Effect of non-invasive follicular thyroid neoplasm with papillary-like features (NIFTP) terminology on surgical management concepts / La importancia de la terminología en el tratamiento de la neoplasia folicular no invasiva de tiroides con características de tipo papilar

Background: Despite the strict diagnostic criteria recently proposed for non-invasive follicular thyroid neoplasm with papillary-like features (NIFTP), its incidence is still unknown. Employing a retrospective analysis of the follicular variant of papillary thyroid carcinoma (FVPTC), we investigated the diagnosis, prevalence and postoperative course of NIFTP. Methods: We examined retrospectively the records of 112 patients who had undergone thyroid surgery and had a postoperative diagnosis of FVPTC at our hospital from 2010 to 2021. All clinical, radiologic, and pathologic features were evaluated. Results: Only 34 (27.9%) patients met the strict pathologic criteria for NIFTP; 11 cases having been diagnosed as NIFTP initially and 23 after re-evaluation of histopathologic slides. None of the 11 NIFTP patients underwent a 2-stage operation, in contrast to 10 (29.4%) patients initially diagnosed as FVPTC who had a completion thyroidectomy after the initial hemithyroidectomy. The median follow-up was 14.5 (ranging from 0 to 78) months. None of the cases developed a recurrence. Conclusion: To avoid unnecessary treatment or the follow-up advised for papillary thyroid carcinoma, clinicians and pathologists should be familiar with the terminology and the corresponding diagnostic criteria for NIFTP and their impact on management.(AU)

Introducción: A pesar de los definidos criterios diagnósticos recientemente propuestos para la neoplasia folicular de tiroides no invasiva con características de tipo papilar, designada con el acrónimo NIFTP de sus siglas en inglés (non-invasive follicular thyroid neoplasm with papillary-like nuclear features), todavía no se conoce su incidencia real. Empleando un análisis retrospectivo de la variante folicular de carcinoma papilar de tiroides (VFCPT), investigamos el diagnóstico, la prevalencia y el curso postoperativo de la NIFTP. Método: Examen retrospectivo de archivos de 112 pacientes operados de tiroides, y que tenían un diagnóstico postoperatorio de VFCPT en nuestro centro entre los años 2010 y 2021. Se evaluaron todos los datos clínicos, radiológicos e histopatológicos. Resultados: Solo 34 (27,9%) pacientes cumplían los criterios patológicos estrictos de NIFTP; 11 casos habían sido diagnosticados inicialmente y 23 después de una reevaluación de las láminas histopatológicas. Ninguno de los 11 casos iniciales de NIFTP fue sometido a una operación de 2 etapas, sin embargo, en 10 (29,4%) de los pacientes diagnosticados primero como VRCPT se practicó una tiroidectomía completa después de la hemitiroidectomía inicial. El seguimiento medio fue de 14,5 meses (entre 0 y 78 meses). Ningún paciente desarrolló recidivas. Conclusión: Para evitar un tratamiento excesivo o seguimiento tradicional aconsejado para el carcinoma papilar de tiroides, tanto los clínicos como los anatomopatólogos deben familiarizarse con la terminología y los criterios diagnósticos de la NIFTP, y como estos influencian en el tratamiento.(AU)

Comportamiento clínico de la variante oncocítica del cáncer papilar de tiroides: comparación de su evolución frente al cáncer papilar, variantes clásica y de células altas / Clinical behaviour of papillary thyroid cancer oncocytic variant: Stage-matched comparison versus classical and tall cell variant papillary thyroid cancer

