Deligiorgi Maria V, Trafalis Dimitrios T
Department of Pharmacology-Clinical Pharmacology Unit, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527 Athens, Greece.
J Clin Med. 2022 Jun 14;11(12):3417. doi: 10.3390/jcm11123417.
Hypothyroidism in patients with solid non-thyroid cancer is a tantalizing entity, integrating an intriguing thyroid hormones (THs)-cancer association with the complexity of hypothyroidism itself. The present narrative review provides a comprehensive overview of the clinical relevance of hypothyroidism in solid non-thyroid cancer. Hypothyroidism in patients with solid non-thyroid cancer is reminiscent of hypothyroidism in the general population, yet also poses distinct challenges due to the dual role of THs in cancer: promoting versus inhibitory. Close collaboration between oncologists and endocrinologists will enable the prompt and personalized diagnosis and treatment of hypothyroidism in patients with solid non-thyroid cancer. Clinical data indicate that hypothyroidism is a predictor of a decreased or increased risk of solid non-thyroid cancer and is a prognostic factor of favorable or unfavorable prognosis in solid non-thyroid cancer. However, the impact of hypothyroidism with respect to the risk and/or prognosis of solid non-thyroid cancer is not a consistent finding. To harness hypothyroidism, or THs replacement, as a personalized anticancer strategy for solid non-thyroid cancer, four prerequisites need to be fulfilled, namely: (i) deciphering the dual THs actions in cancer; (ii) identifying interventions in THs status and developing agents that block tumor-promoting THs actions and/or mimic anticancer THs actions; (iii) appropriate patient selection; and (iv) counteracting current methodological limitations.
实体非甲状腺癌患者的甲状腺功能减退是一个引人关注的问题，它将有趣的甲状腺激素（THs）与癌症的关联和甲状腺功能减退本身的复杂性结合在一起。本叙述性综述全面概述了实体非甲状腺癌中甲状腺功能减退的临床相关性。实体非甲状腺癌患者的甲状腺功能减退与普通人群中的甲状腺功能减退相似，但由于THs在癌症中的双重作用：促进和抑制，也带来了独特的挑战。肿瘤学家和内分泌学家之间的密切合作将使实体非甲状腺癌患者的甲状腺功能减退能够得到及时和个性化的诊断与治疗。临床数据表明，甲状腺功能减退是实体非甲状腺癌风险降低或增加的一个预测因素，并且是实体非甲状腺癌预后良好或不良的一个预后因素。然而，甲状腺功能减退对实体非甲状腺癌风险和/或预后的影响并非一致的发现。要将甲状腺功能减退或THs替代作为实体非甲状腺癌的个性化抗癌策略，需要满足四个先决条件，即：（i）解读THs在癌症中的双重作用；（ii）确定THs状态的干预措施并开发阻断肿瘤促进性THs作用和/或模拟抗癌性THs作用的药物；（iii）进行适当的患者选择；以及（iv）克服当前的方法学局限性。
