title: Increased risk of papillary thyroid cancer in systemic sclerosis associated with autoimmune thyroiditis.
abstract: OBJECTIVE
  Patients with SSc have an increased risk of malignancy compared with the general population. Before now, no study has evaluated the risk of thyroid cancer (TC) in SSc patients. The aim of the study was to evaluate the prevalence of TC in SSc patients.
  
  
  METHODS
  We studied the prevalence of TC in 327 unselected SSc patients in comparison with two population-based, gender- and age-matched control groups (654 subjects from an iodine-deficient area and 654 subjects from an iodine-sufficient area). Thyroid status was assessed by measurement of circulating thyroid hormones and autoantibodies, thyroid ultrasonography and fine-needle aspiration cytology (when necessary).
  
  
  RESULTS
  Circulating thyroid-stimulating hormone, anti-thyroglobulin and anti-thyroperoxidase antibody levels, and the prevalence of hypothyroidism were significantly higher in SSc patients (P < 0.01, for all). Six patients with papillary TC (PTC) were detected among SSc patients, whereas only one case was observed in each of controls 1 and 2 (P = 0.007, for both). In SSc all patients with TC had evidence of thyroid autoimmunity vs 40% of the other SSc patients (P = 0.001).
  
  
  CONCLUSIONS
  These data suggest a high prevalence of papillary TC in SSc patients, in particular in the presence of thyroid autoimmunity; careful thyroid monitoring would be opportune during the follow-up of these patients.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, alessandro.antonelli@med.unipi.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonelli
authors.affiliation: Department of Medical, Surgical, Maternal, Pediatric and Adult Sciences, University of Modena & Reggio Emilia, Modena and.
authors.forename: Clodoveo
authors.initials: C
authors.lastname: Ferri
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa.
authors.forename: Silvia Martina
authors.initials: SM
authors.lastname: Ferrari
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Domenicantonio
authors.affiliation: Department of Medical, Surgical, Maternal, Pediatric and Adult Sciences, University of Modena & Reggio Emilia, Modena and.
authors.forename: Dilia
authors.initials: D
authors.lastname: Giuggioli
authors.affiliation: Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
authors.forename: David
authors.initials: D
authors.lastname: Galleri
authors.affiliation: Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Miccoli
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa.
authors.forename: Poupak
authors.initials: P
authors.lastname: Fallahi
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology; D002291:Carcinoma, Papillary; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012595:Scleroderma, Systemic / Q000453:epidemiology* / Q000473:pathology; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000473:pathology; D013967:Thyroiditis, Autoimmune / Q000453:epidemiology* / Q000473:pathology
keywords: SSc; thyroid autoimmunity; thyroid cancer; thyroid nodules