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Alkhalaileh H, Wei R, Lee JKY, Jones J, Li J. Relationship between TSH and free thyroxine in outpatient cancer patient population. Endocrine 2023; 82:319-325. [PMID: 37286745 DOI: 10.1007/s12020-023-03399-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND The inverse log-linear relationship between Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) is well established and reliably used for evaluation of hypothalamus-pituitary-thyroid (HPT) axis function. However, there are limited data regarding oncologic states in the TSH-FT4 relationship. The purpose of this study was to evaluate thyroid pituitary hypothalamic feedback regulation by the inverse log TSH and FT4 relationship in the cancer patient population at the Ohio State University Comprehensive Cancer Center (OSUCCC-James). METHODS This retrospective study analyzed the correlation between TSH and FT4 results from 18846 outpatient subjects collected in August 2019-November 2021 at the Department of Family Medicine (OSU Wexner Medical Center), Department of Oncology (OSUCCC-James). Patients with diagnoses related to cancers were included in the oncology group. Patients with diagnoses not related to cancers were included in the non-oncology group. Patients of the Department of Endocrinology, Department of Cardiology, Department of Obstetrics & Gynecology and Department of Hematology were excluded from this study. Time of collection for TSH and FT4 was from 7am to 7 pm. Data were analyzed by morning (7am-12pm) and afternoon (12pm-7pm). Spearman correlation and non-linear fit were used for data analysis. Sex differences were analyzed as well in each group. RESULTS Overall, an inverse correlation was observed between TSH and FT4 in both groups (non-oncology and oncology) regardless of sample collection time and sex differences. Further analysis by linear model in log TSH and FT4 showed a significant inverse fit in males compared with females in the group of oncology, both in the afternoon (p < 0.05). Data were further analyzed by ranges of FT4, as lower or higher (pathophysiology) or within (physiology) the reference interval of FT4. There was no statistical significance between the non-oncology and oncology groups, but relatively good correlation in non-oncology group in either physiologic or pathophysiologic FT4 levels and sample collection time. Interestingly, the best correlation between TSH and FT4 was found in the non-oncology group at pathophysiologic FT4 concentrations (abnormally high). In addition, at pathophysiologic FT4 concentrations (abnormally low), the oncology group demonstrated a significant TSH response in the morning than in the afternoon (p < 0.05). CONCLUSIONS Though overall the TSH-FT4 curves showed an inverse relationship, there are variations of TSH-FT4 relationship for collection times when considering FT4 in physiologic or pathophysiologic states. The results advance understanding of TSH response, which is beneficial for the interpretation of thyroid disease. We recommend re-evaluation for interpretation of pituitary hypothalamic axis by TSH results when FT4 is abnormally high in oncology patients or low in non-oncology patients, due to poor predictability and the potential for misdiagnosis. A better understanding of the complex nature of the TSH-FT4 relationship may need further study with better defining subclinical states of cancer patients.
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Affiliation(s)
| | - Ruhan Wei
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | - Jason K Y Lee
- Department of Clinical Laboratory, University Hospital, the Ohio State University, Columbus, OH, USA
| | - JoAnna Jones
- Department of Pathology, the Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Jieli Li
- Department of Pathology, the Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Jacob L, Koyanagi A, Haro JM, Shin JI, Smith L, Gremke N, Kalder M, Kostev K. Is there an association between breast cancer and incident adhesive capsulitis of the shoulder? A retrospective cohort study from Germany. Support Care Cancer 2023; 31:347. [PMID: 37212901 DOI: 10.1007/s00520-023-07808-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/11/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Preliminary data suggest that women with breast cancer are at particularly high risk of adhesive capsulitis of the shoulder. Therefore, this study aimed to investigate the potential association between breast cancer and adhesive capsulitis in adults from Germany. METHODS This retrospective cohort study included all women aged ≥ 18 years who were diagnosed for the first time with breast cancer in one of 1,274 general practices in Germany between January 2000 and December 2018 (index date). Women without breast cancer were matched (1:1) to those with breast cancer using a propensity score based on age at the index date, index year, and the average number of medical consultations per year during the follow-up. In women without breast cancer, the index date was a randomly selected visit date between 2000 and 2018. The association between breast cancer and the 10-year incidence of adhesive capsulitis was studied using Kaplan-Meier curves and a Cox regression model adjusted for age and several comorbidities. RESULTS There were 52,524 women included in this study (mean [SD] age 64.2 [12.9] years). The 10-year incidence of adhesive capsulitis was 3.6% in both the group with and the group without breast cancer (log-rank p-value = 0.317). The Cox regression analysis further showed no significant association between breast cancer and adhesive capsulitis (HR = 0.96, 95% CI = 0.86-1.08). CONCLUSION In this sample of women from Germany, breast cancer was not significantly associated with adhesive capsulitis. Although the present preliminary findings are reassuring, general practitioners should regularly assess shoulder function in breast cancer survivors.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain
- Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys 23, Barcelona, Spain
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Niklas Gremke
- Department of Gynecology and Obstetrics, Philipps-University, Marburg, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, Philipps-University, Marburg, Germany
| | - Karel Kostev
- Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt am Main, Germany.
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Han M, Wang Y, Jin Y, Zhao X, Cui H, Wang G, Gang X. Benign thyroid disease and the risk of breast cancer: An updated systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:984593. [PMID: 36313770 PMCID: PMC9596990 DOI: 10.3389/fendo.2022.984593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The correlation between benign thyroid disease (BTD) and breast cancer (BC) has long been discussed. However, the definite relationship and potential mechanism between them are still disputed. The current meta-analysis aimed at performing a comprehensive assessment of the relationship between different types of benign thyroid disease and the risk of breast cancer, furthermore, assessing whether benign thyroid disease exerts an influence on the aggressiveness of breast cancer. METHOD A systematic literature search (PubMed, Web of Science, MEDLINE, and Embase databases) identified studies to evaluate the correlation between BTD and BC risk. Data were analyzed using version 16.0 STATA software, including the odds ratio (OR) and its corresponding 95% confidence intervals (CIs). Publication bias and quality assessment were conducted for the included studies. RESULT Overall, 18 studies involving 422,384 patients with BTD were incorporated. The outcome showed that autoimmune thyroiditis (OR: 2.56, 95%CI: 1.95-3.37, I2 = 0.0%, p=0.460), goiter (OR: 2.13, 95%CI: 1.19-3.79, I2 = 80.6%, p=0.000), and Graves' disease (OR: 5.01, 95%CI: 1.49-16.82, I2 = 0.0%, p=0.358) was connected with a higher risk of BC. Both hypothyroidism (OR: 0.82, 95%CI: 0.64-1.04, I2 = 85.0%, p=0.000) and hyperthyroidism (OR: 1.07, 95%CI: 0.93-1.24, I2 = 24.9%, p=0.206) had no significant association with the risk of BC. Additionally, the pooled analysis showed no apparent correlation between BTD and aggressiveness of BC. However, subgroup analysis indicated a positive relationship between BTD and aggressiveness of BC in the Europe subgroup (HR: 2.05, 95%CI: 1.32-3.17, I2 = 86.4%, p=0.000). CONCLUSION Autoimmune thyroiditis, goiter, and Graves' disease are connected with an increased risk of BC. Furthermore, subgroup analysis suggested that BTD increases the aggressiveness of BC in the European population geographically. Nevertheless, further research is needed to prove these discoveries.
