Department of Endocrinology, Gansu Provincial Hospital, Dong gang West Road, Lanzhou, 730000, Gansu, People's Republic of China.
Clinical Evidence Based Medicine Center, Gansu Provincial Hospital, Dong gang West Road, Lanzhou, 730000, Gansu, People's Republic of China.
J Endocrinol Invest. 2017 Oct;40(10):1035-1047. doi: 10.1007/s40618-017-0679-x. Epub 2017 May 17.
To investigate the relationship between hypothyroidism, hyperthyroidism, thyroid hormone replacement, and the risk of breast cancer.
We searched the PubMed, Cochrane Library, EMbase, Web of Science, and China Biology Medicine (CBM) databases through June 2016 to identify researches that assessed the relationship between thyroid dysfunction and the risk of breast cancer together with the impact of thyroid hormone substitution treatment on incidence of breast cancer. Quality of evidence was assessed per outcome, using GRADE.
A total of 13 population-based studies including 24,808 participants were identified as eligible for this meta-analysis. A meta-analysis of 12 researches illustrated that hypothyroidism was not related to the risk for breast cancer [odds ratio (OR) = 0.83, 95% confidence interval (CI) 0.64-1.08, P = 0.162]. 10 researches illustrated that hyperthyroidism was also not related to the risk of breast cancer (OR = 1.03, 95% CI 0.83-1.30, P = 0.767). The impact of therapy was evaluated in six researches; there was no proof of a relationship between thyroid hormone substitution treatment and breast cancer with an overall OR of 0.83 (95% CI 0.57-1.21, P = 0.965).
Our meta-analysis illustrated that thyroid dysfunction may not be related to increased risk of breast cancer as well as the thyroid hormone substitution treatment did not reduce the incidence of breast cancer; while this study has some confounders that might weaken the results of this meta-analysis, we believe that the findings provide valuable information for stakeholders concerned with outcomes in patients with thyroid dysfunction.
研究甲状腺功能减退症、甲状腺功能亢进症、甲状腺激素替代治疗与乳腺癌风险之间的关系。
我们检索了 PubMed、Cochrane 图书馆、EMbase、Web of Science 和中国生物医学文献数据库，以确定评估甲状腺功能障碍与乳腺癌风险之间关系以及甲状腺激素替代治疗对乳腺癌发病率影响的研究，按结局评估证据质量，使用 GRADE 方法。
共有 13 项基于人群的研究，包括 24808 名参与者，被确定符合本荟萃分析的纳入标准。对 12 项研究的荟萃分析表明，甲状腺功能减退症与乳腺癌风险无关[比值比（OR）=0.83，95%置信区间（CI）0.64-1.08，P=0.162]。10 项研究表明甲状腺功能亢进症与乳腺癌风险也无关（OR=1.03，95%CI 0.83-1.30，P=0.767）。6 项研究评估了治疗的影响；没有证据表明甲状腺激素替代治疗与乳腺癌之间存在关系，总 OR 为 0.83（95%CI 0.57-1.21，P=0.965）。
我们的荟萃分析表明，甲状腺功能障碍与乳腺癌风险增加无关，甲状腺激素替代治疗并不能降低乳腺癌的发病率；虽然这项研究存在一些混杂因素，可能削弱了这项荟萃分析的结果，但我们认为这些发现为关注甲状腺功能障碍患者结局的利益相关者提供了有价值的信息。
