, nodül çapı (<2 cm), nodül sayısı (>2), preoperatif ince iğne aspirasyon biyopsi (İİAB) sonucu, operasyon tipi, tümör alt grubu, tümör çapı, multifokalite, lenf nodu metastazı (LNM), kapsül invazyonu, ekstratiroidal yayılım (ETY), risk grubu ve rekürrens parametreleri KLT varlığının etkilerini araştırmada kullanıldı. Grupların istatiksel karşılaştırılmasında SPSS programı 18.0 versiyonu kullanıldı. p<0,05 değeri anlamlı kabul edildi. Bulgular: Nodül çapı 2 cm'den küçük olan hastalarda KLT varlığı daha sık gözlendi (p=0,004). KLT varlığı olan hastalarda ETY anlamlı olarak daha az saptandı (p=0,017). KLT varlığı olan hastaların çoğunluğu düşük risk grubunda idi (p=0,05). Sonuç: Eşlik eden KLT varlığında papiller mikrokarsinom daha sık gözlenmektedir. Çalışmamızda, KLT zemininde gelişen PTK olgularının, 2 cm'den küçük çaplı nodüllerde ve daha erken evrede saptandığı, daha az sıklıkta ETY gösterdiği sonucuna varılmıştır.

Anahtar Kelimeler: Tiroid kanseri; kronik lenfositik tiroidit
ABSTRACT
 Objective: The presence of chronic lymphocytic thyroiditis (CLT) in patients with papillary thyroid carcinoma (PTC) has been suggested to have positive effects on prognosis. However, there are contradictory views in the literature. In our study, we investigated the effect on clinical prognosis of the coexistence of CLT with PTC. Material and Methods: 259 (232F, 27M) patients who underwent thyroidectomy between January 2014 and August 2018 were diagnosed with PTC (144 papillary microcarcinoma). In 170 (65%) patients, PTC was diagnosed with CLT histopathologically. Age, gender, nodule diameter (< 2 cm), number of nodules (> 2), preoperative fine needle aspiration biopsy (FNAB) result, type of operation, tumor subgroup, tumor diameter, multifocality, lymph node metastasis (LNM), capsule invasion, extrathyroidal extension (ETE), risk group, and recurrence parameters were used to investigate the effects of CLT. SPSS programme 18.0 version was used for statistical analysis of the groups. p<0.05 values were considered as significant. Results: The presence of CLT was more frequent in patients with nodule diameter smaller than 2 cm (p=0.004). ETE was significantly lower in patients with CLT (p=0.017). The majority of patients with CLT were in the low-risk group (p=0.05). Conclusion: Papillary microcarcinoma is more common in the presence of concomitant CLT. In our study, it was concluded that patients with PTC developing on the background of CLT were detected in nodules diameter smaller than 2 cm and in earlier stage and ETE was less frequently.

Keywords: Thyroid cancer; chronic lymphocytic thyroiditis
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