ECE2023 Eposter Presentations Thyroid (128 abstracts)
The role of thyroid peroxidase antibodies on the risk of thyroid cancer: a systematic review and meta-analysis of surgical cohort studies
Dimitra Bantouna 1 , Ioannis Zoupas 2 , Juan C Jaume 3 , Shanawaz Imam 3 , Evaggelos Karvounis 4 , Sarantis Livadas 5,6 , Panagiotis Anagnostis 7 & Rodis Paparodis 3,8
1Private Practice, Patras, Greece; 2National and Kapodistrian University of Athens, Medical School, Athens, Greece; 3University of Toledo College of Medicine and Life Sciences, Center for Diabetes and Endocrine Research, Toledo, OH, United States; 4Euroclinic Hospital, Endocrine Surgery Center of Excellence, Athens, Greece; 5Athens Medical Center, Endocrinology, Diabetes and Metabolism, Athens, Greece; 6Endocrinology, Diabetes and Metabolism Clinics, Private Practice, Athens, Greece; 7Medical School, Aristotle University of Thessaloniki, First Department of Obstetrics and Gynecology, Thessaloniki, Greece; 8Endocrinology, Diabetes and Metabolism Clinics, Private Practice, Patras, Greece
Introduction: Hashimoto’s thyroiditis raises the risk for thyroid cancer (TC) in surgical series, but the role of thyroid peroxidase antibodies (TPO) remains controversial in that regard. We designed the present study to evaluate the effect of preoperative TPO titers in the risk of DTC.
Methods: A comprehensive search was conducted in PubMed, CENTRAand Scopus databases in November 2021 for the terms “thyroid cancer” and “TPO” or “peroxidase antibodies”. We characterized the differential risk found in patients with high titers of TPO (TPO+), as compared to those with low or undetectable titers (TPO-) with regard to TC. Data are expressed as odds ratio (OR) with 95% confidence interval (CI).
Results: We retrieved and reviewed 408 records; 22 retrospective cohort studies (2006-2021) from 7 countries and n=30,077 subjects, fulfilled the eligibility criteria: 15 studies in East Asia with n=24,096 subjects and 7 studies in the Western world with n=5981 subjects (19.9%)]. These comprised n=17,374 subjects with benign disease and n=12,703 with TC. The reference used for TPO+ was 23.6±18.8 (Range 5.1-50.0 IU/ml); n=6,105 patients were TPO+ and n=22,882 were TPO-. TC was present in n=2,817 TPO+ patients (46,14%) and n=9,122 TPO- patients (39,87%), RR 1.31 (1.24 - 1.39, P< 0.0001). A high titer of TPO was associated with increased risk for DTC in Asian cohorts, [OR 1.21 (1.13-1.29, P< 0.0001)] and Western world alike, [OR 1.91 (1.66-2.21), P< 0.0001]; That risk was statistically significantly higher in the Western world cohorts as compared to east Asia cohorts OR 1.65 (1.44-1.89), P< 0.0001.
Conclusions: Thyroid peroxidase antibodies are an integral part of Hashimoto’s thyroiditis, which is a well characterized risk factor for thyroid cancer and seem to increase that risk as well. That effect seems significantly higher in the Western world, as compared to the East Asia region. Further studies are needed to characterize the effects of the immune response, with regard to thyroid cancer risk.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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