The relationship between Hashimoto's thyroiditis (HT) and thyroid cancer (TC) is a controversial topic; it remains unclear if HT acts as a risk factor of TC. The aim of our study was to compare the presence of HT and thyroid function in patients with TC and benign nodules. We analyzed 2571 patients after fine needle aspiration biopsy of thyroid nodule. Totally, 91 patients with primary TC and 182 sex- and age-matched controls were included. Positive antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-Tg) antibodies were associated with TC (anti-TPO 44% in TC vs. 27% in controls, P = 0.005, anti-TG 35% in TC group vs. 21% in controls, P = 0.018), and the TC group had significantly higher TSH (median 1.88 mIU/l vs. 1.21 mIU/l, P < 0.001). Using multiple logistic regression, positive anti-TPO was identified as an independent risk factor (OR 2.21, P = 0.018), while spontaneously suppressed TSH < 0.5 mIU/l was a protective factor (OR 0.3, P = 0.01) against TC. In conclusion, nodules in subjects with positive antithyroid antibodies could be considered to have a higher risk of malignancy. However, based on our results, it is not possible to declare that TC is triggered by HT.

3rd Department of Medicine Department of Endocrinology and Metabolism 1st Faculty of Medicine Charles University and General University Hospital Prague U Nemocnice 1 128 08 Praha 2 Czech Republic

Department of ENT Surgery of Head and Neck Na Homolce Hospital Roentgenova 2 37 150 00 Praha 5 Czech Republic

Dialectology Center Institute of Clinical and Experimental Medicine Vídeňská 1958 140 21 Praha 4 Czech Republic

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Davies L., Welch H. G. Current thyroid cancer trends in the United States. JAMA Otolaryngology–Head & Neck Surgery. 2014;140(4):317–322. doi: 10.1001/jamaoto.2014.1. PubMed DOI

Aschebrook-Kilfoy B., Ward M. H., Sabra M. M., Devesa S. S. Thyroid cancer incidence patterns in the United States by histologic type, 1992–2006. Thyroid. 2011;21(2):125–134. doi: 10.1089/thy.2010.0021. PubMed DOI PMC

McLeod D. S. A., Cooper D. S. The incidence and prevalence of thyroid autoimmunity. Endocrine. 2012;42(2):252–265. doi: 10.1007/s12020-012-9703-2. PubMed DOI

Vanderpump M. P. J., Tunbridge W. M. G. Epidemiology and prevention of clinical and subclinical hypothyroidism. Thyroid. 2002;12(10):839–847. doi: 10.1089/105072502761016458. PubMed DOI

Balkwill F., Mantovani A. Inflammation and cancer: back to Virchow? The Lancet. 2001;357(9255):539–545. doi: 10.1016/S0140-6736(00)04046-0. PubMed DOI

Dailey M. E., Lindsay S., Skahen R. Relation of thyroid neoplasms to Hashimoto disease of the thyroid gland. Archives of Surgery. 1955;70(2):291–297. doi: 10.1001/archsurg.1955.01270080137023. PubMed DOI

Kim E. S., Lim D. J., Baek K. H., et al. Thyroglobulin antibody is associated with increased cancer risk in thyroid nodules. Thyroid. 2010;20(8):885–891. doi: 10.1089/thy.2009.0384. PubMed DOI

Zhang L., Li H., Ji Q. H., et al. The clinical features of papillary thyroid cancer in Hashimoto’s thyroiditis patients from an area with a high prevalence of Hashimoto’s disease. BMC Cancer. 2012;12(1):p. 610. doi: 10.1186/1471-2407-12-610. PubMed DOI PMC

Lee J. H., Kim Y., Choi J. W., Kim Y. S. The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. European Journal of Endocrinology. 2013;168(3):343–349. doi: 10.1530/EJE-12-0903. PubMed DOI

Azizi G., Keller J. M., Lewis M., et al. Association of Hashimoto’s thyroiditis with thyroid cancer. Endocrine-Related Cancer. 2014;21(6):845–852. doi: 10.1530/ERC-14-0258. PubMed DOI PMC

Liu X., Zhu L., Cui D., et al. Coexistence of histologically confirmed Hashimoto’s thyroiditis with different stages of papillary thyroid carcinoma in a consecutive Chinese cohort. International Journal of Endocrinology. 2014;2014:7. doi: 10.1155/2014/769294.769294 PubMed DOI PMC

Fiore E., Rago T., Scutari M., et al. Papillary thyroid cancer, although strongly associated with lymphocytic infiltration on histology, is only weakly predicted by serum thyroid auto-antibodies in patients with nodular thyroid diseases. Journal of Endocrinological Investigation. 2009;32(4):344–351. doi: 10.1007/BF03345725. PubMed DOI

Gabalec F., Srbova L., Nova M., et al. Impact of Hashimoto’s thyroiditis, TSH levels, and anti-thyroid antibody positivity on differentiated thyroid carcinoma incidence. Endokrynologia Polska. 2016;67(1):48–53. doi: 10.5603/EP.a2016.0022. PubMed DOI

Cibas E. S., Ali S. Z., NCI Thyroid FNA State of the Science Conference The Bethesda system for reporting thyroid cytopathology. American Journal of Clinical Pathology. 2009;132(5):658–665. doi: 10.1309/AJCPPHLWMI3JV4LA. PubMed DOI

Haugen B. R., Alexander E. K., Bible K. C., et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133. doi: 10.1089/thy.2015.0020. PubMed DOI PMC

Bongiovanni M., Spitale A., Faquin W. C., Mazzucchelli L., Baloch Z. W. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytologica. 2012;56(4):333–339. doi: 10.1159/000339959. PubMed DOI

Shu S., Plautz G. E., Krauss J. C., Chang A. E. Tumor immunology. JAMA. 1997;278(22):1972–1981. doi: 10.1001/jama.1997.03550220178023. PubMed DOI

Cunha L. L., Ferreira R. C., Marcello M. A., Vassallo J., Ward L. S. Clinical and pathological implications of concurrent autoimmune thyroid disorders and papillary thyroid cancer. Journal of Thyroid Research. 2011;2011:13. doi: 10.4061/2011/387062.387062 PubMed DOI PMC

Muzza M., Degl’Innocenti D., Colombo C., et al. The tight relationship between papillary thyroid cancer, autoimmunity and inflammation: clinical and molecular studies. Clinical Endocrinology. 2010;72(5):702–708. doi: 10.1111/j.1365-2265.2009.03699.x. PubMed DOI

Tam A. A., Kaya C., Kılıç F. B. M., Ersoy R., Çakır B. Thyroid nodules and thyroid cancer in Graves’ disease. Arquivos Brasileiros de Endocrinologia & Metabologia. 2014;58(9):933–938. doi: 10.1590/0004-2730000003569. PubMed DOI

Belfiore A., Russo D., Vigneri R., Filetti S. Graves’ disease, thyroid nodules and thyroid cancer. Clinical Endocrinology. 2001;55(6):711–718. doi: 10.1046/j.1365-2265.2001.01415.x. PubMed DOI

Boelaert K., Horacek J., Holder R. L., Watkinson J. C., Sheppard M. C., Franklyn J. A. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. The Journal of Clinical Endocrinology & Metabolism. 2006;91(11):4295–4301. doi: 10.1210/jc.2006-0527. PubMed DOI

Fiore E., Rago T., Provenzale M. A., et al. Lower levels of TSH are associated with a lower risk of papillary thyroid cancer in patients with thyroid nodular disease: thyroid autonomy may play a protective role. Endocrine-Related Cancer. 2009;16(4):1251–1260. doi: 10.1677/ERC-09-0036. PubMed DOI