Autoimmune thyroiditis in paediatric thyroid cancer: clinical features and outcomes.

IF 5.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Michaela Kuhlen, Marina Kunstreich, Desiree Dunstheimer, Niklas Aumann, Kerstin Lorenz, Markus Luster, Kurt W Schmid, Antje Redlich
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Abstract

Objective: To evaluate clinical characteristics and survival outcomes of paediatric differentiated thyroid carcinoma (paedDTC) in patients with and without autoimmune thyroiditis (AIT).

Design: Retrospective cohort analysis of paedDTC patients with and without AIT, prospectively enrolled in the German Malignant Endocrine Tumour Registry between 1997 and 2024.

Methods: We analysed data from paediatric patients (<18 years) with histopathologically confirmed DTC, stratified by AIT status. Variables included demographics, tumour characteristics, lymph node involvement, and metastasis. Survival outcomes were assessed using Kaplan-Meier estimates.

Results: Among 401 evaluable patients, 16.0% had AIT. AIT patients were significantly older at diagnosis (P < .001) and showed a non-significant tendency toward higher female predominance (P = .098). Patients with AIT demonstrated significantly lower rates of distant metastasis (7.5% vs. 22.2%, P = .014) compared with those without AIT. No significant differences were observed in tumour size, capsule invasion, lymphatic or vascular invasion, soft tissue infiltration, or multifocality. A tendency toward improved event-free survival (EFS) was observed in AIT patients (87.5% vs. 72.1%, P = .255), while overall survival (OS) was comparable (91.8% vs. 86.0%, P = .167) during the study period. Among patients with known AIT history, paedDTC was significantly more frequently diagnosed through surveillance compared with non-AIT patients (44.2% vs. 28.3%, P = .022).

Conclusions: AIT was present in 16% of paedDTC patients and was associated with reduced distant metastasis. A tendency toward improved EFS but similar OS during the follow-up period was observed. Earlier detection through surveillance in AIT patients may contribute to these findings, warranting further investigation into underlying biological mechanisms.

小儿甲状腺癌的自身免疫性甲状腺炎:临床特征和结果
目的:评价合并和不合并自身免疫性甲状腺炎(AIT)的儿童分化型甲状腺癌(paedDTC)的临床特点和生存结局。设计:回顾性队列分析1997年至2024年间在德国恶性内分泌肿瘤登记处登记的伴有和不伴有AIT的paedDTC患者。方法:我们分析了来自儿科患者的资料(结果:在401例可评估的患者中,16.0%患有AIT。结论:16%的paedDTC患者存在AIT,并且与远处转移减少有关。在随访期间,观察到有改善EFS的趋势,但OS相似。通过监测早期发现AIT患者可能有助于这些发现,需要进一步研究潜在的生物学机制。
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来源期刊
European Journal of Endocrinology
European Journal of Endocrinology 医学-内分泌学与代谢
CiteScore
9.80
自引率
3.40%
发文量
354
审稿时长
1 months
期刊介绍: European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.
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