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Affiliation(s)
- Mingyue Han
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Yao Wang
- Department of Orthopedics, The Second Hospital Jilin University, Changchun, China
| | - Yuanhui Jin
- Hospital Office, Meihekou City Central Hospital, Meihekou, China
| | - Xue Zhao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Haiying Cui
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Guixia Wang, ; Xiaokun Gang, gang
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Guixia Wang, ; Xiaokun Gang, gang
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Piciu A, Piciu D, Polocoser N, Kovendi AA, Almasan I, Mester A, Morariu DS, Cainap C, Cainap SS. Diagnostic Performance of F18-FDG PET/CT in Male Breast Cancers Patients. Diagnostics (Basel) 2021; 11:diagnostics11010119. [PMID: 33451072 PMCID: PMC7828478 DOI: 10.3390/diagnostics11010119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION F18-FDG PET/CT is the most important hybrid imaging used in the diagnostic, staging, follow-up, and treatment evaluation response in cancer patients. However, it is well-known that in breast cancer the use of F18-FDG is not included in the first line protocol of initial diagnostic, both in female and male breast cancer patients. F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. This study assesses F18-FDG PET/CT systemic staging in male patients with diagnosed breast cancer and determines detection rates for unsuspected distant metastases and synchronous malignancies. METHODS We analyzed a number of 170 male patients with breast cancer, seen between 2000-2020, in a tertiary center. From this group, between 2013-2020 a number of 23 patients underwent F18-FDG PET/CT. Rates of upstaging were determined for each case and the detection of other primary malignancies was analyzed. RESULTS Median age of male breast cancer group was 61.3 y (range, 34-85 y), most had intraductal carcinoma (82.4%) and unsuspected distant metastases, which increased patient stage to IV, observed in 27%. In 4 out 23 patients (17.4%), F18-FDG PET/CT identified synchronous cancers (2 prostate cancers, 1 thyroid and 1 colon cancer). CONCLUSION F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. Baseline F18-FDG PET/CT has a substantial impact on the initial staging and on clinical management in male breast patients and should be considered for use in newly diagnosed patients.
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Affiliation(s)
- Andra Piciu
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Doina Piciu
- PhD School of Iuliu Hatieganu, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
- Department of Endocrine Tumors and Nuclear Medicine, Institute of Oncology, 400012 Cluj-Napoca, Romania
- Correspondence:
| | - Narcis Polocoser
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Anita A. Kovendi
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Iulia Almasan
- PhD School of Iuliu Hatieganu, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
- Department of Endocrine Tumors and Nuclear Medicine, Institute of Oncology, 400012 Cluj-Napoca, Romania
| | - Alexandru Mester
- Departement of Oral Health, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Dragos-Stefan Morariu
- Department of Surgery, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Calin Cainap
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.P.); (N.P.); (A.A.K.); (C.C.)
| | - Simona Sorana Cainap
- Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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Chen S, Wu F, Hai R, You Q, Xie L, Shu L, Zhou X. Thyroid disease is associated with an increased risk of breast cancer: a systematic review and meta-analysis. Gland Surg 2021; 10:336-346. [PMID: 33633990 PMCID: PMC7882351 DOI: 10.21037/gs-20-878] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/11/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND This study investigated the relationship between thyroid diseases and the risk of breast cancer (BC). Clarifying this issue can help medical staff perform of early prevention, diagnosis and treatment for breast cancer patients. METHODS The meta-analysis combined data from cohort studies and case-control to obtain a comprehensive result of the relationship between thyroid diseases and risk of BC. We comprehensively searched PubMed, EMbase, Web of Science, and the Cochrane Library. The search period was from the establishment of the databases to August 2020. Literature was collected and screened individually by two reviewers. There was English language restriction on the search and unpublished literature was excluded. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected studies prior to data extraction. The data collected included country, author, year of publication, research type, and number of cases. In cases where the data and study heterogeneity permitted, meta-analyses were performed, and odd ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. Data were analyzed using the STATA 15.1 software. RESULTS A total of 21 articles were included in this study. Hyperthyroidism, thyroid cancer, thyroglobulin antibody (TGAb) levels, and thyroid microsomal antibody (TPOAb) levels were all significantly associated with an increased risk of BC, while hypothyroidism was associated with a reduced risk of BC. CONCLUSIONS This study demonstrated that hyperthyroidism, autoimmune thyroiditis (AITD), and thyroid cancer are significantly associated with an increased risk of BC, while hypothyroidism is associated with a reduced risk of BC.
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Affiliation(s)
- Shi Chen
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fei Wu
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Rui Hai
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qian You
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Linjun Xie
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Liang Shu
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiangyu Zhou
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Kong H, Chen J, Tang SC. Synchronous papillary thyroid carcinoma and breast ductal carcinoma. J Int Med Res 2020; 48:300060520948710. [PMID: 32865067 PMCID: PMC7469738 DOI: 10.1177/0300060520948710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 48-year-old woman was admitted to our hospital with a lump in her left breast. She was diagnosed with synchronous papillary thyroid carcinoma and breast ductal carcinoma. The patient underwent four cycles of neoadjuvant chemotherapy with epirubicin and cyclophosphamide, and one cycle of docetaxel. She then underwent left breast mastectomy and radical resection of thyroid cancer (total thyroidectomy and bilateral central group [levels VI and VII] lymph node dissection) at the same time. She was administered three cycles of chemotherapy with docetaxel and radiotherapy. The patient had no metastasis in the follow-up period. A literature search was performed to characterize the epidemiology, etiology, management, and prognosis of this condition. We speculate that hormone treatment could be a probable pathogenesis of synchronous breast and thyroid cancers.
