Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, South Korea.
Department of Pathology, Seoul National University College of Medicine. Seoul, South Korea; Department of Pathology, Seoul National University Boramae Medical Center, Seoul, South Korea.
Eur J Surg Oncol. 2021 Jun;47(6):1316-1323. doi: 10.1016/j.ejso.2021.01.015. Epub 2021 Jan 22.
Breast cancer co-occurred with thyroid cancer might be associated with thyroid hormone receptor (TR) and estrogen receptor (ER), but few have been reported. We aimed to investigate the expression and prognostic significance of ERs and TRs in such settings.
Tissue microarrays were constructed from 75 patients with breast and thyroid cancer (BC + TC) who were retrospectively recruited between 1999 and 2012 and 147 with breast cancer only (BC controls). The ERα, ERβ, TRα, and TRβ expression levels were analyzed by immunohistochemistry.
TRα expression was more frequently observed in the BC + TC group than the BC control group both in the normal (51.5% vs 23.3%, respectively, p = 0.009) and cancer tissues (21.6% vs 6.8%, respectively, p = 0.001). The BC + TC group showed greater ERα-positivity in the cancer tissues (79.7% vs 58.7%, respectively, p = 0.002) than the BC control group. The degree of ERα- and TRα-positivity was unchanged by radioactive treatment or serum thyroid stimulating hormone levels. In the BC + TC group, ERα-positivity was associated with earlier disease stage I/IIA (81.0% vs 50.0%; p = 0.031) and lower recurrence rates (8.5% vs 40.0%; p = 0.002). TRα-positivity alone was not associated with any recurrence-free survival-related differences, and ERα- and TRα-negativity were associated with significantly shorter recurrence-free survival (p < 0.001).
Enhanced ERα and TRα expression in breast cancer is associated with thyroid cancer occurrence, and the observed association with prognosis suggests the possible role of ERs and TRs in the link between breast cancer and thyroid cancer.
乳腺癌合并甲状腺癌可能与甲状腺激素受体（TR）和雌激素受体（ER）有关，但报道较少。我们旨在研究此类情况下 ER 和 TR 的表达及预后意义。
回顾性收集了 1999 年至 2012 年间 75 例乳腺癌合并甲状腺癌（BC+TC）患者和 147 例单纯乳腺癌（BC 对照组）患者的组织微阵列，采用免疫组织化学法分析 ERα、ERβ、TRα 和 TRβ 的表达水平。
TRα 在正常组织（分别为 51.5%和 23.3%，p=0.009）和肿瘤组织（分别为 21.6%和 6.8%，p=0.001）中，BC+TC 组的表达频率均高于 BC 对照组。BC+TC 组肿瘤组织中 ERα 阳性率更高（分别为 79.7%和 58.7%，p=0.002）。放射性治疗或血清促甲状腺激素水平并未改变 ERα 和 TRα 的阳性程度。在 BC+TC 组中，ERα 阳性与疾病分期较早（I/IIA 期）（81.0%比 50.0%；p=0.031）和复发率较低（8.5%比 40.0%；p=0.002）有关。TRα 阳性与无复发生存无关，而 ERα 和 TRα 阴性与无复发生存显著缩短有关（p<0.001）。
乳腺癌中 ERα 和 TRα 的表达增强与甲状腺癌的发生有关，观察到与预后的关联提示 ER 和 TR 可能在乳腺癌和甲状腺癌之间的联系中起作用。