Objetivo El cáncer papilar de tiroides (CPT) tiene diferentes variantes y la mayoría de ellas presentan diferencias sutiles. La variante oncocítica (VO) es un subtipo poco frecuente de CPT, sobre el pronóstico de la cual existen resultados controvertidos en la literatura. Investigamos su agresividad y curso clínico comparándolos con la variante clásica (VC) y la variante de células altas (CA) de CPT en diferentes estadios. Material y métodos En este estudio de cohortes retrospectivo se incluyeron: 100 muestras simples de VO, 71 de CA y 1.219 de VC. Las muestras VO se compararon con las VC y las de CA sobre la base de parámetros de pronóstico independientes. La recurrencia de la VO también se comparó estadio por estadio con la VC y CA. Resultados La edad media fue de 46,8 años y la relación hombres/mujeres de 25/75 para la VO. Las tasas de recurrencia en nuestro estudio fueron del 16% en VO; del 13,5% en VC y del 56% en CA. Existe una diferencia estadísticamente significativa con respecto a la recurrencia entre el estadio 1 y el estadio 4 comparando la VO y la VC (p=0,023; p=0,03, respectivamente). También hay una diferencia estadísticamente significativa con respecto a la recurrencia entre el estadio 1 y el estadio 4 comparando la VO y la CA (p=0,001; p=0,024, respectivamente). Se puede suponer que la VO tiene un comportamiento entre la VC y la CA, pero muy cercana a la CA. Conclusión La VO parece ser un poco más agresiva que la VC. A pesar de un tamaño de muestra inadecuado para los estadios 2 y 3, nuestros hallazgos implican un mayor riesgo de recurrencia para la VO que para la VC en los estadios avanzados (estadios 3 y 4) y la VC tiene un pronóstico más desfavorable que VO en estadios precoces (estadios 1 y 2), según el modelo de estadio pareado (AU)

Objective Papillary thyroid cancer (PTC) has many variants and most of them are mild tumors. Oncocytic variant (OV) is a rare subtype of PTC. There are controversial results about its prognosis in the literature. We investigated its aggressivity and clinical course by comparing it with classical variant (CV) and tall cell variant (TV) of PTC over a stage-matched design. Material and methods Pure 100 OV, 71 TV and 1,219 CV were included in this retrospective cohort study. OV was compared with CV and TV according to independent prognostic parameters. OV was also compared stage by stage with CV and TV for recurrence. Results Mean age was 46,8 years and male/female ratio 25/75 for OV. The recurrence rates in our study were 16% in OV, 13,5% in CV and 56% in TV. There is a statistically significant difference according to recurrence between stage 1 and stage 4 OV and CV (P = 0.023, P = 0.03, respectively). There is also a statistically significant difference between stage 1 and stage 4 OV and TV according to recurrence (P = 0.001, P = 0.024, respectively). OV can be supposed to behave between CV and TV, but very closer to CV. Conclusions OV seems to be slightly more aggressive than CV. Despite an inadequate sample size for stage 2 and 3, our findings imply an increased recurrence risk for OV than CV at the advanced stages (stage 3 and 4) and CV has an unfavorable prognosis than OV at early stages (stage 1 and 2) according to stage-matched model (AU)

Role of papillary thyroid carcinoma patients with Hashimoto thyroiditis: evaluation of oxidative stress and inflammatory markers

Purpose Papillary thyroid carcinoma (PTC) is the most frequent subtype of thyroid cancer; Hashimoto's thyroiditis (HT), autoimmune disease, commonly affects the thyroid gland; there is possibly a correlation between both, but the exact mechanisms that involve this relationship are still under debate. Since oxidative stress (OS) and the inflammatory environment participate in the development of several types of cancer, the objective of the present study was to establish the microenvironment and systemic participation of OS and inflammatory markers in patients with PTC and HT. Methods Blood and tissue samples were collected from 115 patients: BENIGN (n = 63); PTC (n = 27); HT (n = 15) and PTC + HT (n = 10), and sixty-three were samples from healthy individuals (control group). Results Superoxide dismutase, Catalase, reduced Glutathione, markers of lipid peroxidation and inflammation were evaluated in blood. Immunohistochemistry was performed on 3-nitrotyrosine, 4-hydroxynonenal, Ki-67 and VEGF. The results indicate that antioxidant enzymes were more active in groups with thyroid disorders compared to control, while the concentration of Reduced glutathione was reduced in BENIGN and PTC groups. When PTC and PTC + HT groups were analyzed, no significant differences were found in relation to the antioxidant defense and inflammatory markers. The ability to contain the induced lipid peroxidation was lower and a high level of malondialdehyde was observed in the PTC group. All immunohistochemical markers had higher scores in the PTC group compared to PTC + HT. Conclusion There was a more pronounced presence of OS and a greater activity of cell proliferation and angiogenesis markers in PTC than in PTC + HT group (AU)

MiR-181a promotes cell proliferation and migration through targeting KLF15 in papillary thyroid cancer

