甲状腺功能障碍对乳腺癌风险的影响:一项最新的荟萃分析。

IF 4.1 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Thi-Van-Trinh Tran, Cari Meinhold Kitahara, Laurence Leenhardt, Florent de Vathaire, Marie-Christine Boutron-Ruault, Neige Journy
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引用次数: 1

摘要

在2019年1月29日之前发表的关于甲状腺功能亢进/功能减退与乳腺癌发病率之间关联的研究的系统回顾和荟萃分析中,我们发现诊断为甲状腺功能亢进的风险高于甲状腺功能亢进,但与诊断为甲状腺功能减退的风险无关。这项为期2年的荟萃分析旨在研究更年期在这一关联中的作用,以及与血液中促甲状腺激素(TSH)和甲状腺激素水平的剂量-反应关系。在排除了只有死亡率随访、甲状腺功能障碍被评估为癌症生物标志物或既往乳腺癌诊断的研究后,我们回顾了截至2021年12月1日发表并在MEDLINE、COCHRANE图书馆、Embase或Web of Science中确定的25项研究;其中9例被纳入先前的荟萃分析。25项研究中有22项的风险估计被纳入meta分析,并使用随机效应模型进行汇总。与甲状腺功能亢进和甲状腺功能减退相比,甲状腺功能亢进和甲状腺功能减退的诊断分别与较高(合并风险比(RR): 1.12, 95% CI: 1.06-1.18, 3829例暴露)和较低(RR = 0.93, 95% CI: 0.86-1.00, 5632例暴露)的乳腺癌风险相关。绝经后妇女甲状腺功能亢进后的风险增加更大(RR = 1.19, 95% CI 1.09-1.30),绝经前妇女甲状腺功能减退后风险降低更明显(RR = 0.69, 95% CI 0.53-0.89)。在没有甲状腺疾病史的女性中,TSH水平每增加1 mIU/L,乳腺癌风险降低0.8% (95% CI > 0-1.5%)。总之,这项荟萃分析支持甲状腺激素水平与乳腺癌风险之间的关联,这种关联可能因绝经状态而改变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of thyroid dysfunction on breast cancer risk: an updated meta-analysis.

In a previous systematic review and meta-analysis of studies reporting associations between hyper-/hypothyroidism and breast cancer incidence published through 29 January 2019, we identified a higher risk with diagnosed hyperthyroidism compared to euthyroidism, but no association with diagnosed hypothyroidism. This 2-year updated meta-analysis aims to investigate the role of menopause in this association and the dose-response relationship with blood levels of thyroid-stimulating hormone (TSH) and thyroid hormones. After the exclusion of studies with only mortality follow-up, with thyroid dysfunction evaluated as a cancer biomarker or after prior breast cancer diagnosis, we reviewed 25 studies that were published up to 01 December 2021 and identified in MEDLINE, the COCHRANE library, Embase, or Web of Science; of these, 9 were included in the previous meta-analysis. Risk estimates from 22 of the 25 studies were included in the meta-analysis and pooled using random-effects models. Compared to euthyroidism, hyperthyroidism and hypothyroidism diagnoses were associated with higher (pooled risk ratio (RR): 1.12, 95% CI: 1.06-1.18, 3829 exposed cases) and lower risks (RR = 0.93, 95% CI: 0.86-1.00, 5632 exposed cases) of breast cancer, respectively. The increased risk after hyperthyroidism was greater among postmenopausal women (RR = 1.19, 95% CI 1.09-1.30) and the decreased risk after hypothyroidism was more pronounced among premenopausal women (RR = 0.69, 95% CI 0.53-0.89). Among women with no prior history of thyroid disease, every 1 mIU/L increase in TSH level was associated with a 0.8% (95% CI > 0-1.5%) lower risk of breast cancer. In conclusion, this meta-analysis supports an association between thyroid hormone levels and breast cancer risk, which could be modified by menopausal status.

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来源期刊
Endocrine-related cancer
Endocrine-related cancer 医学-内分泌学与代谢
CiteScore
7.80
自引率
2.60%
发文量
138
审稿时长
6-12 weeks
期刊介绍: Endocrine-Related Cancer is an official flagship journal of the Society for Endocrinology and is endorsed by the European Society of Endocrinology, the United Kingdom and Ireland Neuroendocrine Society, and the Japanese Hormones and Cancer Society. Endocrine-Related Cancer provides a unique international forum for the publication of high quality original articles describing novel, cutting edge basic laboratory, translational and clinical investigations of human health and disease focusing on endocrine neoplasias and hormone-dependent cancers; and for the publication of authoritative review articles in these topics. Endocrine neoplasias include adrenal cortex, breast, multiple endocrine neoplasia, neuroendocrine tumours, ovary, prostate, paraganglioma, parathyroid, pheochromocytoma pituitary, testes, thyroid and hormone-dependent cancers. Neoplasias affecting metabolism and energy production such as bladder, bone, kidney, lung, and head and neck, are also considered.
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