Michalaki V, Kondi-Pafiti A, Gennatas S, Antoniou A, Primetis H, Gennatas C
Oncology Clinic, Areteion Hospital, University of Athens, Athens, Greece.
J BUON. 2009 Jul-Sep;14(3):425-8.
The relationship between breast cancer and thyroid diseases is controversial. Conflicting results have been reported in the literature. The incidence of autoimmune and non-autoimmune thyroid diseases were investigated in patients with breast cancer who had received prior therapy as compared with age-matched control individuals without breast or thyroid disease.
Clinical and ultrasound evaluation of the thyroid gland, and determination of serum thyroid hormones and autoantibody levels were performed in 143 breast cancer patients and 128 healthy control individuals. Patients were classified into subgroups according to estrogen receptor (ER) and progesterone receptor (PR) status and type of oncological treatment.
The mean values for serum antibodies against thyroid peroxidase (anti-TPO) were 9 IU/ml and 25 IU/ml for antithyroglobulin antibodies (anti-TGB) in breast cancer patients, and 9.5 IU/ml and 23.5 IU/ml, respectively, in the control group (p>0.05. The difference between breast cancer patients and the control group in the incidence of autoimmune and non-autoimmune thyroid diseases was not statistically significant. No significant differences between the groups according to both menopausal status and ER status were seen (p= 0.67). Also, no significant influence of hormonal therapy with tamoxifen and chemotherapy on serum levels of thyroid stimulating hormone (TSH), free thyroxin (fT4), TPO and TGB autoantibodies was proved.
This study demonstrated a similar incidence of thyroid enlargement and the same frequency of thyroid disturbances in patients with breast cancer and controls. No relationship was found among ER and PR status, and the presence of serum thyroid autoantibodies. Although we have been unable to demonstrate any impact of breast cancer therapy on thyroid function tests, more prolonged studies with larger number of patients may be required to demonstrate significant trends.
乳腺癌与甲状腺疾病之间的关系存在争议。文献报道的结果相互矛盾。本研究调查了接受过前期治疗的乳腺癌患者中自身免疫性和非自身免疫性甲状腺疾病的发病率,并与年龄匹配的无乳腺或甲状腺疾病的对照个体进行比较。
对143例乳腺癌患者和128例健康对照个体进行甲状腺的临床和超声评估,并测定血清甲状腺激素和自身抗体水平。患者根据雌激素受体(ER)和孕激素受体(PR)状态以及肿瘤治疗类型分为亚组。
乳腺癌患者血清甲状腺过氧化物酶抗体(抗-TPO)的平均值为9 IU/ml,抗甲状腺球蛋白抗体(抗-TGB)为25 IU/ml,对照组分别为9.5 IU/ml和23.5 IU/ml(p>0.05)。乳腺癌患者与对照组在自身免疫性和非自身免疫性甲状腺疾病发病率上的差异无统计学意义。根据绝经状态和ER状态,两组之间未见显著差异(p = 0.67)。此外,未证实他莫昔芬激素治疗和化疗对血清促甲状腺激素(TSH)、游离甲状腺素(fT4)、TPO和TGB自身抗体水平有显著影响。
本研究表明,乳腺癌患者和对照组甲状腺肿大的发生率相似,甲状腺功能紊乱的频率相同。未发现ER和PR状态与血清甲状腺自身抗体的存在之间存在关联。虽然我们未能证明乳腺癌治疗对甲状腺功能测试有任何影响,但可能需要对更多患者进行更长时间的研究以证明显著趋势。