IntroductionPapillary thyroid cancer (PTC) is the predominant histological type of thyroid cancer, accounting for 80% of thyroid cancers. MiR-181a is a novel microRNA that is usually upregulated in multiple cancers. This study aims to explore the role and underlying mechanism of miR-181a in PTC.MethodsCCK8 and Transwell assays were performed to evaluate cell viability and migration. The mRNA level of miR-181a and KLF15 was calculated by qRT-PCR. The protein level of E-Cadherin, N-Cadherin and GAPDH was evaluated by western blot. Dual luciferase assay was conducted to validate that miR-181a directly targeting the 3′-UTR of KLF15 mRNA in TPC-1 cells.ResultsWe observed that miR-181a was overexpressed and KLF15 was low expressed in PTC tissues and cell lines. Upregulation of miR-181a or downregulation of KLF15 predicted poor outcomes in PTC patients. MiR-181a improved cell growth of PTC, migration and epithelial–mesenchymal transition (EMT) in TPC-1 cells. KLF15 was a target gene of miR-181a and its expression was mediated by miR-181a. KLF15 partially reversed the facilitating effect of miR-181a on cell proliferation and migration in TPC-1 cells.ConclusionWe discovered that miR-181a served as an oncogene downregulating KLF15, thereby inhibiting cell proliferation, migration and the EMT. These findings demonstrate that miR-181a plays a significant role in PTC progression and could be a therapeutic target for PTC.

Genome-wide scanning for CHD1L gene in papillary thyroid carcinoma complicated with type 2 diabetes mellitus

Purpose Papillary thyroid carcinoma (PTC) represents the most common subtype of thyroid cancer (TC). This study was set out to explore the potential effect of CHD1L on PTC and type 2 diabetes mellitus (T2DM). Methods We searched for T2DM susceptibility genes through the GWAS database and obtained T2DM-related differentially expressed gene from the GEO database. The expression and clinical data of TC and normal samples were collated from the TCGA database. Receiver operating characteristic (ROC) curve analysis was subsequently applied to assess the sensitivity and specificity of the CHD1L for the diagnosis of PTC. The MCP-counter package in R language was then utilized to generate immune cell score to evaluate the relationship between CHD1L expression and immune cells. Then, we performed functional enrichment analysis of co-expressed genes and DEGs to determine significantly enriched GO terms and KEGG to predict the potential functions of CHD1L in PTC samples and T2DM adipose tissue. Results From two genes (ABCB9, CHD1L) were identified to be DEGs (p < 1 * 10−5) that exerted effects on survival (HR > 1, p < 0.05) in PTC and served as T2DM susceptibility genes. The gene expression matrix-based scoring of immunocytes suggested that PTC samples with high and low CHD1L expression presented with significant differences in the tumor microenvironment (TME). The enrichment analysis of CHD1L co-expressed genes and DEGs suggested that CHD1L was involved in multiple pathways to regulate the development of PTC. Among them, Kaposi sarcoma-associated herpesvirus infection, salmonella infection and TNF signaling pathways were highlighted as the three most relevant pathways. GSEA analysis, employed to analyze the genome dataset of PTC samples and T2DM adipose tissue presenting with high and low expression groups of CHD1L, suggests that these differential genes are related to chemokine signaling pathway, leukocyte transendothelial migration and TCELL receptor signaling pathway (AU)

Occult Thyroid Carcinoma: A Tertiary Hospital Experience in Ibadan, Nigeria / Carcinoma de tiroides oculto: una experiencia en un hospital terciario en Ibadan, Nigeria

Introduction: There is a dearth of knowledge on the proportion that occult thyroid carcinoma constitutes amongst patients with thyroid cancer in our practice. This study was therefore conducted to review the cases of occult thyroid carcinoma with a focus on the presentation, management, and the outcome of care in a low resource tertiary hospital setting.Materials and Methods: We conducted a retrospective cross-sectional descriptive study of 62 patients who were managed for thyroid cancer over a 15-year-period at the University College Hospital, Ibadan, Nigeria. The patients who had more than two follow-up visits to the Thyroid Clinic, over the preceding fifteen years were included in this study. The types of surgeries performed on the patients were noted. The data were analyzed using descriptive statistics. We also identified the various limitations that might have hindered the effective care of such patients.Results: Sixty-two consecutive patients, 12 male (19.4%) and 50 females (80.6%) with a median interquartile age range of 45 years, were diagnosed with thyroid cancer. The surgeries performed on the patients were total thyroidectomy, 48 (77.4%), completion-thyroidectomy, 14 (22.6%), near total thyroidectomy, etc. Occult thyroid cancer constituted 38 (61.3%) of the patients managed for thyroid cancer. The most common histology subtype was papillary carcinoma. We identified late presentation, inadequate oncologic surgery, financial constraint etc., as limitations of optimal care.Conclusions: In view of the proportion of occult thyroid cancer in this cohort of patients, the clinically benign goitres might contain carcinoma or micro-carcinoma. Therefore, an aggressive public health campaign to encourage early presentation of our patients and primary reduction through total thyroidectomy is recommended to improve the outcome of care.(AU)

