Smyth Peter P A
Endocrine laboratory, Department of Medicine and Therapeutics, and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland.
Breast Cancer Res. 2003;5(5):235-8. doi: 10.1186/bcr638. Epub 2003 Jul 29.
A renewal of the search for a link between breast cancer and thyroid disease has once again demonstrated an increased prevalence of autoimmune thyroid disease in patients with breast cancer. This is the most recent of many studies showing an association between a variety of thyroid disorders and breast cancer. Such an association is not surprising as both diseases are female predominant with a similar postmenopausal peak incidence. The significance of the presence of thyroid autoantibodies, particularly thyroid peroxidase antibodies, in serum from patients with breast cancer is unknown, but it has been suggested that antibody positivity is associated with better prognosis. One area in which thyroid and breast functions overlap is in the uptake and utilization of dietary iodide. Experimental findings showing the ability of iodine or iodine-rich seaweed to inhibit breast tumour development is supported by the relatively low rate of breast cancer in Japanese women who consume a diet containing iodine-rich seaweed. However, there is as yet no direct evidence that iodine, iodinated compounds, or a combination of iodine and selenium is the antimammary carcinogenic element in the Japanese diet. It remains to be resolved whether the perceived breast cancer-thyroid disease relationship is thyroid or iodine related or, in the case of thyroid autoantibodies, is the consequence of an immune response to the carcinoma. Is this response breast specific and does it relate to iodine status? These and many other questions await resolution before a definitive role in the natural history of breast carcinoma can be assigned to the thyroid.
对乳腺癌与甲状腺疾病之间联系的再次探寻，再次表明乳腺癌患者中自身免疫性甲状腺疾病的患病率有所增加。这是众多显示各种甲状腺疾病与乳腺癌之间存在关联的研究中最新的一项。这种关联并不令人惊讶，因为这两种疾病在女性中更为常见，且绝经后发病率峰值相似。乳腺癌患者血清中甲状腺自身抗体，尤其是甲状腺过氧化物酶抗体的存在意义尚不清楚，但有人认为抗体阳性与较好的预后相关。甲状腺和乳腺功能重叠的一个领域是膳食碘的摄取和利用。实验结果表明碘或富碘海藻具有抑制乳腺肿瘤发展的能力，这一结果得到了食用富含碘海藻饮食的日本女性乳腺癌发病率相对较低的支持。然而，目前尚无直接证据表明碘、碘化化合物或碘与硒的组合是日本饮食中抗乳腺致癌的元素。乳腺癌与甲状腺疾病之间的这种关系究竟是与甲状腺有关还是与碘有关，或者就甲状腺自身抗体而言，是对癌症的免疫反应的结果，仍有待解决。这种反应是否具有乳腺特异性，是否与碘状态有关？在能够确定甲状腺在乳腺癌自然病程中的明确作用之前，这些以及许多其他问题都有待解决。
