title: How do etiological factors can explain the different clinical features of patients with differentiated thyroid cancer and their histopathological findings?
abstract: The aim was to retrospectively analyse the clinical-histopathological characteristics of patients with newly diagnosis of differentiated thyroid cancer (DTC) referred to two Italian centres, one in Northern and the other in Southern Italy, between 2000 and 2013. 1081 patients were included and subdivided into two groups: group A (474 patients from Novara) and group B (607 patients from Naples). The group A came from the industrial area of Novara, while the Group B came from the areas around Vesuvius and Campi Flegrei. The two groups were comparable for iodine levels, body mass index, diagnostic timing and clinical procedures. For all patients, demographic and clinical data were collected. No difference was found in gender, whereas the age at diagnosis was later in the group A (group A 53.1 ± 15.16 years, group B 41.9 ± 14.25 years, p < 0.001). In both groups, the most frequent histotype was papillary thyroid cancer (PTC) with prevalence of follicular variant in group A (p < 0.0001) and classical variant in group B (p < 0.0001). Aggressive histological features were mainly seen in group A (bilaterality p < 0.0001, multifocality p < 0.0001 and thyroid capsular invasion p < 0.0001). Microcarcinomas were more frequent in group A (p < 0.0001) but mostly characterized by bilaterality (p < 0.001) and multifocality (p < 0.04). In both groups, tumour-associated thyroiditis showed a significant increase over the years (group A p < 0.05, group B p < 0.04). Environmental factors could justify the differences found in our study. These preliminary data should stimulate the need for an Italian Cancer Registry of DTC in order to allow an epidemiological characterization, allowing the identification of specific etiological factors and an improvement in the management of the disease.
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy. loredana.pagano@med.uniupo.it.
authors.forename: Loredana
authors.initials: L
authors.lastname: Pagano
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mele
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Arpaia
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Samà
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Caputo
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Ippolito
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Peirce
authors.affiliation: Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Prodam
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Valente
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciancia
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Aimaretti
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Biondi
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D063646:Carcinogenesis / Q000473:pathology; D002291:Carcinoma, Papillary / Q000473:pathology*; D018265:Carcinoma, Papillary, Follicular / Q000473:pathology*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology*
keywords: Clinical–histopathological features; Environmental factors; Thyroid cancer; Tumourigenesis induction