Thyro-gastric autoimmunity in patients with differentiated thyroid cancer: a prospective study

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• 作者：Francesco Cicone ; Annalisa Papa ; Chiara Lauri ; Anna Tofani ; Camilla Virili…
• 关键词：Autoimmune thyroid disease ; Differentiated thyroid cancer ; Autoimmune gastritis ; Atrophy body gastritis ; Iron deficiency anemia ; Pernicious anemia
• 刊名：Endocrine
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：49
• 期：1
• 页码：163-169
• 全文大小：186 KB
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• 作者单位：Francesco Cicone (1) (2)
  Annalisa Papa (1) (2)
  Chiara Lauri (1) (2)
  Anna Tofani (2)
  Camilla Virili (3) (4)
  Marco Centanni (3) (4)
  Francesco Scopinaro (1) (2)
  Bruno Annibale (1) (5)
  
  1. Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, “Sapienza-University of Rome, Rome, Italy
  2. Unit of Nuclear Medicine, Sant’Andrea Hospital, Rome, Italy
  3. Unit of Endocrinology, AUSL Latina, Latina, Italy
  4. Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza-University of Rome, Rome, Italy
  5. Unit of Gastroenterology, Sant’Andrea Hospital, Rome, Italy
  
• 刊物主题：Endocrinology; Diabetes; Internal Medicine; Science, general;
• 出版者：Springer US
• ISSN：1559-0100

文摘

Thyro-gastric autoimmunity has not been previously evaluated in patients with differentiated thyroid cancer (DTC), although its long-term complications may be relevant for the management of DTC patients. We assessed the prevalence of gastric autoimmunity and autoimmune gastritis (AG) in patients with Hashimoto’s thyroiditis (HT) and concomitant DTC. Prevalence of parietal cell antibody (PCA) positivity, iron deficiency anemia (IDA), and pernicious anemia (PA) were prospectively assessed in 150 DTC patients referred for radioiodine ablation after total thyroidectomy. Patients were classified as HT (n?=?31) and non-HT (n?=?119) based on a combination of serological, ultrasonographic, and histological findings. Patients with PCA positivity were subsequently addressed to endoscopy for confirmation of atrophy body gastritis, required for the diagnosis of AG. For all the variables under study, a comparison between groups was made using Fisher’s exact test and appropriate parametric and non-parametric tests. PCA positivity was significantly more prevalent in HT than in non-HT patients (12.9 vs 1.6?%, p?=?0.017). After Hp eradication, a reversal of PCA positivity was observed in 3/4 patients in the HT group. IDA and PA did not differ significantly between groups. In the HT group, only one patient had endoscopical confirmation of mild gastric corporal atrophy. Gastric autoimmunity shows higher prevalence in patients with DTC and concomitant HT than in patients with DTC alone; however, in most cases, PCA positivity was associated with Hp infection. Furthermore, although previous reports found up to one-third of patients with HT to have associated AG, in our cohort AG was extremely rare.