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Affiliation(s)
- Heng Kong
- Department of Thyroid and Breast Surgery, Baoan Central Hospital of Shenzhen (Fifth Affiliated Hospital of Shenzhen University), Shenzhen City, Guangdong Province, China.,Department of General Surgery, Shenzhen University General Hospital, Shenzhen University, Shenzhen City, Guangdong Province, China
| | - JiXin Chen
- Department of General Surgery, Shenzhen University General Hospital, Shenzhen University, Shenzhen City, Guangdong Province, China
| | - Shou-Ching Tang
- Cancer Center and Research Institute, Clinical and Translational Research, University of Mississippi Medical Center, Guyton Research Building, 2500 North State Street, Starkville, MS, USA
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Mostafaei S, Kazemnejad A, Norooznezhad AH, Mahaki B, Moghoofei M. Simultaneous Effects of Viral Factors of Human Papilloma Virus and Epstein-Barr Virus on Progression of Breast and Thyroid Cancers: Application of Structural Equation Modeling. Asian Pac J Cancer Prev 2020; 21:1431-1439. [PMID: 32458652 PMCID: PMC7541891 DOI: 10.31557/apjcp.2020.21.5.1431] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Indexed: 01/19/2023] Open
Abstract
This study aimed to assess effects of the sets of EBV and HPV expressed proteins simultaneously on the sets of cellular/inflammatory factors in breast and thyroid cancers using structural equation modeling. In this multi-center case-control study, according to the inclusion and exclusion criteria, 83 breast and 57 thyroid specimens were collected from the eligible patients. In addition, 31 and 18 histopathological evaluated normal breast and thyroid samples were also examined as age-matched healthy controls. In addition, ELISA and Real-time PCR were used to measure the expression level of viral and cellular/inflammatory genes and proteins. Structural equation modeling was used to test the causal associations between the sets of EBV and HPV expressed proteins with inflammatory factors in breast and thyroid cancers development. Breast cancer patients had a higher incidence of HPV-positively and EBV-positively than healthy controls (OR=1.66, 95%CI=0.79-3.47, P-value=0.177), (OR=3.18, 95%CI=1.52-6.63, P-value=0.002), respectively. In addition, thyroid cancer patients had a significantly higher incidence of EBV-positivity than healthy controls (OR=3.72, 95% CI=1.65-8.36, P-value=0.001). After fitting the SEM model, HPV proteins factor has significant direct and total effects on the cellular/inflammatory factors in breast cancer (direct effect: β=0.426, P-value=0.01; total effect: β=0.549, P-value<0.001). However, EBV proteins factor has most significant total effect on the cellular/inflammatory factors in breast cancer (total effect: β=0.804, P-value<0.001) than the cellular/inflammatory factors in thyroid cancer (total effect: β=0.789, P-value<0.001). For the first time, a significant association between EBV and HPV -genes, anoikis resistance and the development of breast and thyroid cancers demonstrated by using SEM, Simultaneously.
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Affiliation(s)
- Shayan Mostafaei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Amir Hossein Norooznezhad
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Regenerative Medicine Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Mahaki
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Moghoofei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Dobrinja C, Scomersi S, Giudici F, Vallon G, Lanzaro A, Troian M, Bonazza D, Romano A, Zanconati F, de Manzini N, Bortul M. Association between benign thyroid disease and breast cancer: a single center experience. BMC Endocr Disord 2019; 19:104. [PMID: 31623603 PMCID: PMC6798360 DOI: 10.1186/s12902-019-0426-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/10/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The relationship between breast cancer (BC) and thyroid disease (TD) is still controversial. The aim of the study was to investigate the possible coexistence of TD in patients with newly diagnosed BC and its correlation with BC clinical presentation with regard to menopausal status and stage of disease. METHODS This is a retrospective cohort study of all patients treated for primary BC between 2014 and 2016 at the Breast Unit of Trieste University Hospital. Clinical charts and reports were reviewed for coexisting thyroid disorders (i.e. hyperthyroidism, hypothyroidism, benign TD, thyroid cancer, thyroid autoimmunity) and menopausal status at the time of BC diagnosis. Biomolecular profile, stage, and grading of BC were also evaluated. RESULTS A total of 786 women and 7 men were included in the study. Co-presence of TD was found in 161(20.3%) cases: of these, 151(19.4%) patients presented benign TD and 10(1.3%) patients presented thyroid carcinoma. Thyroid autoimmunity was found in 51(32%) patients. Regarding thyroid function, 88(55%) patients had hypothyroidism, 19(12%) hyperthyroidism, and 54(33%) normal thyroid function. No statistically significant correlation was found between age and TD (p = 0.16), although TD was more common in women aged ≥60 years. Women with BC diagnosed at pre-menopausal age were more likely to have thyroid autoimmune diseases (45% vs. 29%, p = 0.05). No association was detected among BC molecular profiles with either thyroid autoimmunity (p = 0.26) or altered thyroid function (p = 0.63). High-grade BC was more frequent in women with hyperthyroidism (52.9%, p = 0.04), but the grading was independent from the presence of thyroid autoimmune disease (p = 0.87). BC stage was related to both thyroid autoimmunity (p = 0.04) and thyroid function (p < 0.001), with 55.2% of women affected by benign TD presenting with stage I BC and more aggressive BCs found in hypothyroid patients. CONCLUSIONS According our study results, patients with primary BC present a greater incidence of autoimmunity disorders, especially when diagnosed in the pre-menopausal setting. However, further prospective studies are required to definitively prove causality.
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Affiliation(s)
- Chiara Dobrinja
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Serena Scomersi
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
- Breast Unit Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Fabiola Giudici
- Breast Unit Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Giulia Vallon
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Alessio Lanzaro
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Marina Troian
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Deborah Bonazza
- UCO Anatomia e Istologia Patologica-Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Andrea Romano
- UCO Anatomia e Istologia Patologica-Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Fabrizio Zanconati
- UCO Anatomia e Istologia Patologica-Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Nicolò de Manzini
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Marina Bortul
- Breast Unit Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
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Rahman S, Archana A, Jan AT, Dutta D, Shankar A, Kim J, Minakshi R. Molecular Insights Into the Relationship Between Autoimmune Thyroid Diseases and Breast Cancer: A Critical Perspective on Autoimmunity and ER Stress. Front Immunol 2019; 10:344. [PMID: 30881358 PMCID: PMC6405522 DOI: 10.3389/fimmu.2019.00344] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/11/2019] [Indexed: 12/12/2022] Open
Abstract
The etiopathologies behind autoimmune thyroid diseases (AITDs) unravel misbehavior of immune components leading to the corruption of immune homeostasis where thyroid autoantigens turn foe to the self. In AITDs lymphocytic infiltration in the thyroid shows up a deranged immune system charging the follicular cells of the thyroid gland (thyrocytes) leading to the condition of either hyperthyroidism or hypothyroidism. The inflammation in AITDs consistently associate with ER function due to which disturbances in the ER protein homeostasis leads to unfolded protein response (UPR) that promotes pathogenesis of autoimmunity. The roles of ER stress in the instantaneous downregulation of MHC class I molecules on thyrocytes and the relevance of IFN γ in the pathogenesis of AITD has been well-documented. Thyroglobulin being the major target of autoantibodies in most of the AITDs is because of its unusual processing in the ER. Autoimmune disorders display a conglomeration of ER stress-induced UPR activated molecules. Several epidemiological data highlight the preponderance of AITDs in women as well as its concurrence with breast cancer. Both being an active glandular system displaying endocrine activity, thyroid as well as breast tissue show various commonalities in the expression pattern of heterogenous molecules that not only participate in the normal functioning but at the same time share the blame during disease establishment. Studies on the development and progression of breast carcinoma display a deranged and uncontrolled immune response, which is meticulously exploited during tumor metastasis. The molecular crosstalks between AITDs and breast tumor microenvironment rely on active participation of immune cells. The induction of ER stress by Tunicamycin advocates to provide a model for cancer therapy by intervening glycosylation. Therefore, this review attempts to showcase the molecules that are involved in feeding up the relationship between breast carcinoma and AITDs.