Introducción: Existe una escasez de conocimiento sobre la proporción que constituye el carcinoma de tiroides oculto entre los pacientes con cáncer de tiroides en nuestra práctica. Por lo tanto, este estudio se realizó para revisar los casos de carcinoma de tiroides oculto con un enfoque en la presentación, el manejo y el resultado de la atención en un entorno hospitalario terciario de bajos recursos.Materiales y Métodos: Realizamos un estudio descriptivo transversal retrospectivo de 62 pacientes que fueron tratados por cáncer de tiroides durante un período de 15 años en el University College Hospital, Ibadan, Nigeria. Se incluyeron en este estudio los pacientes que tuvieron más de dos visitas de seguimiento al centro durante los quince años anteriores. Se anotaron los tipos de cirugías realizadas a los pacientes. Los datos se analizaron mediante estadística descriptiva. También identificamos las diversas limitaciones que podrían haber obstaculizado la atención eficaz de estos pacientes. Resultados: Sesenta y dos pacientes consecutivos, 12 hombres (19,4%) y 50 mujeres (80,6%) con una mediana de edad intercuartil de 45 años, fueron diagnosticados de cáncer de tiroides. Las cirugías realizadas a los pacientes fueron tiroidectomía total, 48 (77,4%), tiroidectomía completa, 14 (22,6%), tiroidectomía casi total, etc. El cáncer de tiroides oculto constituyó 38 (61,3%) de los pacientes tratados por cáncer de tiroides. El subtipo histológico más común fue el carcinoma papilar. Identificamos la presentación tardía, la cirugía oncológica inadecuada, la restricción financiera, etc., como limitaciones de la atención óptima. Conclusiones: Dada la proporción de cáncer de tiroides oculto en esta cohorte de pacientes, los bocios clínicamente benignos pueden contener carcinoma o microcarcinoma. Por lo tanto, se recomienda una agresiva campaña de salud pública para fomentar...(AU)

Carcinoma papilar en tiroides lingual. Una entidad inusual / Lingual thyroid papillary carcinoma. An unusual entity

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Cirugía tiroidea en la edad pediátrica: causas y resultados / Thyroid surgery in pediatric patients: causes and results

OBJETIVO: La cirugía tiroidea es poco frecuente en la edad pediátrica, aunque ha aumentado su frecuencia en los últimos años. El objetivo de este estudio es analizar las causas y los resultados de estos procedimientos en un centro quirúrgico pediátrico. MÉTODOS: Estudio retrospectivo que incluyó a todos los pacientes que necesitaron cirugía tiroidea en nuestro servicio entre 2000-2019. Se recogieron datos demográficos, diagnóstico, patología asociada, tipo de procedimiento quirúrgico realizado, resultados anatomopatológicos y complicaciones intra y posoperatorias. RESULTADOS: Se incluyeron 47 pacientes con una edad media en el momento de la intervención de 8,9 ± 3,9 años. El diagnóstico más frecuente fue síndrome MEN2 (n = 30, 29 MEN2A y 1 MEN2B), seguido de carcinoma papilar de tiroides (n = 5), adenoma folicular (n = 5), bocio multinodular (n = 4), carcinoma folicular (n = 1), carcinoma papilar del conducto tirogloso (n = 1) y síndrome de Graves-Basedow (n = 1). Se realizaron 38 tiroidectomías totales (el 73,7% fueron profilácticas), tres dobles hemitiroidectomías, cinco hemitiroidectomías y en cinco casos fue necesario realizar una linfadenectomía. No se presentaron complicaciones intraoperatorias ni lesiones de nervio laríngeo recurrente. La estancia media posoperatoria fue de 1,3 ± 0,6 días. Siete pacientes presentaron hipoparatiroidismo transitorio asintomático y en un caso, persistente sintomático. Los resultados anatomopatológicos de las tiroidectomías profilácticas fueron: 18 hiperplasias de células C, 7 microcarcinomas y 3 sin alteraciones histopatológicas. CONCLUSIONES: La cirugía tiroidea en la edad pediátrica es segura en manos de equipos especializados. Aunque sigue siendo un procedimiento poco habitual, su frecuencia está aumentando en los últimos años

