The incidence of Hashimoto’s thyroiditis (HT) in combination with thyroid cancer is increasing year by year, especially in combination with papillary microscopic carcinoma (PTMC), and the immune response in the inflammatory microenvironment of HT can both trigger and inhibit the progression of PTMC, so surgical management of HT in combination with PTMC is still recommended, but the timing and scope of surgery are controversial. Surgery should be performed in accordance with the guidelines, with emphasis on individualized treatment. In general, in cases of unilateral lobar PTMC with no high-risk factors, lobectomy + isthmus is recommended. In cases with a long history of HT, significantly elevated thyroid autoantibodies and thyroid stimulating hormone (TSH) levels, confirmed bilateral multifocal carcinoma, cervical lymph node metastases or distant metastases, total thyroidectomy should be performed. Lymph node dissection in the ipsilateral central region should be performed at the same time as lobectomy; for enlarged lymph nodes in the lateral cervical region, in principle, dissection should be performed after evidence is obtained. Because of the enlarged thyroid gland, the tendency to bleed, and the enlarged lymph nodes in the central region in combined HT, the difficulty of surgery increases, and the risk of injury to the recurrent laryngeal nerve and parathyroid glands increases. The association of Hashimoto’s disease with thyroid cancer: 1. It is believed that HT may be a precancerous lesion of thyroid cancer, and HT causes or induces the appearance of thyroid cancer, and studies at the molecular level have detected specific genetic alterations in HT during thyroid cancer development, such as RET/PTC rearrangement and BRAF gene mutations. 2. It is believed that because the autoimmune response can inhibit or kill cancer cells, HT has a certain inhibitory effect on the growth and metastasis of tumor cells, thus thyroid cancer shows clinical features such as microscopic cancer foci, low invasiveness, low incidence of lymph node metastasis and better prognosis. Hashimoto’s disease in combination with thyroid cancer: A Meta-analysis of 10,648 cases of differentiated thyroid cancer (PTC) in 38 studies showed that 2471 cases (23.2%) of HT were combined with PTC, mostly in female patients (OR=2.7, P<0.001< span="">); with multifocal (OR=1.5, P=0.010), extraglandular infiltration (OR=1.3, P=0.002) and lymph node metastasis (OR=1.3, P=0.041); significantly improved recurrence-free survival in patients with PTC with HT compared with those without HT (HR=0.6, P=0.001) Surgical treatment: Extent of thyroidectomy: Generally, for patients with unilateral PTMC confirmed preoperatively or by intraoperative cryopathology and without recurrence of HT, the following treatment options were available For patients with a long history of HT, significantly elevated levels of thyroid autoantibodies (e.g. TPOAb) and thyroid stimulating hormone (TSH), confirmed bilateral cancer, multifocal cancer, cervical lymph node metastasis or distant metastasis, total thyroidectomy is indicated. Lymph node dissection: In addition to radical thyroid cancer resection, ipsilateral lymph node dissection in the central region should be performed; for the diagnosis of enlarged lymph nodes in the lateral cervical region by combining 2D ultrasound, ultrasonography, FNAB and thyroglobulin testing with fine needle aspiration, in principle, lymph node dissection should be performed after obtaining evidence. recurrence and reoperation.