Abstract
We thank you for the opportunity to review the interesting letter of Drs. Rijntjes and Schomburg (1) regarding our published work on the association between Hashimoto's thyroiditis (HT) pathology and the risk for differentiated thyroid cancer (DTC) (2).
As stated by these distinguished authors, choosing a non-orthodox way of reporting relative risk made our results appear less impressive. Our approach showed a statistically less potent association between HT and DTC, especially in the group of patients with HT with partially functional thyroid glands on low-dose replacement with levothyroxine (Hypo-HT; LT4-Low) and in the group of patients with normal thyroid function and HT pathology (Euth-HT). We appreciated the enthusiastic agreement Drs. Rijntjes and Schomburg's reanalysis showed for our conclusions. We were also pleased to read in their letter that “as important and clinically relevant news should do, these data rapidly found their way into a major German physician magazine.” We would like to add that not just a German magazine but also the prestigious journal Nature Endocrinology Reviews highlighted our publication (3).
With this letter, we would like to reiterate the validity of our results by citing our recently published data in which we studied the characteristics of the inflammatory responses accompanying all types of HT (from euthyroid to hypothyroid) associated with thyroid cancer (4). Profiling of lymphocytes infiltrating thyroid glands of patients with HT and thyroid cancer provided clues for failure of tumor immunity and a scientific rationale for the statistical association first reported in Thyroid.