OBJECTIVE: Even though thyroid surgery is rare in pediatric patients, frequency has increased in the last years. The objective of this study was to analyze the causes and results of these procedures in a pediatric surgical facility. PATIENTS AND METHODS: Retrospective study including all patients requiring thyroid surgery in our department from 2000 to 2019. Demographic data, diagnostic data, associated pathology, type of surgical procedure, pathological results, and intraoperative and postoperative complications were recorded. RESULTS: 47 patients with a mean age of 8.9 ± 3.9 years at surgery were included. The most frequent diagnosis was MEN syndrome (n = 30, 29 MEN 2A and 1 MEN 2B), followed by thyroid papillary carcinoma (n = 5), follicular adenoma (n = 5), multinodular goiter (n = 4), follicular carcinoma (n = 1), thyroglossal duct papillary carcinoma (n = 1), and Graves-Basedow syndrome (n = 1). 38 total thyroidectomies (73.7% of which were prophylactic), 3 double hemithyroidectomies, 5 hemithyroidectomies, and 5 lymphadenectomies were performed. No intraoperative complications or recurrent laryngeal nerve lesions were noted. Mean postoperative hospital stay was 1.3 ± 0.6 days. 7 patients had transitory asymptomatic hypoparathyroidism, and 1 patient had persistent symptomatic hypoparathyroidism. Pathological results of prophylactic thyroidectomies were: 18 C cell hyperplasias, 7 microcarcinomas, and 3 cases without histopathological disorders. CONCLUSIONS: Thyroid surgery in pediatric patients is safe if performed by specialized personnel. Even though it remains rare, frequency has increased in the last years

Bone metastasis of papillary thyroid carcinoma simulating a pulmonary origin. Unusual immunohistochemistry leading to misdiagnosis / Metástasis ósea de cáncer papilar de tiroides simulando un origen pulmonar. Inmunohistoquímica inusual que conduce a un diagnóstico equívoco

Immunophenotypical features from tumors can be variable and, sometimes, confusing. We herein report a 61 year old woman with two foci of papillary thyroid microcarcinoma who developed a bone lesion four months after total thyroidectomy/central lymphadenectomy (mpT1aN0), with an immunohistochemical pattern suggestive of a pulmonary rather than a thyroid origin (CK7, napsin-A and TTF1 positive; and negative thyroglobulin). Further biomarkers (HBME-1 and PAX8) were performed in order to confirm primary tumor, leading to conclusion of a bone metastasis from thyroid papillary carcinoma. We believe it is always advisable to perform more than one biomarker as part of a panel to get a more reliable diagnosis

Las características inmunofenotípicas de los tumores pueden ser variables y, a veces, confusas. Reportamos el caso de una mujer de 61 años con 2 focos de microcarcinoma papilar de tiroides, que desarrolló una lesión ósea a los 4 meses de practicarse tiroidectomía total/linfadenectomía central (mpT1aN0), con patrón inmunohistoquímico sugerente de origen pulmonar en lugar de tiroideo (CK7, napsina-A y TTF1 positivos, y tiroglobulina negativa). Se analizaron biomarcadores adicionales (HBME-1 y PAX8) para confirmar el tumor primario, llegándose a la conclusión de metástasis ósea por cáncer papilar de tiroides. Creemos que es siempre recomendable analizar más de un biomarcador como parte de un panel, para obtener un diagnóstico más fiable

Warthin-like, una variante infrecuente del carcinoma papilar de tiroides / Warthin-like, a rare variant of papillary thyroid cancer

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Disección cervical radioguiada con semillas de I125 como tratamiento de la recurrencia de cáncer papilar de tiroides / Selective Neck Dissection Guided by a Radioactive I125 Seed for Papillary Thyroid Carcinoma Recurrence

