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Thyroid:甲状腺疾病史的绝经后妇女乳腺癌风险

2020-02-05 xing.T MedSci原创

由此可见,与无甲状腺疾病史的女性相比,甲状腺功能低下与乳腺癌风险降低有关。这主要见于接受甲状腺替代疗法但从未使用过MHT的人群中。在甲状腺功能减退症的治疗选择中,左甲状腺素与乳腺癌风险之间呈现了最强的负相关关联。

甲状腺疾病与乳腺癌之间的关联仍然存在争议,部分原因是队列规模较小且结果不一致。近日,甲状腺疾病领域权威杂志Thyroid上发表了一篇研究文章,研究人员调查了绝经后妇女的这种联系,以确定甲状腺功能亢进或甲状腺功能减退是否与乳腺癌风险有关,并确定更年期激素治疗(MHT)是否进一步改变了这一风险。

研究人员对1993年至1998年之间参加临床试验和观察研究的50到79岁多种族美国绝经后妇女进行了一项前瞻性队列研究,并随访至2017年2月28日。研究人员记录了侵袭性乳腺癌的发生情况,并在确诊乳腺癌之前确定了甲亢或甲状腺功能减退的病史。研究人员分析了MHT在两个研究组中的改善作用。所有统计检验都是两侧的。

在纳入研究的134122名女性中,8137名参与者在随访期间发生了浸润性乳腺癌。有甲状腺功能减退病史(患病率[HR] 0.91,置信区间[95%CI] 0.86-0.97)与服用左甲状腺素[HR 0.89,95%CI为0.82-0.96]的女性与浸润性乳腺癌呈显著负相关。通过使用MHT评估效果改善情况,在非MHT使用者中,甲状腺替代药物治疗的甲状腺功能减退与乳腺癌风险之间的负相关性最强[HR为0.80,95%CI为0.69-0.93]。结果在种族/民族方面没有显著差异。尽管甲亢的病史与浸润性乳腺癌的风险增加相关[HR为1.11,95%CI为0.91-1.35],但这一发现没有统计学意义。根据甲状腺疾病状态,研究人员在乳腺癌的监测、流行病学和最终结果阶段、组织学类型、形态学等级或受体状态(雌激素受体、孕激素受体、人表皮生长因子受体2)方面没有发现显著差异。

由此可见,与无甲状腺疾病史的女性相比,甲状腺功能低下与乳腺癌风险降低有关。这主要见于接受甲状腺替代疗法但从未使用过MHT的人群中。在甲状腺功能减退症的治疗选择中,左甲状腺素与乳腺癌风险之间呈现了最强的负相关关联。

原始出处:

Chien-Hsiang Weng,etal.Breast Cancer Risk in Postmenopausal Women with Medical History of Thyroid Disorder in the Women's Health Initiative.Thyroid.2020.https://www.liebertpub.com/doi/10.1089/thy.2019.0426

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    2020-02-12 1478fa69m73暂无昵称

    学习了

    0

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    2020-02-07 zxxiang
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