Hashimoto's thyroiditis and papillary thyroid carcinoma. Are cytokeratin 19 and P63 proteins of any diagnostic value?
BACKGROUND
The relation between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) remains controversial. We aimed to study the coexistence of PTC and HT and the diagnostic utility of cytokeratin19 and P63 proteins expression in all positive for PTC cases of HT.


METHODS
We analyzed data from 343 patients who underwent fine needle aspiration cytology followed by thyroid surgery over a six years period. Thyroid scans and blood measurements for anti-thyroid peroxidase antibodies (TPOAb), thyroid stimulating hormone (TSH), anti-thyroglobulin antibodies (TgAb) and free thyroid hormones were performed. We assessed the expression of monoclonal antibodies against cytokeratin 19 (CK19) and factor P63 in all positive for PTC patients.


RESULTS
Hashimoto's thyroiditis was diagnosed by histology in 93 patients. They were: 90 female and 3 male patients. Both HT and PTC were present in 6 female patients (6,7%). All their thyroid scans showed heterogeneous distribution of the tracer with a cold nodule. Laboratory examination showed high levels of TSH as well as of TPOAb in all PTC patients. Cytokeratin 19 showed positive expression in all PTC patients, whereas P63 showed focal positivity in 4/6 cases. We did not estimate the duration of HT in our study.


CONCLUSIONS
This study showed that 6,7% of female patients with HT also had PTC and all had elevated serum TSH, which may be a risk factor for PTC. The age of PTC patients was between 19-42 years.
Department of Clinical Cytology, Volos General Hospital, Greece. milanako76@ yahoo.gr.
Smaroula N
SN
Divani
George P
GP
Kalodimos
Matteo A
MA
Lioupis
Nikolaos Ch
NC
Syrmos
D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002277:Carcinoma / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002291:Carcinoma, Papillary; D015984:Causality; D015897:Comorbidity; D005260:Female; D006115:Greece / Q000453:epidemiology; D050031:Hashimoto Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007453:Iodide Peroxidase / Q000097:blood; D053539:Keratin-19 / Q000097:blood*; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013972:Thyrotropin / Q000097:blood; D055815:Young Adult
D014408:Biomarkers, Tumor; C081876:CKAP4 protein, human; D053539:Keratin-19; D008565:Membrane Proteins; D013972:Thyrotropin; D007453:Iodide Peroxidase