Faculty of Medicine, McGill University, Montreal, QC, Canada.
J Otolaryngol Head Neck Surg. 2012 Jun 1;41(3):160-3.
Vitamin D, classically involved in calcium homeostasis, has garnered recent interest for its potential role in cancer prevention and therapy. Although few risk factors have been established in the development of well-differentiated thyroid carcinoma, some would argue that no clear modifiable risk factor exists. Our study is one of the first to explore the relationship between vitamin D deficiency and thyroid cancer.
This retrospective cohort study was done at a university-affiliated thyroid cancer centre. In 2010, 212 patients undergoing thyroidectomy had their preoperative 25-hydroxyvitamin D(3) levels recorded in addition to the final pathologies of their resected thyroid nodule. The patients were stratified based on vitamin D status; vitamin D deficiency (VDD), reflecting levels under the established threshold of 37.5 nmol/L; and vitamin D sufficiency (VDS), reflecting levels above it. The primary outcome of malignancy rate was used to compare the proportion of malignant nodules in the VDD versus the VDS groups.
The malignancy rate rises when comparing the VDS and VDD groups, from 37.5 (33 of 88) to 75% (9 of 12), respectively, corresponding to a relative risk of 2.0 (p = .03, 95% CI 1.07-2.66).
This is the first study to demonstrate the inverse relationship between VDD and well-differentiated thyroid carcinoma. Larger prospective studies are needed to replicate these results. Should this happen, VDD may be the first modifiable risk factor for thyroid cancer.
经典上与钙稳态有关的维生素 D 因其在癌症预防和治疗中的潜在作用而受到关注。尽管已经确定了一些影响分化型甲状腺癌发展的风险因素，但有人认为不存在明确的可改变的风险因素。我们的研究是探索维生素 D 缺乏与甲状腺癌之间关系的首批研究之一。
这是一项在大学附属甲状腺癌中心进行的回顾性队列研究。2010 年，在 212 例行甲状腺切除术的患者中，除了切除的甲状腺结节的最终病理外，还记录了他们术前的 25-羟维生素 D(3)水平。根据维生素 D 状态对患者进行分层；维生素 D 缺乏（VDD）反映了低于 37.5 nmol/L 的既定阈值的水平；维生素 D 充足（VDS）反映了高于该水平的水平。恶性率是主要结局，用于比较 VDD 组与 VDS 组恶性结节的比例。
VDS 组与 VDD 组相比，恶性率升高，分别为 37.5%（88 例中的 33 例）和 75%（12 例中的 9 例），相对风险为 2.0（p =.03，95%CI 1.07-2.66）。
这是第一项表明 VDD 与分化良好的甲状腺癌之间存在反比关系的研究。需要更大的前瞻性研究来复制这些结果。如果发生这种情况，VDD 可能是甲状腺癌的第一个可改变的风险因素。