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Affiliation(s)
- Safikur Rahman
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, South Korea
| | - Ayyagari Archana
- Department of Microbiology, Swami Shraddhanand College, University of Delhi, New Delhi, India
| | - Arif Tasleem Jan
- School of Biosciences and Biotechnology, Baba Ghulam Shah Badshah University, Rajouri, India
| | - Durgashree Dutta
- Department of Biochemistry, Jan Nayak Chaudhary Devilal Dental College, Sirsa, India
| | - Abhishek Shankar
- Department of Preventive Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Jihoe Kim
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan, South Korea
| | - Rinki Minakshi
- Department of Microbiology, Swami Shraddhanand College, University of Delhi, New Delhi, India
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10
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Arer İM, Yabanoğlu H, Kuş M, Akdur A, Avcı T. Retrospective Analysis of Patients with Synchronous Primary Breast and Thyroid Carcinoma. Eur J Breast Health 2018; 14:80-84. [PMID: 29774315 DOI: 10.5152/ejbh.2018.3853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/30/2017] [Indexed: 12/19/2022]
Abstract
Objective Breast and thyroid cancers are commonly encountered malignancies. Increased risk of breast cancer in follow-up period of thyroid cancer or vice versa has been reported. However, they have some associations, synchronous presentation of these tumors is rare. We presented 12 patients diagnosed as breast and thyroid cancer and treated at the same time. Materials and Methods Mastectomy and thyroidectomy were performed in 19 patients at the same time. 7 patients were excluded because of benign thyroid pathology. Therefore 12 patients who had diagnosis of synchronous breast and thyroid cancer were included. Data regarding clinical, pathological, treatment and prognostic factors was retrospectively analyzed. Results Total thyroidectomy was performed in all patients. The mean age of patients was 54 years (min. 44-max. 70). Only one patient was male. Thyroid pathology was detected preoperatively by FDG PET-CT scan in 11 patients. Breast reconstruction was performed in three patients. The most commonly seen thyroid malignancy was papillary thyroid carcinoma. Postoperative complication rate was 33.3%. Adjuvant chemotherapy was given in 11 patients whereas one patient received adjuvant radiotherapy. Conclusion Although synchronous presentation of breast and thyroid cancer is rare, surgical treatment of both of these tumors can be safely performed at the same time. Association of these tumors should be evaluated by large scaled studies.
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Affiliation(s)
- İlker Murat Arer
- Department of General Surgery, Baskent University, Adana Training and Research Center, Adana, Turkey
| | - Hakan Yabanoğlu
- Department of General Surgery, Baskent University, Adana Training and Research Center, Adana, Turkey
| | - Murat Kuş
- Department of General Surgery, Baskent University, Adana Training and Research Center, Adana, Turkey
| | - Aydıncan Akdur
- Department of General Surgery, Baskent University School of Medicine, Ankara, Turkey
| | - Tevfik Avcı
- Department of General Surgery, Baskent University School of Medicine, Ankara, Turkey
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11
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Sindoni A, Fama' F, Rosano' A, Scisca C, Dionigi G, Koch CA, Gioffrè-Florio M, Benvenga S. Thyroid nodules coexisting with either cystic or solid breast nodules: a new clue for this association between nodules coming from ultrasonography. Gland Surg 2017; 6:630-637. [PMID: 29302478 DOI: 10.21037/gs.2017.09.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Thyroid and breast nodules (BNs) are common, their prevalence varying based mainly on the population (including age, residence in area of different iodine availability) studied and methods used. The coincidence of thyroid and breast diseases remains controversial and the majority of the studies evaluate the association between breast cancer and thyroid disorders. Here we describe our experience of such association in a non-oncological series. Methods Between the years 2000 and 2005, 3,372 patients from outpatient clinics were referred for thyroid ultrasonography (US) at our University Hospital; concurrent breast US in the 1,896 women revealed the presence of BNs in 127. The 127 women were divided into two groups, based on the cystic or solid nature of the BN(s). Results In 84/127 (66.1%) the single or multiple BN was/were cystic (group 1), while in the remaining 43 (33.9%) the single or multiple BN was/were solid [group 2; 19/43 had one thyroid nodule (TN) and the remaining 24/43 had ≥2 TNs]. When BN were cystic the coexisting TN(s) was/were more likely to be concordant in localization (i.e., right/right or left/left localization) whereas, when the BN were solid, the coexisting thyroid nodule/nodules was/were more likely to be discordant. In women with cystic BNs (CBNs), TNs were more frequently multiple (64% of cases), whereas in cases with solid BNs (SBNs), the frequency of single and multiple TNs was approximately the same. In patients with TNs/CBNs, TNs tend to be subcentimetric and localized in the inferior pole of either thyroid lobe. In patients with TNs/SBNs, TNs tend to be larger and localized in the middle of either thyroid lobe. Conclusions In women with BNs associated with TNs, there are interesting differences concerning TNs when patients are stratified based on the cystic or solid nature of the BN.
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Affiliation(s)
- Alessandro Sindoni
- Unit of Nuclear Medicine, IRCCS-CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Fausto Fama'
- Division of Endocrine Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Messina, Italy
| | - Antonio Rosano'
- Master Program on Childhood, Adolescence and Women's Endocrine Health, University of Messina, Messina, Italy
| | - Claudio Scisca
- Department of Clinical & Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Gianlorenzo Dionigi
- Division of Endocrine Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Messina, Italy
| | - Christian A Koch
- Division of Endocrinology, Endocrine Tumor Program, Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA
| | - Maria Gioffrè-Florio
- Division of Endocrine Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Messina, Italy
| | - Salvatore Benvenga
- Master Program on Childhood, Adolescence and Women's Endocrine Health, University of Messina, Messina, Italy.,Department of Clinical & Experimental Medicine, University Hospital of Messina, Messina, Italy.,Interdepartmental Program of Molecular & Clinical Endocrinology, and Women's Endocrine Health, University Hospital of Messina, Messina, Italy
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12
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McVeigh TP, Mulligan RJ, McVeigh UM, Owens PW, Miller N, Bell M, Sebag F, Guerin C, Quill DS, Weidhaas JB, Kerin MJ, Lowery AJ. Investigating the association of rs2910164 with cancer predisposition in an Irish cohort. Endocr Connect 2017; 6:614-624. [PMID: 28899898 PMCID: PMC5640569 DOI: 10.1530/ec-17-0196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 09/12/2017] [Indexed: 01/05/2023]
Abstract
INTRODUCTION MicroRNAs (miRNAs) are small noncoding RNA molecules that exert post-transcriptional effects on gene expression by binding with cis-regulatory regions in target messenger RNA (mRNA). Polymorphisms in genes encoding miRNAs or in miRNA-mRNA binding sites confer deleterious epigenetic effects on cancer risk. miR-146a has a role in inflammation and may have a role as a tumour suppressor. The polymorphism rs2910164 in the MIR146A gene encoding pre-miR-146a has been implicated in several inflammatory pathologies, including cancers of the breast and thyroid, although evidence for the associations has been conflicting in different populations. We aimed to further investigate the association of this variant with these two cancers in an Irish cohort. METHODS The study group comprised patients with breast cancer (BC), patients with differentiated thyroid cancer (DTC) and unaffected controls. Germline DNA was extracted from blood or from saliva collected using the DNA Genotek Oragene 575 collection kit, using crystallisation precipitation, and genotyped using TaqMan-based PCR. Data were analysed using SPSS, v22. RESULTS The total study group included 1516 participants. This comprised 1386 Irish participants; 724 unaffected individuals (controls), 523 patients with breast cancer (BC), 136 patients with differentiated thyroid cancer (DTC) and three patients with dual primary breast and thyroid cancer. An additional cohort of 130 patients with DTC from the South of France was also genotyped for the variant. The variant was detected with a minor allele frequency (MAF) of 0.19 in controls, 0.22 in BC and 0.27 and 0.26 in DTC cases from Ireland and France, respectively. The variant was not significantly associated with BC (per allele odds ratio = 1.20 (0.98-1.46), P = 0.07), but was associated with DTC in Irish patients (per allele OR = 1.59 (1.18-2.14), P = 0.002). CONCLUSION The rs2910164 variant in MIR146A is significantly associated with DTC, but is not significantly associated with BC in this cohort.
