Thyroid hormone and breast carcinoma - Primary hypothyroidism is associated with a reduced incidence of primary breast carcinoma
Thyroid hormone and breast carcinoma - Primary hypothyroidism is associated with a reduced incidence of primary breast carcinoma
复制标题
DOI：
10.1002/cncr.20881
复制
发表时间：
2005-03-15
期刊：
影响因子：
6.2
通讯作者：
Hortobagyi, GN
中科院分区：
文献类型：
--
作者：
Cristofanilli, M;Yamamura, Y;Hortobagyi, GN
背景为了探讨原发性甲状腺功能减退症（HYPT）在乳腺癌发生中的作用，作者评价了1）HYPT与浸润性乳腺癌诊断的相关性和2）HYPT患者乳腺癌的临床病理特征。在这项回顾性病历审查研究中，从作者的部门数据库中确定了1136名原发性乳腺癌（PBC）妇女。这些妇女（病例）与1088名参加乳腺癌筛查诊所的健康参与者（对照组）的年龄（+/- 5岁）和种族频率相匹配。在确诊乳腺癌前或筛查访视前接受甲状腺替代治疗的HYPT妇女被识别。病例组和对照组的平均年龄（分别为51.6岁和51.0岁; P = 0.30）和绝经状态（绝经前65.4%和绝经后62%; P = 0.10）相当。242例妇女（10.9%）与HYPT的情况下，确定。对照组的患病率明显高于病例组（分别为14.9%和7.0%; P < 0.001）。PBC患者发生HYPT的可能性比健康对照组低57%（比值比，0.431，95%可信区间，0.33-0.57）。78名患有PBC的白色患者患有HYPT，与甲状腺功能正常的女性相比，他们在诊断时年龄较大（58.8岁对51.1岁; P < 0.001），更可能有局部疾病（95.0% vs. 85.9%临床T1或T2疾病; P = 0.025），并且更可能没有病理性淋巴结受累（62.8% vs. 54.4%; P = 0.15）。原发性HYPT与PBC风险降低和更惰性的侵袭性疾病相关。这些数据表明，甲状腺激素在乳腺癌的病因学中可能具有生物学作用，并指出了乳腺癌预防和治疗的研究领域。
BACKGROUND. To investigate the role of primary hypothyroidism (HYPT) on breast carcinogenesis, the authors evaluated 1) the association between HYPT and a diagnosis of invasive breast carcinoma and 2) the clinicopathologic characteristics of breast carcinoma in patients with HYPT.METHODS. For this retrospective chart review Study, 1136 women with primary breast carcinoma (PBC) were identified from the authors' departmental data base. These women (cases) were frequency-matched for age (+/- 5 vears) and ethnicity with 1088 healthy participants (controls) who attended a breast carcinona screening clinic. Women with HYPT who were receiving thyroid-replacement therapy before they were diagnosed with breast carcinoma or before the screening visit were identified.RESULTS. The mean ages of cases and controls (51.6 years vs. 51.0 years, respectively; P = 0.30) and their menopausal status (65.4% premenopausal vs. 62% postmenopausal; P = 0.10) were comparable. Two hundred forty-two women in the case group (10.9%) with HYPT were identified. The prevalence of this condition was significantly greater the control group compared with the case group (14.9% vs. 7.0%, respectively; P < 0.001). PBC patients were 57% less likely to have HYPT compared with their healthy counterparts (odds ratio, 0.431 95% confidence interval, 0.33-0.57). Seventy-eight white patients with PBC had HYPT and, compared with women who were euthyroid, they were older at the time of diagnosis (58.8 years vs. 51.1 years; P < 0.001), were more likely to have localized disease (95.0% vs. 85.9% clinical T1 or T2 disease, respectively; P = 0.025), and were more likely to have no pathologic lymph node involvement (62.8% vs. 54.4%; P = 0.15).CONCLUSIONS. Primary HYPT was associated with a reduced risk for PBC and a more indolent invasive disease. These data Suggest a possible biologic role for thyroid hormone in the etiology of breast carcinoma and indicate areas of research for the prevention and treatment of breast carcinoma.