Autoimmunity in differentiated thyroid cancer: significance and related clinical problems

Hormones (Athens). Apr-Jun 2010;9(2):109-17. doi: 10.14310/horm.2002.1261.

Abstract

Coexistence of differentiated thyroid cancer (DTC) and thyroid autoimmune diseases could represent a mere coincidence due to the frequent occurrence of autoimmunity, but there may also be a pathological and causative link between the two conditions. The coincidence of DTC with Hashimoto's disease has been variably reported at between 0.5 and 22.5% and of DTC with Graves' disease between 0 and 9.8%. In this review available evidence for thyroid autoimmunity in DTC is summarized and it is concluded that thyroid cancer does coexist with thyroid autoimmunity, implying that patients treated for autoimmune thyroid diseases should have a careful follow-up. Furthermore, the presence of thyroglobulin antibodies (TgAb) in patients with DTC may limit the use of serum thyroglobulin as a tumor marker due to methodological problems in the determination of serum thyroglobulin. However, in such cases serial TgAb measurements may be used as a surrogate marker for recurrence of thyroid cancer during the long-term monitoring of DTC patients.

Publication types

  • Review

MeSH terms

  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / radiotherapy
  • Autoimmunity*
  • Biomarkers, Tumor / blood
  • Carcinoma / diagnosis
  • Carcinoma / immunology*
  • Carcinoma / pathology
  • Carcinoma / radiotherapy
  • Cell Differentiation*
  • Humans
  • Predictive Value of Tests
  • Prognosis
  • Radiation Dosage
  • Radiopharmaceuticals / adverse effects
  • Radiotherapy / adverse effects
  • Risk Factors
  • Thyroglobulin / blood
  • Thyroid Diseases / diagnosis
  • Thyroid Diseases / immunology*
  • Thyroid Diseases / radiotherapy
  • Thyroid Neoplasms / diagnosis
  • Thyroid Neoplasms / immunology*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / radiotherapy

Substances

  • Biomarkers, Tumor
  • Radiopharmaceuticals
  • Thyroglobulin