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Affiliation(s)
- T P McVeigh
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - R J Mulligan
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - U M McVeigh
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - P W Owens
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - N Miller
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - M Bell
- Department of EndocrinologySchool of Medicine, NUI Galway, Galway, Ireland
| | - F Sebag
- Department of Endocrine Surgery Centre hospitalo-universitaire de La ConceptionAssistance Publique Hôpitaux de Marseille, Marseille, France
- Aix-Marseille UniversitéFaculté de Médecine, Marseille, France
| | - C Guerin
- Department of Endocrine Surgery Centre hospitalo-universitaire de La ConceptionAssistance Publique Hôpitaux de Marseille, Marseille, France
- Aix-Marseille UniversitéFaculté de Médecine, Marseille, France
| | - D S Quill
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - J B Weidhaas
- David Geffen School of MedicineUniversity of California, Los Angeles, USA
| | - M J Kerin
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - A J Lowery
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
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13
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Muller I, Kilburn LS, Taylor PN, Barrett-Lee PJ, Bliss JM, Ellis P, Ludgate ME, Dayan CM. TPOAb and Thyroid Function Are Not Associated with Breast Cancer Outcome: Evidence from a Large-Scale Study Using Data from the Taxotere as Adjuvant Chemotherapy Trial (TACT, CRUK01/001). Eur Thyroid J 2017; 6:197-207. [PMID: 28868260 PMCID: PMC5567117 DOI: 10.1159/000460246] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/07/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Small-scale studies correlated the presence of thyroid autoimmunity with both improved or worsened breast cancer outcome. OBJECTIVES We aimed to clarify this association in a large cohort using the phase III, randomized, controlled Taxotere as Adjuvant Chemotherapy Trial (TACT, CRUK01/001). METHODS TACT women >18 years old with node-positive or high-risk node-negative early breast cancer (pT1-3a, pN0-1, M0), with stored plasma (n = 1,974), taken 15.5 (median; IQR 7.0-24.0) months after breast surgery were studied. Patients had also received chemotherapy (100%), radiotherapy (1,745/1,974; 88.4%), hormonal therapy (1,378/ 1,974; 69.8%), or trastuzumab (48/1,974; 2.4%). History of thyroid diseases and/or related treatments was not available. The prognostic significance of autoantibodies to thyroid peroxidase (TPOAb; positive ≥6 kIU/L), free-thyroxine and thyrotropin (combined: euthyroid, hypothyroid, hyperthyroid) was evaluated for disease-free survival (DFS), overall-survival (OS), and time-to-recurrence (TTR), with Cox regression models in univariate and multivariable analyses. The extended median follow-up was 97.5 months. RESULTS No difference in DFS was found by TPOAb status (unadjusted hazard ratio [HR]: 0.97, 95%CI: 0.78-1.19; p = 0.75) and/or thyroid function (unadjusted HR [hypothyroid vs. euthyroid]: 1.15, 95% CI: 0.79-1.68; p = 0.46; unadjusted HR [hyperthyroid vs. euthyroid]: 1.14, 95% CI: 0.82-1.61; p = 0.44). Similar results were obtained for OS, TTR, multivariable analyses, when TPOAb titre by tertiles was considered, and in a subgroup of 123 patients with plasma collected before adjuvant treatments. CONCLUSIONS No evidence for a prognostic role of TPOAb and/or thyroid function in moderate-to-high-risk early breast cancer was found in the largest and longest observational study to date.
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Affiliation(s)
- Ilaria Muller
- Thyroid Research Group, School of Medicine, Cardiff University, Cardiff, UK
| | - Lucy S. Kilburn
- Institute of Cancer Research – Clinical Trials & Statistics Unit (ICR-CTSU), London, UK
| | - Peter N. Taylor
- Thyroid Research Group, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Judith M. Bliss
- Institute of Cancer Research – Clinical Trials & Statistics Unit (ICR-CTSU), London, UK
| | - Paul Ellis
- Guy's Hospital and King's College, London, UK
| | - Marian E. Ludgate
- Thyroid Research Group, School of Medicine, Cardiff University, Cardiff, UK
| | - Colin M. Dayan
- Thyroid Research Group, School of Medicine, Cardiff University, Cardiff, UK
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14
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Godlewska M, Arczewska KD, Rudzińska M, Łyczkowska A, Krasuska W, Hanusek K, Ruf J, Kiedrowski M, Czarnocka B. Thyroid peroxidase (TPO) expressed in thyroid and breast tissues shows similar antigenic properties. PLoS One 2017; 12:e0179066. [PMID: 28575127 PMCID: PMC5456382 DOI: 10.1371/journal.pone.0179066] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Thyroid peroxidase (TPO) is essential for physiological function of the thyroid gland. The high prevalence of thyroid peroxidase antibodies (TPOAbs) in patients with breast cancer and their protective role had previously been demonstrated, indicating a link between breast cancer and thyroid autoimmunity. Recently, TPO was shown to be present in breast cancer tissue samples but its antigenicity has not been analyzed. METHODS In this study, we investigated TPO expression levels in a series of fifty-six breast cancer samples paired with normal (peri-tumoral) tissue and its antigenic activity using a panel of well-characterized murine anti-human TPOAbs. RESULTS We have shown that TPO transcripts were present in both normal and cancer tissue samples, although the amounts in the latter were reduced. Additionally, we observed that TPO levels are lower in more advanced cancers. TPO protein expression was confirmed in all tissue samples, both normal and cancerous. We also found that the antigenicity of the immunodominant regions (IDRs) in breast TPO resembles that of thyroid TPO, which is crucial for effective interactions with human TPOAbs. CONCLUSIONS Expression of TPO in breast cancer together with its antigenic activity may have beneficial effects in TPOAb-positive breast cancer patients. However, further studies are needed to confirm the beneficial role of TPOAbs and to better understand the underlying mechanism.
