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探索新冠病毒与甲状腺癌的未知关联,聚焦分化型甲状腺癌:呼吁谨慎对待

Charting the Unknown Association of COVID-19 with Thyroid Cancer, Focusing on Differentiated Thyroid Cancer: A Call for Caution.

作者信息

Deligiorgi Maria V, Siasos Gerasimos, Vakkas Lampros, Trafalis Dimitrios T

机构信息

Clinical Pharmacology Unit-Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., 11527 Athens, Greece.

First Department of Cardiology, Hippokration General Hospital of Athens, Faculty of Mediine, National and Kapodistrian University of Athens, 11527 Athens, Greece.

出版信息

Cancers (Basel). 2021 Nov 18;13(22):5785. doi: 10.3390/cancers13225785.

Abstract

BACKGROUND

Conceived of as the "silver lining" of the dark cloud of the coronavirus disease 2019 (COVID-19) pandemic, lessons taught by this catastrophe should be leveraged by medical authorities and policy makers to optimize health care globally. A major lesson is that resilient health systems should absorb sudden shocks incited by overwhelming health emergencies without compromising the continuum of care of chronic diseases, especially of cancer.

METHODS

The present review dissects the association between COVID-19 and thyroid cancer (TC), especially with differentiated TC (DTC), focusing on available data, knowledge gaps, current challenges, and future perspectives.

RESULTS

Obesity has been incriminated in terms of both COVID-19 severity and a rising incidence of TC, especially of DTC. The current conceptualization of the pathophysiological landscape of COVID-19-(D)TC association implicates an interplay between obesity, inflammation, immunity, and oxidative stress. Whether COVID-19 could aggravate the health burden posed by (D)TC or vice versa has yet to be clarified. Improved understanding and harnessing of the pathophysiological landscape of the COVID-19-(D)TC association will empower a mechanism-guided, safe, evidence-based, and risk-stratified management of (D)TC in the COVID-19 era and beyond.

CONCLUSION

A multidisciplinary patient-centered decision-making will ensure high-quality (D)TC care for patients, with or without COVID-19.

摘要

背景

2019年冠状病毒病(COVID-19)大流行这团乌云被视为有“一线希望”,这场灾难所带来的教训应由医学权威机构和政策制定者加以利用,以优化全球医疗保健。一个主要教训是,有韧性的卫生系统应能承受由压倒性的突发卫生事件引发的突然冲击,同时不影响慢性病(尤其是癌症)的连续护理。

方法

本综述剖析了COVID-19与甲状腺癌(TC)之间的关联,尤其是与分化型TC(DTC)的关联,重点关注现有数据、知识空白、当前挑战和未来前景。

结果

肥胖在COVID-19严重程度以及TC(尤其是DTC)发病率上升方面都受到了指责。目前对COVID-19与(D)TC关联的病理生理格局的概念化涉及肥胖、炎症、免疫和氧化应激之间的相互作用。COVID-19是否会加重(D)TC带来的健康负担,反之亦然,尚待阐明。更好地理解和利用COVID-19与(D)TC关联的病理生理格局,将有助于在COVID-19时代及以后对(D)TC进行机制导向、安全、循证和风险分层管理。

结论

以患者为中心的多学科决策将确保为患有或未患有COVID-19的患者提供高质量的(D)TC护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efb9/8616091/3fe4b423ed12/cancers-13-05785-g001.jpg

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