title: Role of chronic lymphocytic thyroiditis in central node metastasis of papillary thyroid carcinoma.
abstract: OBJECTIVE
  (1) To investigate the role of chronic lymphocytic thyroiditis (CLT) in central node metastasis of papillary thyroid carcinoma (PTC) and (2) to evaluate the presence of chronic lymphocytic thyroiditis according to PTC-specific molecular markers.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  All patients who underwent total thyroidectomy with central neck dissection for PTC at Oregon Health & Science University between 2005 and 2010 were screened for the presence of CLT and reviewed for clinical prognostic factors. Patients with inadequate central neck dissections were excluded. Molecular markers for PTC were analyzed on archived tumor samples.
  
  
  RESULTS
  A total of 139 patients met selection criteria. The rate of CLT was 43.8%. The rate of central node positivity was 63%. Presence of CLT was associated with a significantly lower proportion of central node metastases (49% vs 74%, P = .003) and angiolymphatic invasion (31% vs 15%, P = .03). There was no significant difference in mean age, tumor size, and extracapsular extension. Molecular genotyping did not reveal a significant difference in the types of mutations found in both groups.
  
  
  CONCLUSIONS
  The data indicate a lower incidence of central compartment lymph node metastasis in those with CLT in this patient population, suggesting a potential protective role in tumor spread. The equal distribution of tumor mutations between the carcinomas with and without evidence of CLT argues against a mutation-specific antigen as the immunologic stimulus. Further research is needed to characterize the role of autoimmunity in thyroid cancer.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA. lorien@alum.mit.edu
authors.forename: Lorien M
authors.initials: LM
authors.lastname: Paulson
authors.forename: Maisie L
authors.initials: ML
authors.lastname: Shindo
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Schuff
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000235:genetics; D044963:Biopsy, Fine-Needle; D018265:Carcinoma, Papillary, Follicular / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D004252:DNA Mutational Analysis; D005260:Female; D050031:Hashimoto Disease / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D006801:Humans; D019656:Loss of Heterozygosity / Q000235:genetics; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011505:Protein-Tyrosine Kinases / Q000235:genetics; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy
chemical_list: D014408:Biomarkers, Tumor; D015514:Oncogene Proteins, Fusion; D011505:Protein-Tyrosine Kinases; C093573:ret-PTC fusion oncoproteins, human; D048493:Proto-Oncogene Proteins B-raf