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Affiliation(s)
- Marlena Godlewska
- Department of Biochemistry and Molecular Biology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Katarzyna D. Arczewska
- Department of Biochemistry and Molecular Biology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Magdalena Rudzińska
- Department of Biochemistry and Molecular Biology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Anna Łyczkowska
- Department of Biochemistry and Molecular Biology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Wanda Krasuska
- Department of Biochemistry and Molecular Biology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Karolina Hanusek
- Department of Biochemistry and Molecular Biology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Jean Ruf
- UMR-MD2, Aix-Marseille University, Marseille Medical School, Marseille, France
| | - Mirosław Kiedrowski
- Clinical Department of Oncology and Hematology, Central Clinical Hospital of the Ministry of Interior in Warsaw, Warsaw, Poland
| | - Barbara Czarnocka
- Department of Biochemistry and Molecular Biology, Center of Postgraduate Medical Education, Warsaw, Poland
- * E-mail:
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15
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Fröhlich E, Wahl R. Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases. Front Immunol 2017; 8:521. [PMID: 28536577 PMCID: PMC5422478 DOI: 10.3389/fimmu.2017.00521] [Citation(s) in RCA: 220] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 04/19/2017] [Indexed: 12/17/2022] Open
Abstract
Autoimmune diseases have a high prevalence in the population, and autoimmune thyroid disease (AITD) is one of the most common representatives. Thyroid autoantibodies are not only frequently detected in patients with AITD but also in subjects without manifest thyroid dysfunction. The high prevalence raises questions regarding a potential role in extra-thyroidal diseases. This review summarizes the etiology and mechanism of AITD and addresses prevalence of antibodies against thyroid peroxidase, thyroid-stimulating hormone receptor (TSHR), and anti-thyroglobulin and their action outside the thyroid. The main issues limiting the reliability of the conclusions drawn here include problems with different specificities and sensitivities of the antibody detection assays employed, as well as potential confounding effects of altered thyroid hormone levels, and lack of prospective studies. In addition to the well-known effects of TSHR antibodies on fibroblasts in Graves' disease (GD), studies speculate on a role of anti-thyroid antibodies in cancer. All antibodies may have a tumor-promoting role in breast cancer carcinogenesis despite anti-thyroid peroxidase antibodies having a positive prognostic effect in patients with overt disease. Cross-reactivity with lactoperoxidase leading to induction of chronic inflammation might promote breast cancer, while anti-thyroid antibodies in manifest breast cancer might be an indication for a more active immune system. A better general health condition in older women with anti-thyroid peroxidase antibodies might support this hypothesis. The different actions of the anti-thyroid antibodies correspond to differences in cellular location of the antigens, titers of the circulating antibodies, duration of antibody exposure, and immunological mechanisms in GD and Hashimoto's thyroiditis.
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Affiliation(s)
- Eleonore Fröhlich
- Internal Medicine (Department of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry), University of Tuebingen, Tuebingen, Germany
- Center for Medical Research, Medical University Graz, Graz, Austria
| | - Richard Wahl
- Internal Medicine (Department of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry), University of Tuebingen, Tuebingen, Germany
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16
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Chiappa C, Rovera F, Rausei S, Del Ferraro S, Fachinetti A, Lavazza M, Marchionini V, Arlant V, Tanda ML, Piantanida E, Kim HY, Anuwong A, Dionigi G. Breast cancer and thyroid diseases: analysis of 867 consecutive cases. J Endocrinol Invest 2017; 40:179-184. [PMID: 27624298 DOI: 10.1007/s40618-016-0543-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/31/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the association of breast cancer with thyroid diseases. Many authors have already studied the possible relationship between these two diseases, but the results are nowadays conflicting. MATERIALS AND METHODS Our study examining 867 patients with breast cancer (862 women and 5 men, average age = 61 years old) of whom 141 also had thyroid disease evaluated the recurrence of thyroid diseases and their association with different types of breast cancer. Statistical analyses were performed using SPSS software for Windows; we used nonparametric tests (Chi-square and Mann-Whitney), and the level of significance was set at p < 0.05. RESULTS We found a significant association between breast cancer diagnosed after menopause and thyroid disease (p < 0.003). Moreover, we analyzed the role of thyroid autoimmunity identifying an association between chronic autoimmune thyroiditis and breast cancer diagnosed before menopause (p < 0.05). Regarding receptor profile of breast carcinoma, we have found an increased expression of estrogen receptors in patients with autoimmune thyroiditis compared to patients with any other thyroid diseases (p < 0.03). Contrariwise, we do not have found any difference between the group with every thyroid disease and the group without thyroid disease (p < 1.00). We did not find other statistically significant associations with breast cancer's parameters like family history, tumor size, lymph node metastasis, distant metastasis, cancer clinical and pathological stage, differentiation grade and expression of Ki67, p53 and Her2 in the two main groups with or without thyroid disease. Likewise, we did not found other statistically significant association between hypothyroidism or hyperthyroidism and breast cancer.
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MESH Headings
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/etiology
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/etiology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/etiology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Female
- Follow-Up Studies
- Humans
- Lymphatic Metastasis
- Male
- Middle Aged
- Neoplasm Grading
- Prognosis
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Thyroid Diseases/complications
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Affiliation(s)
- C Chiappa
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy.
| | - F Rovera
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - S Rausei
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - S Del Ferraro
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - A Fachinetti
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - M Lavazza
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - V Marchionini
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - V Arlant
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - M L Tanda
- Endocrine Unit, Ospedale di Circolo - University of Insubria, Varese, Italy
| | - E Piantanida
- Endocrine Unit, Ospedale di Circolo - University of Insubria, Varese, Italy
| | - H Y Kim
- KUMC Thyroid Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - A Anuwong
- Department of Surgery, Police General Hospital, Faculty of Medicine, Siam University, Pathumwan, Bangkok, Thailand
| | - G Dionigi
- Senology Research Center - 1st Division of Surgery, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
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Fierabracci A, Pellegrino M. The Double Role of p53 in Cancer and Autoimmunity and Its Potential as Therapeutic Target. Int J Mol Sci 2016; 17:ijms17121975. [PMID: 27897991 PMCID: PMC5187775 DOI: 10.3390/ijms17121975] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 01/22/2023] Open
Abstract
p53 is a sequence-specific short-lived transcription factor expressed at low concentrations in various tissues while it is upregulated in damaged, tumoral or inflamed tissue. In normally proliferating cells, p53 protein levels and function are tightly controlled by main regulators, i.e., MDM2 (mouse double minute 2) and MDM4 proteins. p53 plays an important role due to its ability to mediate tumor suppression. In addition to its importance as a tumor suppressor, p53 coordinates diverse cellular responses to stress and damage and plays an emerging role in various physiological processes, including fertility, cell metabolism, mitochondrial respiration, autophagy, cell adhesion, stem cell maintenance and development. Interestingly, it has been recently implicated in the suppression of autoimmune and inflammatory diseases in both mice and humans. In this review based on current knowledge on the functional properties of p53 and its regulatory pathways, we discuss the potential utility of p53 reactivation from a therapeutic perspective in oncology and chronic inflammatory disorders leading to autoimmunity.
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Affiliation(s)
- Alessandra Fierabracci
- Infectivology and Clinical Trials Area, Children's Hospital Bambino Gesù, 00146 Rome, Italy.
| | - Marsha Pellegrino
- Infectivology and Clinical Trials Area, Children's Hospital Bambino Gesù, 00146 Rome, Italy.
