Risk factors for the occurrence and recurrence of papillary thyroid carcinoma with Hashimoto's thyroiditis based on next- generation sequencing

Purpose To investigate the risk factors for the occurrence and recurrence of Hashimoto's thyroiditis (HT) combined with PTC using Next-Generation Sequencing (NGS). Methods 249 patients who underwent thyroid cancer surgery in the First Affiliated Hospital of Anhui Medical University from October 2020 to December 2020 were included, and the clinical data, NGS results and 4-year follow-up recurrence were collected, analyzing the related risk factors causing HT combined with PTC and its risk factors for recurrence. Results patients with RET rearrangement-positive patients in the HT group had a higher lymph node metastasis(LNM) and recurrence rate (P < 0.05); and patients with BRAF mutation in the HT group had more males and were more often seen with multifocal ( P < 0.05). Binary logistic regression analysis suggested that multifocal, RET rearrangement, low age, and lymph node negativity were risk factors for HT combined with PTC. The results of univariate COX analysis showed that the number of cancer foci, LNM, extrathyroidal extension(ETE), recurrence risk stratification, TSH, RET rearrangement positivity, and RET rearrangement interaction with Hashimoto's effect were risk factors for recurrence after PTC. The results of multifactorial COX regression analysis showed that ETE, recurrence risk stratification were risk factors for recurrence after PTC surgery. Conclusions BRAF mutations are lower in HT combined with PTC but do not have a significant role in recurrence, and the recurrence rate of PTC combined with HT is higher if accompanied by RET rearrangement, and more caution is needed for intraoperative clearance in such patients.