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甲状腺癌与甲状腺自身免疫性疾病:分子层面与临床结局综述

Thyroid cancer and thyroid autoimmune disease: A review of molecular aspects and clinical outcomes.

机构信息

Laboratory of Molecular Pathology, Department of Pathological Sciences, State University of Londrina (UEL), Londrina, PR, Brazil.

Department of Surgical Clinic, State University of Londrina (UEL), Londrina, PR, Brazil.

出版信息

Pathol Res Pract. 2020 Sep;216(9):153098. doi: 10.1016/j.prp.2020.153098. Epub 2020 Jul 4.

Abstract

Thyroid cancer (TC) is the most prevalent malignant neoplasm that affects the endocrine system. Hashimoto's thyroiditis (HT), also known as chronic lymphocytic thyroiditis, is the most common autoimmune thyroid disease (AITD) that, together with Graves' disease (GD), represent the main autoimmune diseases that affect the thyroid gland. Some studies suggest a greater risk of AITD and the development of TC, while others, investigate its relationship with TC progression and patient prognosis. In this review, we have analyzed published data on the molecular aspects related to the association between AITD and TC, addressing their influence on TC progression, diagnosis, and prognosis of the patients. MEDLINE database (PubMed) platform was used as a search engine and the original articles related to the topic were selected using the keywords combination "thyroid cancer and Hashimoto thyroiditis" or "thyroid carcinoma and thyroid autoimmune disease". After the selection, we categorized the main findings of the papers into four topics: antitumor immunity, tumor progression, diagnosis, and prognosis. Although most of the studies have pointed out the presence of AITD as a factor that increases the risk of TC, few molecular mechanisms to support this conclusion have been described. Additionally, little information is available to explain, pathophysiologically, the effects of autoimmunity in TC diagnosis, progression, and prognosis.

摘要

甲状腺癌(TC)是最常见的影响内分泌系统的恶性肿瘤。桥本甲状腺炎(HT),又称慢性淋巴细胞性甲状腺炎,是最常见的自身免疫性甲状腺疾病(AITD),与格雷夫斯病(GD)一起,代表了影响甲状腺的主要自身免疫性疾病。一些研究表明 AITD 和 TC 的发病风险更高,而另一些研究则探讨了它们与 TC 进展和患者预后的关系。在这篇综述中,我们分析了已发表的关于 AITD 与 TC 之间关联的分子方面的数据,探讨了它们对 TC 进展、诊断和患者预后的影响。我们使用 MEDLINE 数据库(PubMed)平台作为搜索引擎,并使用“甲状腺癌和桥本甲状腺炎”或“甲状腺癌和甲状腺自身免疫性疾病”的关键词组合选择与主题相关的原始文章。选择后,我们将论文的主要发现分为四个主题:抗肿瘤免疫、肿瘤进展、诊断和预后。尽管大多数研究指出 AITD 是增加 TC 风险的因素,但很少有描述支持这一结论的分子机制。此外,几乎没有信息可以从病理生理学上解释自身免疫在 TC 诊断、进展和预后中的作用。

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