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18
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Hypothyroidism in Pancreatic Cancer: Role of Exogenous Thyroid Hormone in Tumor Invasion-Preliminary Observations. J Thyroid Res 2016; 2016:2454989. [PMID: 27123358 PMCID: PMC4830736 DOI: 10.1155/2016/2454989] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 12/23/2022] Open
Abstract
According to the epidemiological studies, about 4.4% of American general elderly population has a pronounced hypothyroidism and relies on thyroid hormone supplements daily. The prevalence of hypothyroidism in our patients with pancreatic cancer was much higher, 14.1%. A retrospective analysis was performed on patients who underwent pancreaticoduodenectomy (Whipple procedure) or distal pancreatectomy and splenectomy (DPS) at Thomas Jefferson University Hospital, Philadelphia, from 2005 to 2012. The diagnosis of hypothyroidism was correlated with clinicopathologic parameters including tumor stage, grade, and survival. To further understand how thyroid hormone affects pancreatic cancer behavior, functional studies including wound-induced cell migration, proliferation, and invasion were performed on pancreatic cancer cell lines, MiaPaCa-2 and AsPC-1. We found that hypothyroid patients taking exogenous thyroid hormone were more than three times likely to have perineural invasion, and about twice as likely to have higher T stage, nodal spread, and overall poorer prognostic stage (P < 0.05). Pancreatic cancer cell line studies demonstrated that exogenous thyroid hormone treatment increased cell proliferation, migration, and invasion (P < 0.05). We conclude that exogenous thyroid hormone may contribute to the progression of pancreatic cancer.
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Anil C, Guney T, Gursoy A. The prevalence of benign breast diseases in patients with nodular goiter and Hashimoto's thyroiditis. J Endocrinol Invest 2015; 38:971-5. [PMID: 25827711 DOI: 10.1007/s40618-015-0269-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/04/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The evidence regarding association between thyroid disorders and benign and malignant breast diseases is increasing. The studies exploring the relationship between thyroid and breast diseases usually have focused on thyroid autoimmunity and functions in patients with breast pathologies. In this study, we aimed to reveal the frequency of benign breast conditions in patients with nodular thyroid disease (NTD) and Hashimoto's thyroiditis (HT). METHODS Seventy-one women with NTD, ninety-five women with HT and seventy-two healthy people as a control group were included in the study. Serum thyroid-stimulating hormone, free triiodothyronine, free thyroxine, and thyroid peroxidase autoantibody levels were measured, and thyroid and breast ultrasonography were performed by a single operator in order to determine thyroid and breast pathology. RESULTS Benign breast diseases were detected in 54.9% of patients with NTD, in 47.4% of those with HT, and 29.2% of control group in the study (p < 0.01 for nodular and Hashimoto groups versus control group). Simple cyst was found to be the most frequent pathology among benign breast diseases; fibrocystic changes, mixed lesions, benign solid mass, ductal ectasia, and complex cyst followed it. No significant relation was found regarding thyroid function and autoimmunity in patients diagnosed with benign breast disease (p > 0.05). CONCLUSIONS The results of our study support the association between benign breast diseases and thyroid diseases. An important implication of this finding may be demonstration of the necessity of scanning for potential breast pathology in women with nodular or autoimmune thyroid disease in clinical practice.
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Affiliation(s)
- C Anil
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 5. Sokak No: 48, Bahcelievler, 06490, Ankara, Turkey,
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Villa NM, Li N, Yeh MW, Hurvitz SA, Dawson NA, Leung AM. SERUM THYROTROPIN CONCENTRATIONS ARE NOT PREDICTIVE OF AGGRESSIVE BREAST CANCER BIOLOGY IN EUTHYROID INDIVIDUALS. Endocr Pract 2015; 21:1040-5. [PMID: 26121443 DOI: 10.4158/ep15733.or] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The potential influence of hypothyroidism on breast cancer remains incompletely understood. The objective of this study was to investigate the relationship between serum thyrotropin (thyroid-stimulating hormone, TSH) concentration and markers of aggressive breast cancer biology as defined by receptor expression profile, tumor grade, and American Joint Committee on Cancer (AJCC) stage characteristics. METHODS This was a retrospective cohort study of patients from 2002 to 2014. All breast cancer patients who had complete receptor (estrogen receptor, ER; progesterone receptor, PR; and human epidermal growth factor receptor 2, Her2/neu) and prediagnosis serum TSH data (n = 437) were included. All patients had 1 of 6 receptor profiles: ER+ PR+ Her2/neu-, ER+ PR- Her2/neu-, ER+ PR+ Her2/neu+, ER+ PR- Her2/neu+, ER- PR- Her2/neu+, or ER- PR- Her2/neu-. Log-transformed serum TSH concentrations were analyzed using multinomial and logistic regressions to identify potential relationships with markers of breast cancer aggressiveness. RESULTS Increasing serum TSH concentration was associated with a lower probability of having the receptor expression profile ER+ PR+ Her2/neu+ compared to patients with the ER+ PR+ Her2/neu- profile (odds ratio [OR] = 0.52, P = .0045). No significant associations between other receptor expression profiles and serum TSH concentration were found. All time-weighted and unweighted median serum TSH concentrations were within normal limits. No significant associations between serum TSH concentration and tumor grade, overall AJCC stage, tumor size (T), lymph node positivity (N), or presence of metastasis (M) were observed. CONCLUSIONS Serum TSH was not associated with markers of breast cancer aggressiveness in our cohort.
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Heublein S, Mayr D, Meindl A, Angele M, Gallwas J, Jeschke U, Ditsch N. Thyroid Hormone Receptors Predict Prognosis in BRCA1 Associated Breast Cancer in Opposing Ways. PLoS One 2015; 10:e0127072. [PMID: 26029931 PMCID: PMC4451081 DOI: 10.1371/journal.pone.0127072] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 04/11/2015] [Indexed: 12/02/2022] Open
Abstract
Since BRCA1 associated breast cancers are frequently classified as hormone receptor negative or even triple negative, the application of endocrine therapies is rather limited in these patients. Like hormone receptors that bind to estrogen or progesterone, thyroid hormone receptors (TRs) are members of the nuclear hormone receptor superfamily. TRs might be interesting biomarkers - especially in the absence of classical hormone receptors. The current study aimed to investigate whether TRs may be specifically expressed in BRCA1 associated cancer cases and whether they are of prognostic significance in these patients as compared to sporadic breast cancer cases. This study analyzed TRα and TRβ immunopositivity in BRCA1 associated (n = 38) and sporadic breast cancer (n = 86). Further, TRs were studied in MCF7 (BRCA1 wildtype) and HCC3153 (BRCA1 mutated) cells. TRβ positivity rate was significantly higher in BRCA1 associated as compared to sporadic breast cancers (p = 0.001). The latter observation remained to be significant when cases that had been matched for clinicopathological criteria were compared (p = 0.037). Regarding BRCA1 associated breast cancer cases TRβ positivity turned out to be a positive prognostic factor for five-year (p = 0.007) and overall survival (p = 0.026) while TRα positivity predicted reduced five-year survival (p = 0.030). Activation of TRβ resulted in down-modulation of CTNNB1 while TRα inhibition reduced cell viability in HCC3153. However, only BRCA1 wildtype MCF7 cells were capable of rapidly degrading TRα1 in response to T3 stimulation. Significantly, this study identified TRβ to be up-regulated in BRCA1 associated breast cancer and revealed TRs to be associated with patients’ prognosis. TRs were also found to be expressed in triple negative BRCA1 associated breast cancer. Further studies need to be done in order to evaluate whether TRs may become interesting targets of endocrine therapeutic approaches, especially when tumors are triple-negative.
