接受过锁骨上淋巴结放疗的乳腺癌患者中的原发性甲状腺功能减退症。
Primary hypothyroidism in breast cancer patients with irradiated supraclavicular lymph nodes.
作者信息
Bruning P, Bonfrèr J, De Jong-Bakker M, Nooyen W, Burgers M
出版信息
Br J Cancer. 1985 May;51(5):659-63. doi: 10.1038/bjc.1985.99.
Abstract
Since the treatment of postmenopausal breast cancer patients with aminoglutethimide caused hypothyroidism with an unexpectedly high frequency previous treatment was suspected to contribute to hypofunction of the thyroid. Serum thyrotropin, triiodothyronine and free thyroxine index were compared between breast cancer patients who had undergone irradiation of regional lymph nodes and non-irradiated breast cancer patients, as well as patients having endometrial or colorectal carcinoma. Subclinical and clinical primary hypothyroidism was significantly more frequent in breast cancer patients who had previously received irradiation on supraclavicular lymph nodes comprising a minor part of the thyroid. Testing for the presence of autoantibodies against thyroid tissue components gave no evidence for radiation-induced autoimmune thyroiditis. Drugs suppressing thyroid hormone synthesis like aminoglutethimide may frequently cause myxedema in such irradiated women, especially at postmenopausal age.
摘要
由于用氨鲁米特治疗绝经后乳腺癌患者时甲状腺功能减退的发生率出乎意料地高，因此怀疑既往治疗可能导致甲状腺功能减退。比较了接受区域淋巴结照射的乳腺癌患者与未接受照射的乳腺癌患者以及子宫内膜癌或结直肠癌患者的血清促甲状腺激素、三碘甲状腺原氨酸和游离甲状腺素指数。在先前接受过甲状腺一小部分的锁骨上淋巴结照射的乳腺癌患者中，亚临床和临床原发性甲状腺功能减退明显更为常见。检测针对甲状腺组织成分的自身抗体未发现辐射诱导的自身免疫性甲状腺炎的证据。像氨鲁米特这样抑制甲状腺激素合成的药物可能经常在这类接受过照射的女性中引起黏液性水肿，尤其是在绝经后年龄。
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