Pregnancy-related hormonal changes and thyroid growth: do they have an impact on the higher incidence of differentiated thyroid cancer in women?

IF 2.8 4区 医学 Q2 ONCOLOGY
Current Opinion in Oncology Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI:10.1097/CCO.0000000000001103
Kris G Poppe, Aglaia Kyrilli, Giuseppe Costante
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Abstract

Purpose of review: To analyze whether pregnancy could play a role in the higher prevalence of differentiated thyroid carcinoma (DTC) in women. Estrogens strongly modify thyroid economy by increasing iodine clearance, thyroid hormone requirement and production. Human chorionic gonadotropin (hCG) contributes to the increased thyroid hormone synthesis. Both estrogens and hCG can interfere with the regulation of thyroid volume and with thyroid nodule development and progression. The potential effect of hCG is exclusively related to its weak agonistic activity on TSH receptor. Estrogen implication on normal and nodule-derived thyrocyte growth has been demonstrated in vitro and in animal models. Furthermore, there is solid clinical evidence showing a promoting effect of pregnancy on thyroid volume and nodule development. Two metaanalyses, one including retrospective and another prospective observational studies, failed to show an association between pregnancy and DTC.

Recent findings: A large pooled prospective analysis using multivariable-adjusted Cox proportional hazard models did not demonstrate an association between DTC and parity. Similarly, no association between PTC occurrence and parity was observed in a prospective cohort analysis by linkage to the statewide Surveillance, Epidemiology, and End Results (SEER).

Summary: The presently available evidence does not support an involvement of pregnancy in DTC etiology.

与妊娠有关的激素变化和甲状腺生长:它们对女性分化型甲状腺癌的高发病率有影响吗?
研究目的分析妊娠是否会导致女性分化型甲状腺癌(DTC)发病率升高。雌激素通过增加碘清除率、甲状腺激素需求量和分泌量,强烈改变甲状腺经济。人绒毛膜促性腺激素(hCG)有助于甲状腺激素合成的增加。雌激素和人绒毛膜促性腺激素(hCG)都会干扰甲状腺容量的调节以及甲状腺结节的发生和发展。hCG 的潜在影响完全与其对 TSH 受体的弱激动活性有关。雌激素对正常甲状腺细胞和结节衍生甲状腺细胞生长的影响已在体外和动物模型中得到证实。此外,有确凿的临床证据表明,妊娠对甲状腺体积和结节的发育有促进作用。两项荟萃分析(一项包括回顾性研究,另一项包括前瞻性观察研究)未能显示妊娠与 DTC 之间存在关联:一项使用多变量调整的考克斯比例危险模型进行的大型前瞻性汇总分析未显示出DTC与奇偶性之间的关系。同样,在一项与全州监测、流行病学和最终结果(SEER)相关联的前瞻性队列分析中,也未观察到 PTC 发生与奇偶校验之间的关联。
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来源期刊
Current Opinion in Oncology
Current Opinion in Oncology 医学-肿瘤学
CiteScore
6.10
自引率
2.90%
发文量
130
审稿时长
4-8 weeks
期刊介绍: With its easy-to-digest reviews on important advances in world literature, Current Opinion in Oncology offers expert evaluation on a wide range of topics from sixteen key disciplines including sarcomas, cancer biology, melanoma and endocrine tumors. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by annotated references detailing the merits of the most important papers.
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