title: Chronic lymphocytic thyroiditis: could it be influenced by a petrochemical complex? Data from a cytological study in South-Eastern Sicily.
abstract: BACKGROUND
  In genetically predisposed individuals, exogenous factors (including pollution) influence the development of Hashimoto's thyroiditis/chronic lymphocytic thyroiditis (CLT). CLT may also be a risk factor for associated thyroid cancer. Few data are available on the role of pollution from petrochemical complexes, one of which is located in the Siracusa province (South-Eastern Sicily), in the pathogenesis of CLT.
  
  
  OBJECTIVE
  i) To study the frequency of CLT in fine-needle aspiration cytology (FNAC)-interrogated thyroid nodules from patients who were stably resident in their zones, comparing it in patients living in the petrochemical complex area (zone A) with that of patients from a control area (zone B). ii) To study the frequency of CLT in the FNAC categories of malignancy risk, comparing the two zones.
  
  
  METHODS
  We retrospectively evaluated cytologically adequate slides of 1323 nodules in 1013 outpatients who underwent ultrasound-guided FNAC from 2006 to 2012. We stratified by area of residence, gender, and FNAC categories of malignancy risk.
  
  
  RESULTS
  CLT was detected with significantly greater frequency in either patients or nodules from zone A compared with zone B (32.0% vs 23.1%, P=0.002 or 28.2% vs 18.8%, P=0.0001), with a female preponderance (F=35.2% vs M=21.1% or 30.4% vs 20.4%, zone A and F=26.5% vs 12.3% or 21.6% vs 9.5%, zone B). Regardless of zone, CLT was approximately twofold more frequent in the suspiciously malignant+malignant classes (TH4+THY5=47.6%, zone A and 32.4%, zone B) compared with the benign+intermediate classes (THY2+THY3=27.3%, zone A and 18.2%, zone B), but with a clear stepwise THY2 through THY5 increase only in zone A (THY2=25.3%, THY5=66.7%; THY2=18.6%, THY5=28.6% in zone B).
  
  
  CONCLUSIONS
  The petrochemical complex-related pollution is an environmental factor involved in the development of CLT and, likely, in the CLT association with thyroid neoplasms.
authors.affiliation: A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina salvoarena72@hotmail.com.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Arena
authors.affiliation: A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina.
authors.forename: Adele
authors.initials: A
authors.lastname: Latina
authors.affiliation: A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina.
authors.forename: Roberto
authors.initials: R
authors.lastname: Baratta
authors.affiliation: A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Burgio
authors.affiliation: A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina.
authors.forename: Damiano
authors.initials: D
authors.lastname: Gullo
authors.affiliation: A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Benvenga
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D004777:Environment; D005260:Female; D050031:Hashimoto Disease / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061329:Oil and Gas Fields; D059392:Petroleum Pollution / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012802:Sicily / Q000453:epidemiology; D016606:Thyroid Nodule / Q000453:epidemiology / Q000473:pathology