Voutsadakis Ioannis A
Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada.
Section of Internal Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON P6B 0A8, Canada.
J Clin Med. 2022 Jan 28;11(3):687. doi: 10.3390/jcm11030687.
Breast cancer, the most prevalent female carcinoma, is characterized by the expression of steroid nuclear receptors in a subset of cases. The most important nuclear receptor with prognostic and therapeutic implications is the Estrogen Receptor (ER), which is expressed in about three out of four breast cancers. The Progesterone Receptor (PR) and the Androgen Receptor (AR) are also commonly expressed. Moreover, non-steroid nuclear receptors, including the vitamin D receptor (VDR) and the thyroid receptors (TRs), are also present in breast cancers and have pathophysiologic implications. Circulating thyroid hormones may influence breast cancer risk and breast cancer cell survival, through ligating their canonical receptors TRα and TRβ but also through additional membrane receptors that are expressed in breast cancer. The expression of TR subtypes and their respective isotypes have diverse effects in breast cancers through co-operation with ER and influence on other cancer-associated pathways. Other components of the TSH/thyroid hormone axis, such as TSH and selenoiodinase enzymes, have putative effects in breast cancer pathophysiology. This paper reviews the pathophysiologic and prognostic implications of the thyroid axis in breast cancer and provides a brief therapeutic perspective.
乳腺癌是最常见的女性癌症，部分病例的特征是类固醇核受体表达。具有预后和治疗意义的最重要核受体是雌激素受体（ER），约四分之三的乳腺癌中都有表达。孕激素受体（PR）和雄激素受体（AR）也常表达。此外，非类固醇核受体，包括维生素D受体（VDR）和甲状腺受体（TRs），也存在于乳腺癌中并具有病理生理学意义。循环甲状腺激素可能通过与它们的经典受体TRα和TRβ结合，也通过乳腺癌中表达的其他膜受体，影响乳腺癌风险和乳腺癌细胞存活。TR亚型及其各自的同种型的表达通过与ER合作并影响其他癌症相关途径，在乳腺癌中具有多种作用。促甲状腺激素/甲状腺激素轴的其他成分，如促甲状腺激素和硒碘酶，在乳腺癌病理生理学中具有假定作用。本文综述了甲状腺轴在乳腺癌中的病理生理学和预后意义，并提供了简要的治疗前景。
