Background: There is some controversy on the potential relationship between autoimmune processes and clinicopathologic features as well as prognosis of differentiated thyroid cancer (DTC), and the evidence is limited by its largely retrospective nature. We examined the relationship between the presence of autoimmune thyroiditis (AT) and 1-year thyroid cancer treatment outcomes in a large multicenter study using prospectively collected data. Methods: We included data from consecutive DTC patients enrolled in the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339). We divided the groups according to the presence (AT) or absence (no autoimmune thyroiditis [noAT]) of associated AT. We used propensity score matching to compare the clinical features and outcomes between the two groups at 1-year follow-up. Results: We included data from 4233 DTC patients, including 3172 (75%) females. The American Thyroid Association (ATA) risk levels were as follows: 51% (2160/4233) low risk, 41.3% (1750/4233) intermediate risk, and 7.6% (323/4233) high risk. There were 1552 patients (36.7%) who had AT. Before propensity score matching, AT patients were significantly younger and had a smaller and bilateral tumor (p < 0.0001). Patients with AT more frequently fell into the low- and intermediate-risk categories, while the ATA high risk was more frequent among noAT patients (p = 0.004). After propensity score matching, patients with AT more frequently showed evidence of disease (structural/biochemical incomplete response) versus excellent/indeterminate response, compared with patients without AT (7.3% vs. 4.5%, p = 0.001), with an odds ratio of 1.86 ([confidence interval: 1.3-2.6], p = 0.0001). However, when considering only structural persistence as the outcome, no statistically significant differences were observed between patients with or without AT (3.4% vs. 2.7%, p = 0.35). The elevated risk associated with the ATA intermediate and high risk at diagnosis remained consistently statistically significant. Conclusions: In this large prospective series, biochemical persistence was more frequent, at 1-year follow-up, in AT patients. However, there was no significant association between the presence of AT and structural persistence of disease. These findings may be explained by the presence of a residual thyroid tissue.

中文翻译：

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一项前瞻性多中心研究，探讨甲状腺癌治疗结果与自身免疫性甲状腺炎之间的关系。

背景：关于自身免疫过程与分化型甲状腺癌（DTC）的临床病理特征和预后之间的潜在关系存在一些争议，并且证据因其主要是回顾性的而受到限制。我们使用前瞻性收集的数据，在一项大型多中心研究中检查了自身免疫性甲状腺炎 (AT) 的存在与 1 年甲状腺癌治疗结果之间的关系。方法：我们纳入了意大利甲状腺癌观察站 (ITCO) 数据库 (NCT04031339) 中登记的连续 DTC 患者的数据。我们根据相关 AT 的存在（AT）或不存在（无自身免疫性甲状腺炎 [noAT]）对各组进行分组。我们使用倾向评分匹配来比较两组在 1 年随访时的临床特征和结果。结果：我们纳入了 4233 名 DTC 患者的数据，其中包括 3172 名 (75%) 女性。美国甲状腺协会（ATA）的风险等级如下：51%（2160/4233）低风险，41.3%（1750/4233）中风险，7.6%（323/4233）高风险。有 1552 名患者 (36.7%) 患有 AT。在倾向评分匹配之前，AT 患者明显更年轻，并且肿瘤较小且为双侧肿瘤 (p < 0.0001)。AT 患者更常见于低风险和中风险类别，而 ATA 高风险在非 AT 患者中更常见 (p = 0.004)。倾向评分匹配后，与没有 AT 的患者相比，AT 患者更频繁地表现出疾病证据（结构/生化不完全反应）与优秀/不确定反应（7.3% vs. 4.5%，p = 0.001），比值比为1.86（[置信区间：1.3-2.6]，p = 0.0001）。然而，当仅考虑结构持久性作为结果时，患有或不患有 AT 的患者之间没有观察到统计学上的显着差异（3.4% vs. 2.7%，p = 0.35）。诊断时与 ATA 中风险和高风险相关的风险升高始终具有统计学显着性。结论：在这项大型前瞻性研究中，AT 患者在 1 年随访时生化持续性更为频繁。然而，AT 的存在与疾病的结构持续性之间没有显着关联。这些发现可以用残留甲状腺组织的存在来解释。