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. 2022 Aug 22;10(8):2051.
doi: 10.3390/biomedicines10082051.

Hashimoto's Thyroiditis Minimizes Lymph Node Metastasis in BRAF Mutant Papillary Thyroid Carcinomas

Peter P Issa  1 , Mahmoud Omar  2 , Yusef Buti  2 , Chad P Issa  1 , Bert Chabot  2 , Christopher J Carnabatu  2 , Ruhul Munshi  2 , Mohammad Hussein  2 , Mohamed Aboueisha  2 , Mohamed Shama  2 , Ralph L Corsetti  2 , Eman Toraih  2   3 , Emad Kandil  2
Affiliations

Hashimoto's Thyroiditis Minimizes Lymph Node Metastasis in BRAF Mutant Papillary Thyroid Carcinomas

Peter P Issa et al. Biomedicines. .

Abstract

Hashimoto's thyroiditis (HT) (autoimmune thyroiditis) is a clinicopathological entity associated with chronic lymphocytic infiltration resulting in hypothyroidism. HT is a double-edged sword that increases the risk of papillary thyroid cancer (PTC), yet it serves as a protective factor for PTC progression. BRAF mutation in PTCs is associated with rapid cell growth, aggressive tumor characteristics, and higher mortality rates. Here, we aimed to analyze the influence of HT in patients with PTCs and its effect on lymph node metastasis (LNM) in BRAF mutant tumors. Adults diagnosed with PTC between 2008 and January 2021 were retrospectively included. A total of 427 patients, 128 of whom had underlying HT, were included. The HT group had significantly higher rates of microcarcinoma (49.2% vs. 37.5%, p = 0.025) and less lateral LNM (8.6% vs. 17.1%, p = 0.024). Interestingly, BRAF-mutated PTCs were found to have significantly less overall LNM (20.9% vs. 51%, p = 0.001), central LNM (25.6% vs. 45.1%, p = 0.040) and lateral LNM (9.3% vs. 29.4%, p = 0.010) in patients with HT when compared to those without underlying HT. HT was found to be an independent protective predictor of overall and lateral LNM. Altogether, HT was able to neutralize the effect of BRAF mutation and was determined to be an independent protective factor against LNM. Specifically, our work may influence treatment-aggressiveness decision making for endocrinologists, oncologists and surgeons alike.

Keywords: Hashimoto’s thyroiditis; lymph node metastasis; protective factor; risk factor; thyroid cancer.

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Conflict of interest statement

The authors declare no conflict of interest. The sponsors had no role in the design, execution, interpretation, or writing of the study.

Figures

Figure 1
Figure 1
Frequency of lymph node metastasis (LNM) according to patient Hashimoto’s thyroiditis (HT) and BRAF mutation status. (A) Number of LNM overall. (B) Frequency of LNM by cervical compartment.
Figure 2
Figure 2
Multivariate logistic regression analysis for determining independent predictors of lymph node metastasis (LNM) in patients with BRAF mutant PTCs. (A) LNM overall. (B) Central LNM (CLNM). (C) Lateral LNM (LLNM). * indicated p < 0.05; ** indicated p < 0.01; *** indicates p < 0.001.
See this image and copyright information in PMC

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