Baldini Enke, Lauro Augusto, Tripodi Domenico, Pironi Daniele, Amabile Maria Ida, Ferent Iulia Catalina, Lori Eleonora, Gagliardi Federica, Bellini Maria Irene, Forte Flavio, Pacini Patrizia, Cantisani Vito, D'Andrea Vito, Sorrenti Salvatore, Ulisse Salvatore
Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy.
Department of Urology, M.G. Vannini Hospital, 00177 Rome, Italy.
J Pers Med. 2022 Jan 25;12(2):156. doi: 10.3390/jpm12020156.
Epidemiological studies aimed at defining the association of thyroid diseases with extra-thyroidal malignancies (EM) have aroused considerable interest in the possibility of revealing common genetic and environmental factors underlying disease etiology and progression. Over the years, multiple lines of evidence indicated a significant relationship between thyroid carcinomas and other primary EM, especially breast cancer. For the latter, a prominent association was also found with benign thyroid diseases. In particular, a meta-analysis revealed an increased risk of breast cancer in patients with autoimmune thyroiditis, and our recent work demonstrated that the odds ratio (OR) for breast cancer was raised in both thyroid autoantibody-positive and -negative patients. However, the OR was significantly lower for thyroid autoantibody-positive patients compared to the negative ones. This is in agreement with findings showing that the development of thyroid autoimmunity in cancer patients receiving immunotherapy is associated with better outcome and supports clinical evidence that breast cancer patients with thyroid autoimmunity have longer disease-free interval and overall survival. These results seem to suggest that factors other than oncologic treatments may play a role in the initiation and progression of a second primary malignancy. The molecular links between thyroid autoimmunity and breast cancer remain, however, unidentified, and different hypotheses have been proposed. Here, we will review the epidemiological, clinical, and experimental data relating thyroid diseases and breast cancer, as well as the possible hormonal and molecular mechanisms underlying such associations.
旨在确定甲状腺疾病与甲状腺外恶性肿瘤（EM）之间关联的流行病学研究，引发了人们对揭示疾病病因和进展背后共同遗传和环境因素可能性的浓厚兴趣。多年来，多条证据表明甲状腺癌与其他原发性EM之间存在显著关系，尤其是乳腺癌。对于后者，还发现与良性甲状腺疾病存在显著关联。特别是，一项荟萃分析显示自身免疫性甲状腺炎患者患乳腺癌的风险增加，并且我们最近的研究表明，甲状腺自身抗体阳性和阴性患者患乳腺癌的比值比（OR）均有所升高。然而，与阴性患者相比，甲状腺自身抗体阳性患者的OR显著更低。这与以下研究结果一致，即接受免疫治疗的癌症患者中甲状腺自身免疫的发展与更好的预后相关，并且支持临床证据，即患有甲状腺自身免疫的乳腺癌患者无病生存期和总生存期更长。这些结果似乎表明，除肿瘤治疗外的其他因素可能在第二原发性恶性肿瘤的发生和进展中起作用。然而，甲状腺自身免疫与乳腺癌之间的分子联系仍未明确，并且已经提出了不同的假设。在此，我们将回顾与甲状腺疾病和乳腺癌相关的流行病学、临床和实验数据，以及这种关联背后可能的激素和分子机制。
