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甲状旁腺功能亢进与甲状腺癌的关系:对发病机制和诊断挑战的见解——一篇叙述性综述

The Nexus of Hyperparathyroidism and Thyroid Carcinoma: Insights into Pathogenesis and Diagnostic Challenges-A Narrative Review.

作者信息

Scerrino Gregorio, Paladino Nunzia Cinzia, Orlando Giuseppina, Salamone Giuseppe, Richiusa Pierina, Radellini Stefano, Melfa Giuseppina, Graceffa Giuseppa

机构信息

Unit of Endocrine Surgery, Department of Surgical Oncology and Oral Sciences, University of Palermo, 90127 Palermo, Italy.

Department of General Endocrine and Metabolic Surgery, Conception Hospital, Aix-Marseille University, 147, Boulevard Baille, 13005 Marseille, France.

出版信息

J Clin Med. 2023 Dec 27;13(1):147. doi: 10.3390/jcm13010147.

Abstract

This review investigates the intricate relationship between hyperparathyroidism (HPT) and thyroid carcinoma (TC), aiming to elucidate their coexistence, potential pathogenetic mechanisms, and clinical implications. A systematic search strategy, employing the MeSH terms 'Hyperparathyroidism' and 'Thyroid Carcinoma', spanned publications from 2013 to 2023 across the PubMed, Web of Science, and Scopus databases. Fifteen selected articles were analyzed. Studies unanimously confirm the notable association between primary hyperparathyroidism (PHPT) and thyroid nodules/cancer, with incidences ranging from 2.8% to 47.1%. Key findings reveal a predilection for papillary thyroid carcinoma (PTC) in this association, showcasing varying tumor characteristics and gender disparities. Lower preoperative serum parathyroid hormone (PTH) levels are a potential risk factor for thyroid cancer in PHPT patients. Diverse surgical approaches and tumor characteristics between PHPT and secondary hyperparathyroidism (SHPT) cases were noted. Moreover, this review underscores the scarcity of definitive guidelines in managing concurrent PHPT and thyroid conditions, advocating for comprehensive assessments to enhance diagnostic accuracy and refine therapeutic interventions. Rare coincidental associations, as highlighted by case reports, shed light on unique clinical scenarios. In essence, this review amalgamates evidence to deepen the understanding of the interplay between HPT and TC, emphasizing the need for further research to elucidate underlying mechanisms and guide clinical management.

摘要

本综述研究了甲状旁腺功能亢进症(HPT)与甲状腺癌(TC)之间的复杂关系,旨在阐明它们的共存情况、潜在发病机制及临床意义。采用“甲状旁腺功能亢进症”和“甲状腺癌”的医学主题词(MeSH)进行系统检索,涵盖了2013年至2023年发表在PubMed、科学网和Scopus数据库中的文献。对筛选出的15篇文章进行了分析。研究一致证实原发性甲状旁腺功能亢进症(PHPT)与甲状腺结节/癌症之间存在显著关联,发病率在2.8%至47.1%之间。主要研究结果显示,在这种关联中乳头状甲状腺癌(PTC)更为常见,呈现出不同的肿瘤特征和性别差异。术前血清甲状旁腺激素(PTH)水平较低是PHPT患者患甲状腺癌的潜在危险因素。研究还指出了PHPT与继发性甲状旁腺功能亢进症(SHPT)病例在手术方式和肿瘤特征方面的差异。此外,本综述强调在同时处理PHPT和甲状腺疾病方面缺乏明确的指南,主张进行全面评估以提高诊断准确性并优化治疗干预措施。病例报告所强调的罕见巧合关联,揭示了独特的临床情况。本质上,本综述整合了证据,以加深对HPT与TC之间相互作用的理解,强调需要进一步研究以阐明潜在机制并指导临床管理。

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