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甲状腺疾病与乳腺癌的相关性:病例对照研究。

Association between thyroid gland diseases and breast cancer: a case-control study.

机构信息

Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany.

Epidemiology, IQVIA, Main Airport Center, Unterschweinstiege 2-14, 60549, Frankfurt, Germany.

出版信息

Breast Cancer Res Treat. 2020 Jul;182(1):207-213. doi: 10.1007/s10549-020-05675-6. Epub 2020 May 18.

Abstract

BACKGROUND

At the present time, there is no consensus on the association between benign thyroid diseases and breast cancer (BC). Therefore, the aim of this study is to help shed some light on the association between hyperthyroidism, hypothyroidism, and thyroiditis and breast cancer risk.

METHODS

Use of the Disease Analyzer database (IQVIA) enabled us to perform a retrospective case-control study of 7408 women aged between 18 and 80, who were treated for an initial breast cancer diagnosis in a general practice in the United Kingdom between 2006 and 2015 (index date). Patients with a previous cancer diagnosis and an observation time of less than 12 months prior to the index date were excluded. The control group consisted of 7408 healthy women, who were matched to cases 1:1 by age, body mass index, hormone replacement therapy, and physician. The main outcome parameters of this study were the presence of thyroid disease (hypothyroidism, hyperthyroidism, struma, and thyroiditis) and the TSH values in the two groups. A univariate logistic regression model was used to investigate the association between benign thyroid diseases, TSH values, and BC.

RESULTS

The mean age was 58.4 years in both groups. We found a significant association between thyroiditis and BC (OR: 1.91, p = 0.01) and were able to refute the association between hyperthyroidism/hypothyroidism and BC. We also found that thyroid-stimulating hormone (TSH) had no significant effect on breast cancer risk.

CONCLUSION

Many experimental studies suggest a link between hyperthyroidism/hypothyroidism and BC. We were able to demonstrate an epidemiological association between thyroiditis and an increased BC risk. This shows the need for close monitoring for BC in women with thyroiditis.

摘要

背景

目前,关于良性甲状腺疾病与乳腺癌(BC)之间的关联尚无共识。因此,本研究旨在阐明甲状腺功能亢进症、甲状腺功能减退症和甲状腺炎与乳腺癌风险之间的关联。

方法

使用疾病分析器数据库(IQVIA),我们对 7408 名年龄在 18 至 80 岁之间的女性进行了回顾性病例对照研究,这些女性在英国的一家普通诊所接受了首次乳腺癌诊断治疗,时间为 2006 年至 2015 年(索引日期)。排除了有既往癌症诊断且在索引日期前观察时间少于 12 个月的患者。对照组由 7408 名健康女性组成,她们通过年龄、体重指数、激素替代疗法和医生与病例进行 1:1 匹配。本研究的主要观察参数是两组中是否存在甲状腺疾病(甲状腺功能减退症、甲状腺功能亢进症、甲状腺肿和甲状腺炎)和 TSH 值。使用单变量逻辑回归模型研究良性甲状腺疾病、TSH 值与 BC 之间的关系。

结果

两组的平均年龄均为 58.4 岁。我们发现甲状腺炎与 BC 之间存在显著关联(OR:1.91,p=0.01),并且能够反驳甲状腺功能亢进症/甲状腺功能减退症与 BC 之间的关联。我们还发现促甲状腺激素(TSH)对乳腺癌风险没有显著影响。

结论

许多实验研究表明甲状腺功能亢进症/甲状腺功能减退症与 BC 之间存在联系。我们能够证明甲状腺炎与 BC 风险增加之间存在流行病学关联。这表明需要密切监测患有甲状腺炎的女性的 BC。

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