Thyroid cancer in HCV-related chronic hepatitis patients: a case-control study.
OBJECTIVE
The present study prospectively investigated prevalence and features of thyroid cancer in patients with hepatitis C virus-related chronic hepatitis (HCV+) in comparison to two samples from the general population with different iodine intake.


METHODS
We studied the prevalence of thyroid cancer in 308 unselected HCV+ patients in comparison to two population-based, gender- and age-matched control groups: 1) 616 subjects from an iodine deficient area; 2) 616 subjects from an iodine-sufficient area. Thyroid status was assessed by measurement of circulating thyroid hormones and autoantibodies, thyroid ultrasonography, and when indicated, fine-needle aspiration cytology.


RESULTS
Circulating thyrotropin, anti-thyroglobulin, and anti-thyroperoxidase antibodies levels, and the prevalence of hypothyroidism were significantly higher in HCV+ patients (p < 0.001 for all). Six patients with papillary thyroid cancer were detected among HCV+ patients, whereas no case was observed in control 1 (p = 0.001), and only one case was observed in control 2 (p = 0.003). In HCV+ patients 83% with thyroid cancer had evidence of thyroid autoimmunity vs 31% of the other HCV+ patients (p = 0.02).


CONCLUSIONS
These data suggest a high prevalence of thyroid papillary cancer in HCV+ patients, overall in presence of thyroid autoimmunity; careful thyroid monitoring is indicated during the follow-up of these patients.
Antonelli
Alessandro
A
Metabolism Unit Department of Internal Medicine, University of Pisa, Italy. a.antonelli@med.unipi.it
Ferri
Clodoveo
C
Fallahi
Poupak
P
Pampana
Alessandro
A
Ferrari
Silvia Martina
SM
Barani
Lucio
L
Marchi
Santino
S
Ferrannini
Ele
E
D000328:Adult; D000368:Aged; D015551:Autoimmunity; D002291:Carcinoma, Papillary / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013961:Thyroid Gland / Q000276:immunology; D013964:Thyroid Neoplasms / Q000453:epidemiology*; D016606:Thyroid Nodule / Q000453:epidemiology; D013972:Thyrotropin
D013972:Thyrotropin