Fierabracci P, Pinchera A, Campani D, Pollina L E, Giustarini E, Giani C
Department of Endocrinology, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy.
J Endocrinol Invest. 2006 Mar;29(3):248-51. doi: 10.1007/BF03345548.
An association between thyroid autoimmunity and breast cancer (BC) has been consistently reported, but the cause of this association is still unknown. The role of lymphocytic infiltration (LI) in breast tumorigenesis is controversial and several data suggest that in BC an increase of lymphoid cell infiltrates or a dysfunctional local immune response may be detected very early during tumor development. Chronic autoimmune thyroiditis is characterized by different degrees of LI in thyroid gland and BC cells share some antigenic properties similar to those detected in thyroid tissue, such as sodium iodide symporter (NIS) and peroxidase activity. The aim of this study was to evaluate the frequency and amount of LI in malignant and in normal peritumoral breast tissues, as expression of autoimmune morphological changes, in a group of BC patients with thyroid autoimmunity. We suppose that an increased LI in breast tissues of this group of patients may help explain the association between BC and thyroid autoimmunity. The study group included 26 BC patients with thyroperoxidase antibodies positivity (TPOAb+), 14 of them (53.8%) with Hashimoto's thyroiditis (HT), and 30 BC patients with no evidence of thyroid autoimmune disorders. Malignant and surrounding normal breast tissues were assessed for LI. The amount of LI was scored as very scanty or scanty (LI S) and moderate or marked (LI M), independently by two expert pathologists. LI S was detected in 19/26 (73.1%) BC tissues from patients with TPOAb positivity and LI M in 7 (26.9%). All BC patients with HT had LI S. LI S was detected in 25/30 (83%) and LI M in 5/30 (17%) of BC tissue from patients with no thyroid autoimmunity. The difference in the amount of LI of BC tissues in patient with or without autoimmune thyroid disorders was not significant. The LI was generally absent or very scanty in remote breast tissue in all cases. In conclusion, in breast malignancies the presence of humoral and/or clinical evidence of thyroid autoimmunity is not associated to autoimmune morphological changes of cancer and peritumoral normal tissue. The LI does not seem to have any role in tumorigenesis in patients with BC and thyroid autoimmunity.
甲状腺自身免疫与乳腺癌(BC)之间的关联一直有报道,但这种关联的原因仍不清楚。淋巴细胞浸润(LI)在乳腺肿瘤发生中的作用存在争议,一些数据表明,在乳腺癌中,在肿瘤发展的早期就可能检测到淋巴细胞浸润增加或局部免疫反应功能失调。慢性自身免疫性甲状腺炎的特征是甲状腺存在不同程度的淋巴细胞浸润,而乳腺癌细胞具有一些与甲状腺组织中检测到的抗原特性相似的抗原特性,如碘化钠同向转运体(NIS)和过氧化物酶活性。本研究的目的是评估一组患有甲状腺自身免疫的乳腺癌患者中,恶性乳腺组织和正常肿瘤周围乳腺组织中淋巴细胞浸润的频率和数量,作为自身免疫形态学变化的表现。我们推测,这组患者乳腺组织中淋巴细胞浸润增加可能有助于解释乳腺癌与甲状腺自身免疫之间的关联。研究组包括26例甲状腺过氧化物酶抗体阳性(TPOAb+)的乳腺癌患者,其中14例(53.8%)患有桥本甲状腺炎(HT),以及30例无甲状腺自身免疫性疾病证据的乳腺癌患者。对恶性乳腺组织和周围正常乳腺组织进行淋巴细胞浸润评估。淋巴细胞浸润的数量由两名专家病理学家独立评分,分为极少或稀少(LI S)以及中度或显著(LI M)。在TPOAb阳性患者的19/26(73.1%)例乳腺癌组织中检测到LI S,7例(26.9%)检测到LI M。所有患有HT的乳腺癌患者均为LI S。在无甲状腺自身免疫的患者中,25/30(83%)例乳腺癌组织检测到LI S,5/30(17%)例检测到LI M。有无自身免疫性甲状腺疾病患者的乳腺癌组织中淋巴细胞浸润数量的差异不显著。在所有病例中,远处乳腺组织中通常不存在或仅有极少的淋巴细胞浸润。总之,在乳腺恶性肿瘤中,甲状腺自身免疫的体液和/或临床证据的存在与癌组织及肿瘤周围正常组织的自身免疫形态学变化无关。淋巴细胞浸润似乎在患有乳腺癌和甲状腺自身免疫的患者的肿瘤发生中不起任何作用。