Maternal health, in-utero, and perinatal exposures and risk of thyroid cancer in offspring: a Nordic population-based nested case-control study.
Maternal health, in-utero, and perinatal exposures and risk of thyroid cancer in offspring: a Nordic population-based nested case-control study.
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孕妇健康、宫内和围产期暴露与子代患甲状腺癌风险：一项基于北欧人群的嵌套病例对照研究。
DOI：
10.1016/s2213-8587(20)30399-5
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Bjørge T
中科院分区：
文献类型：
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作者：
Kitahara CM;Slettebø Daltveit D;Ekbom A;Engeland A;Gissler M;Glimelius I;Grotmol T;Trolle Lagerros Y;Madanat-Harjuoja L;Männistö T;Sørensen HT;Troisi R;Bjørge T
与大多数其他恶性肿瘤相比，甲状腺癌在相对年轻的年龄被诊断出来，并且从青春期早期开始，女性的发病率高于男性。然而，很少有子宫内和生命早期的风险因素已被确定。我们使用来自四个北欧国家的基于人群的登记数据，进行了一项巢式病例对照研究，研究了与母亲病史、妊娠并发症和出生特征相关的后代甲状腺癌风险。每个甲状腺癌病例与多达10个对照组在出生年份、性别、国家和出生县进行匹配。使用条件logistic回归模型计算比值比（OR）和95%置信区间（CI）。在2，437例病例中，81%为乳头状癌，77%为女性，57%在30岁之前（范围：0-48岁）诊断。出生体重偏高（OR/kg= 1.14，95%CI 1.05 - 1.23），先天性甲状腺功能减退症（OR= 4.55，95%CI 1.58 ~ 13.1），母亲孕前糖尿病（OR= 1.69，95%CI 0.98 ~ 2.93），产后出血（OR= 1.28，95%CI 1.06 - 1.55），（来自丹麦的登记数据）妊娠前/妊娠期间母体良性甲状腺疾病（甲状腺功能减退OR=18·1，95% CI 10·5-31·2;甲状腺功能亢进OR=11·9，95% CI 6·80-20·9;甲状腺肿大OR=67·4，95% CI 39·9-114;和良性肿瘤，OR= 22.5，95%CI 6.93 - 73.1）均与后代患甲状腺癌的风险呈正相关。子宫内暴露，特别是与母体甲状腺疾病有关的暴露，可能对后代患甲状腺癌的风险产生长期影响。美国国立卫生研究院国家癌症研究所校内研究计划。
Thyroid cancer is diagnosed at relatively young ages compared to most other malignancies, and the incidence is higher in females than males beginning in early adolescence. However, few in utero and early-life risk factors have been identified. Using population-based registry data from four Nordic countries, we conducted a nested case-control study of thyroid cancer risk in offspring in relation to maternal medical history, pregnancy complications, and birth characteristics. Each thyroid cancer case was matched with up to ten controls on birth year, sex, country, and county of birth. Conditional logistic regression models were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Of the 2,437 cases, 81% were papillary carcinomas, 77% were female, and 57% were diagnosed before age 30 (range: 0-48 years). Higher birth weight (OR per kg=1·14, 95% CI 1·05-1·23), congenital hypothyroidism (OR=4·55, 95% CI 1·58-13·1), and maternal diabetes before pregnancy (OR=1·69, 95% CI 0·98-2·93), postpartum hemorrhage (OR=1·28, 95% CI 1·06-1·55), and (from registry data in Denmark) maternal benign thyroid disease before/during pregnancy (hypothyroidism, OR=18·1, 95% CI 10·5-31·2; hyperthyroidism, OR=11·9, 95% CI 6·80-20·9; goiter, OR=67·4, 95% CI 39·9-114; and benign neoplasms, OR=22·5, 95% CI 6·93-73·1) were each positively associated with risk of thyroid cancer in offspring. In utero exposures, particularly those related to maternal thyroid disorders, may have a long-term influence on thyroid cancer risk in offspring. Intramural Research Program of the National Cancer Institute, National Institutes of Health.