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研究免疫和甲状腺生物标志物在乳腺癌合并桥本甲状腺炎女性中的临床意义。

Investigating the clinical significance of immune and thyroid biomarkers in women with breast cancer and Hashimoto's thyroiditis.

作者信息

Aneed Israa Khalaf, Luaibi Noori Mohammed, Abdulqader Sajid Nader

机构信息

Department of Biology, Mustansiriyah University, College of Science, Baghdad, Iraq.

Department of Biology, Mustansiriyah University, College of Science, Baghdad, Iraq.

出版信息

Reprod Biol. 2025 Jun;25(2):101011. doi: 10.1016/j.repbio.2025.101011. Epub 2025 Apr 12.

DOI:10.1016/j.repbio.2025.101011
PMID:40222067
Abstract

Breast cancer with Hashimoto's thyroiditis (BC-HT) presents a unique immuno-thyroid interplay that remains poorly understood. This study investigates the relationships between thyroid function markers (TSH, T3, T4), immune markers (CD33, CD44), and thyroid autoantibodies (Anti-TPO, Anti-Tg) in BC-HT patients and healthy controls. Normality testing confirmed non-parametric data distribution, necessitating Mann-Whitney U tests for group comparisons. BC-HT patients exhibited significantly elevated TSH, CD33, Anti-TPO, and Anti-Tg levels, alongside reduced T3 and T4, compared to controls, indicating thyroid dysfunction. Spearman's correlation analysis revealed strong negative correlations between TSH and T3/T4 in controls, which were lost in BC-HT, suggesting disruption of normal thyroid feedback mechanisms. Additionally, CD33 and CD44 correlations with thyroid hormones were evident in controls but absent in BC-HT, highlighting altered immune-thyroid interactions. ROC analysis demonstrated high diagnostic performance for TSH, Anti-Tg, and Anti-TPO, with sensitivities exceeding 0.75, whereas CD33 and CD44 showed limited diagnostic utility. These findings suggest a distinct immuno-thyroid dysregulation in BC-HT patients and highlight the potential of thyroid-specific markers for disease stratification. Future research should focus on longitudinal studies and mechanistic investigations to further delineate the role of immune markers in breast cancer pathophysiology within the context of thyroid autoimmunity.

摘要

患有桥本甲状腺炎的乳腺癌(BC-HT)呈现出一种独特的免疫-甲状腺相互作用,目前对此仍知之甚少。本研究调查了BC-HT患者和健康对照者中甲状腺功能标志物(促甲状腺激素、T3、T4)、免疫标志物(CD33、CD44)和甲状腺自身抗体(抗甲状腺过氧化物酶、抗甲状腺球蛋白)之间的关系。正态性检验证实数据呈非参数分布,因此需要采用曼-惠特尼U检验进行组间比较。与对照组相比,BC-HT患者的促甲状腺激素、CD33、抗甲状腺过氧化物酶和抗甲状腺球蛋白水平显著升高,同时T3和T4降低,表明存在甲状腺功能障碍。Spearman相关性分析显示,对照组中促甲状腺激素与T3/T4之间存在强负相关,而在BC-HT患者中这种相关性消失,提示正常甲状腺反馈机制受到破坏。此外,对照组中CD33和CD44与甲状腺激素存在相关性,但在BC-HT患者中不存在,这突出了免疫-甲状腺相互作用的改变。ROC分析表明,促甲状腺激素、抗甲状腺球蛋白和抗甲状腺过氧化物酶具有较高的诊断性能,敏感性超过0.75,而CD33和CD44的诊断效用有限。这些发现表明BC-HT患者存在独特的免疫-甲状腺调节异常,并突出了甲状腺特异性标志物在疾病分层中的潜力。未来的研究应集中在纵向研究和机制研究上,以进一步阐明免疫标志物在甲状腺自身免疫背景下乳腺癌病理生理学中的作用。

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