El lugar más frecuente de recidiva del carcinoma papilar de tiroides es en los ganglios cervicales, siendo la cirugía una de las posibilidades terapéuticas. El riesgo quirúrgico para el paciente se incrementa con cada reintervención. Describimos 3 casos de disección cervical radioguiada con semilla de I125 en recidiva de cáncer de tiroides con lesiones no palpables, realizadas entre 2017 y 2019. Dos de los casos habían sido tratados previamente con tiroidectomía total y linfadenectomía del compartimento central. En todos los casos se colocó la semilla guiada mediante ecografía en la lesión sospechosa, comprobando su localización. La tasa de éxito para localizar el nódulo fue del 100%. No hubo complicaciones posquirúrgicas. Con un seguimiento medio de 15 meses no se han descrito recurrencias. La técnica radioguiada con semilla de I125 es segura y ofrece una gran precisión a la hora de localizar lesiones cervicales no palpables en recidivas de cáncer de tiroides

Lymph nodes are the most common place of recurrence of papillary thyroid cancer, and surgery can be considered a therapeutic option. The risks of surgery increase with every intervention. We present 3 cases of cervical non palpable thyroid cancer recurrence managed with I125 seed radioguided cervical dissection from 2017 to 2019. Two of the cases had already a thyroidectomy and central compartment lymphadenectomy performed. The seed was placed guided by US on the lesion and its position was confirmed afterwards. The target was successfully localized in 100% of cases. There was no post surgery complications. There was no evidence of recurrence with a mean follow up of 15 months. Radioguided surgery using I125 seed it is a save technique and it offers a precise localization of the non palpable thyroid cancer recurrence

Association between chronic lymphocytic thyroiditis and papillary thyroid carcinoma: a retrospective study in surgical specimens / Asociación entre tiroiditis linfocítica crónica y cáncer papilar de tiroides: estudio retrospectivo de especímenes quirúrgicos

INTRODUCTION: The hypothesis of an association between papillary thyroid carcinoma (PTC) and chronic lymphocytic thyroiditis (CLT) continues to generate debate. Retrospective studies suggest that there is a greater probability of diagnosing a PTC in surgical specimens with CLT; however, prospective studies suggest that there is no true increase in risk. METHODS: An analytical, cross-section measurement and retrospective study was carried out considering gender, age and diagnosis of CLT and PTC in surgical specimens. A binary logistic regression model was proposed to predict the probability of carrying out the diagnosis of PTC based on the diagnosis of CLT, gender and age. RESULTS: The study population consisted of 1136 patients, 1047 (92.2%) women and 89 (7.8%) men, with an average age of 47.5±14.3 years. The prevalence of CLT and PTC was 14.9% and 16.1% respectively. Coexistence between PTC and CLT was found in 44 patients, corresponding to 3.9% of the population. Our logistic regression model suggests that the probability of diagnosing PTC in surgical specimens of male patients under 40 years old and with CLT is 53.8%. CONCLUSIONS: We suggest that there is a greater probability of diagnosing PTC in surgical specimens with confirmatory histological data for CLT; in addition, in males under 40 years old this probability increases

INTRODUCCIÓN: La hipótesis que sugiere una asociación entre el cáncer papilar de tiroides (PTC, por sus siglas en inglés) y la tiroiditis linfocítica crónica (CLT, por sus siglas en inglés) sigue generando debate. Los estudios retrospectivos sugieren que existe una mayor probabilidad de realizar un diagnóstico de PTC en las muestras quirúrgicas de CLT. Los estudios prospectivos sugieren que no existe un incremento real del riesgo. MÉTODOS: Se realizó un estudio analítico de medición transversal y temporalidad retrospectiva en cuanto a sexo, edad, diagnóstico de CLT y espécimen quirúrgico de PTC. Se propuso un modelo de regresión logística binaria para predecir la probabilidad de realizarse un diagnóstico de PTC basado en el diagnóstico de CLT, sexo y edad. RESULTADOS: La población de estudio consistió en 1.136 pacientes, 1.047 mujeres (92,2%) y 89 varones (7,8%), con una edad media de 47,5 ± 14,3 años. La prevalencia de CLT y PTC fue del 14,9% y 16,1%, respectivamente. La coexistencia de PTC y CLT fue encontrada en 44 pacientes, correspondiente al 3,9% de la población. Nuestro modelo de regresión logística sugiere que la probabilidad de realizar el diagnóstico de PTC en muestras quirúrgicas de pacientes varones con edades inferiores a 40 años y con CLT es del 53,8%. CONCLUSIONES: Sugerimos que existe una mayor probabilidad de diagnosticar PTC en muestras quirúrgicas con datos histológicos confirmatorios de CLT; además, esta probabilidad puede modificarse sobre la base de sexo masculino y edad superior a 40 años