Meci Andrew, Lorenz F Jeffrey, Goyal Neerav, Goldenberg David
Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2025 Apr;172(4):1192-1198. doi: 10.1002/ohn.1128. Epub 2025 Jan 10.
The role of estrogen in developing thyroid malignancy is poorly understood. Epidemiological studies have shown exogenous estrogen is associated with increased risk in females. Still, no studies to date have investigated this association among biological males undergoing estrogen hormone therapy.
Retrospective cohort study.
TriNetX Research Network.
Biologically male patients prescribed estrogen with at least 5 years of follow-up were queried from the database. Rates of diagnosis of malignant neoplasm of the thyroid gland within 5 years of estrogen hormone therapy prescription were determined, and statistics were conducted within the TriNetX platform.
We identified 6394 biologically male patients from 65 health care organizations prescribed estrogen hormone treatment. The average age was 44.4 years. When balanced for demographic factors as well as known risk factors for thyroid malignancy, the estrogen treatment cohort had a 0.64% risk for diagnosis of thyroid malignancy within 5 years, compared to a 0.27% risk among patients not taking estrogen (relative risk: 2.35, 95% confidence interval: 1.34-4.15, P = .002).
We found a higher risk of developing thyroid cancer in biologically male patients prescribed estrogen hormone therapy. This is the first association found between estrogen and thyroid malignancy in this group.
雌激素在甲状腺恶性肿瘤发生发展中的作用尚不清楚。流行病学研究表明，外源性雌激素与女性风险增加有关。然而，迄今为止尚无研究调查接受雌激素激素治疗的生物学男性中的这种关联。
回顾性队列研究。
TriNetX研究网络。
从数据库中查询接受雌激素治疗且至少随访5年的生物学男性患者。确定雌激素激素治疗处方后5年内甲状腺恶性肿瘤的诊断率，并在TriNetX平台内进行统计。
我们从65个医疗机构中识别出6394名接受雌激素激素治疗的生物学男性患者。平均年龄为44.4岁。在对人口统计学因素以及已知的甲状腺恶性肿瘤风险因素进行平衡后，雌激素治疗组在5年内诊断为甲状腺恶性肿瘤的风险为0.64%，而未服用雌激素的患者风险为0.27%（相对风险：2.35，95%置信区间：1.34 - 4.15，P = 0.002）。
我们发现接受雌激素激素治疗的生物学男性患者患甲状腺癌的风险更高。这是该组中首次发现雌激素与甲状腺恶性肿瘤之间的关联。
