Minlikeeva Albina N, Freudenheim Jo L, Cannioto Rikki A, Eng Kevin H, Szender J Brian, Mayor Paul, Etter John L, Cramer Daniel W, Diergaarde Brenda, Doherty Jennifer A, Dörk Thilo, Edwards Robert, deFazio Anna, Friel Grace, Goodman Marc T, Hillemanns Peter, Høgdall Estrid, Jensen Allan, Jordan Susan J, Karlan Beth Y, Kjær Susanne K, Klapdor Rüdiger, Matsuo Keitaro, Mizuno Mika, Nagle Christina M, Odunsi Kunle, Paddock Lisa, Rossing Mary Anne, Schildkraut Joellen M, Schmalfeldt Barbara, Segal Brahm H, Starbuck Kristen, Terry Kathryn L, Webb Penelope M, Zsiros Emese, Ness Roberta B, Modugno Francesmary, Bandera Elisa V, Chang-Claude Jenny, Moysich Kirsten B
Deparment of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Deparment of Epidemiology and Environmental Health, University at Buffalo, 270 Farber Hall, University at Buffalo, Buffalo, NY 14214-8001, USA.
Br J Cancer. 2017 Sep 26;117(7):1063-1069. doi: 10.1038/bjc.2017.267. Epub 2017 Aug 17.
Findings from in vitro studies suggest that increased exposure to thyroid hormones can influence progression of ovarian tumours. However, epidemiologic evidence on this topic is limited.
We pooled data from 11 studies from the Ovarian Cancer Association Consortium. Using multivariate Cox proportional hazards models, we estimated associations between hyper- and hypothyroidism and medications prescribed for these conditions with 5-year all-cause survival among women diagnosed with invasive ovarian cancer.
Overall, there was a nonsignificant association with history of hyperthyroidism (n=160 cases) and mortality (HR=1.22; 95% CI=0.97-1.53). Furthermore, diagnosis of hyperthyroidism within the 5 years before ovarian cancer diagnosis was associated with an increased risk of death (HR=1.94; 95% CI=1.19-3.18). A more modest association was observed with history of hypothyroidism (n=624 cases) and mortality (HR=1.16; 95% CI=1.03-1.31). Neither duration of hypothyroidism nor use of thyroid medications was associated with survival.
In this large study of women with ovarian cancer, we found that recent history of hyperthyroidism and overall history of hypothyroidism were associated with worse 5-year survival.
体外研究结果表明,甲状腺激素暴露增加可能会影响卵巢肿瘤的进展。然而,关于这一主题的流行病学证据有限。
我们汇总了来自卵巢癌协会联盟11项研究的数据。使用多变量Cox比例风险模型,我们估计了甲状腺功能亢进和减退以及针对这些病症开具的药物与侵袭性卵巢癌确诊女性的5年全因生存率之间的关联。
总体而言,甲状腺功能亢进病史(n = 160例)与死亡率之间无显著关联(HR = 1.22;95% CI = 0.97 - 1.53)。此外,在卵巢癌诊断前5年内诊断为甲状腺功能亢进与死亡风险增加相关(HR = 1.94;95% CI = 1.19 - 3.18)。观察到甲状腺功能减退病史(n = 624例)与死亡率之间存在较适度的关联(HR = 1.16;95% CI = 1.03 - 1.31)。甲状腺功能减退的持续时间和甲状腺药物的使用均与生存率无关。
在这项针对卵巢癌女性的大型研究中,我们发现近期甲状腺功能亢进病史和甲状腺功能减退总体病史与较差的5年生存率相关。