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Affiliation(s)
- Sabine Heublein
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Munich, Germany
- * E-mail:
| | - Doris Mayr
- Department of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Alfons Meindl
- Department of Obstetrics and Gynecology, Technical University of Munich, Munich, Germany
| | - Martin Angele
- Department of Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Julia Gallwas
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Nina Ditsch
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Munich, Germany
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KEMAL YASEMIN, DEMIRAG GUZIN, EKIZ KUBILAY, YUCEL IDRIS. Antithyroid peroxidase antibody positivity is associated with lower incidence of metastasis in breast cancer. Mol Clin Oncol 2015; 3:629-632. [PMID: 26137279 PMCID: PMC4471579 DOI: 10.3892/mco.2015.521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/30/2015] [Indexed: 01/31/2023] Open
Abstract
Thyroid extracts were first used to treat patients with metastatic breast cancer over a century ago. Since then, a number of studies have investigated the association between thyroid disorders and breast cancer. The presence of antibodies to thyroid peroxidase (TPOab) was recently reported to be associated with improved outcome in these patients. The aim of the present study was to evaluate the association between TPOab positivity and clinicopathological characteristics in breast cancer patients. The study included 318 newly diagnosed cases of breast cancer treated at Ondokuz Mayis University Hospital, Samsun, Turkey, between 2008 and 2012. Serum thyroid-stimulating hormone, free triiodothyronine and free thyroxine levels were measured at the time of diagnosis. Of the 318 patients, 253 were considered to be TPOab-negative (TPOab ≤34 IU/ml) and 65 TPOab-positive (TPOab >34 IU/ml). No cases with distant metastases were found in the TPOab-positive group. However, 20 (7.9%) of the 253 patients displayed distant metastases in the TPOab-negative group (P=0.01). Therefore, TPOab positivity was found to be associated with a lower incidence of metastasis in breast cancer patients.
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Affiliation(s)
- YASEMIN KEMAL
- Department of Medical Oncology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55139, Turkey
| | - GUZIN DEMIRAG
- Department of Medical Oncology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55139, Turkey
| | - KUBILAY EKIZ
- Department of Internal Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun 55139, Turkey
| | - IDRIS YUCEL
- Department of Medical Oncology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55139, Turkey
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Özmen T, Güllüoğlu BM, Yegen CŞ, Soran A. Autoimmune Thyroid Disease and Breast Cancer Prognosis. THE JOURNAL OF BREAST HEALTH 2015; 11:67-71. [PMID: 28331694 DOI: 10.5152/tjbh.2015.2462] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 01/06/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The association of breast cancer and thyroid autoimmunity has been suggested by many studies in the literature, but the causality still needed to be proven. With this study we aimed to search the correlation between thyroid autoimmunity and breast cancer prognostic factors. MATERIALS AND METHODS To this prospective cohort study 200 consecutive breast cancer patients, who were operated in our clinic were included. Patients' serum thyroid hormone, anti-thyroglobuline (anti-TG) and anti-thyroid peroxidase (anti-TPO) levels and tumors' prognostic parameters (tumor size, axillary involvement, histological grade, lymphovascular invasion, receptor status, Ki-67 proliferation index) were collected. The correlation between serum thyroid autoantibody levels and tumor's prognostic factors were studied. RESULTS The prevalence of thyroid autoimmunity (high levels of serum anti-TPO and/or anti-TG) was 18.5% (n=37). Patients with thyroid autoimmunity had a significant lower rate of axillary involvement and a lower rate of Ki-67 proliferation index (22% vs. 46% [p=0,007] and 12.73% vs. 20.72% [p=0.025], respectively) and were more commonly included to the "low-risk" group (<14%) according to their Ki-67 scores (68% vs. 46%; p=0.015). Other parameters did not differ between the two groups. CONCLUSION We found a favorable correlation between thyroid autoimmunity and axillary involvement and also Ki-67 proliferation index score, which are two crucial and strongly predictive parameters of breast cancer prognoses. This supports the idea of thyroid autoimmunity being a favorable prognostic parameter. Further studies are necessary to investigate the reasons of protective or predictive effect of high thyroid peroxidase levels in breast cancer patients.
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Affiliation(s)
- Tolga Özmen
- Department of General Surgery, Marmara University Faculty of Medicine, İstanbul, Turkey
| | | | - Cumhur Şevket Yegen
- Department of General Surgery, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Atilla Soran
- Department of General Surgery, Magee Womens Hospital of UPMC, Pittsburgh, ABD
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Zhang C, Zhao H, Li J, Liu H, Wang F, Wei Y, Su J, Zhang D, Liu T, Zhang Y. The identification of specific methylation patterns across different cancers. PLoS One 2015; 10:e0120361. [PMID: 25774687 PMCID: PMC4361543 DOI: 10.1371/journal.pone.0120361] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/20/2015] [Indexed: 12/16/2022] Open
Abstract
Abnormal DNA methylation is known as playing an important role in the tumorgenesis. It is helpful for distinguishing the specificity of diagnosis and therapeutic targets for cancers based on characteristics of DNA methylation patterns across cancers. High throughput DNA methylation analysis provides the possibility to comprehensively filter the epigenetics diversity across various cancers. We integrated whole-genome methylation data detected in 798 samples from seven cancers. The hierarchical clustering revealed the existence of cancer-specific methylation pattern. Then we identified 331 differentially methylated genes across these cancers, most of which (266) were specifically differential methylation in unique cancer. A DNA methylation correlation network (DMCN) was built based on the methylation correlation between these genes. It was shown the hubs in the DMCN were inclined to cancer-specific genes in seven cancers. Further survival analysis using the part of genes in the DMCN revealed high-risk group and low-risk group were distinguished by seven biomarkers (PCDHB15, WBSCR17, IGF1, GYPC, CYGB, ACTG2, and PRRT1) in breast cancer and eight biomarkers (ZBTB32, OR51B4, CCL8, TMEFF2, SALL3, GPSM1, MAGEA8, and SALL1) in colon cancer, respectively. At last, a protein-protein interaction network was introduced to verify the biological function of differentially methylated genes. It was shown that MAP3K14, PTN, ACVR1 and HCK sharing different DNA methylation and gene expression across cancers were relatively high degree distribution in PPI network. The study suggested that not only the identified cancer-specific genes provided reference for individual treatment but also the relationship across cancers could be explained by differential DNA methylation.
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Affiliation(s)
- Chunlong Zhang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Hongyan Zhao
- Department of Gastroenterology, The fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jie Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Hongbo Liu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Fang Wang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Yanjun Wei
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Jianzhong Su
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Dongwei Zhang
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tiefu Liu
- Department of Gastroenterology, The fourth Affiliated Hospital of Harbin Medical University, Harbin, China
- * E-mail: (YZ); (TL)
| | - Yan Zhang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
- * E-mail: (YZ); (TL)
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Patel A, Roston A, Uy A, Radeke E, Roston A, Keith L, Zaren HA. Reproductive health and endocrine disruption in women with breast cancer: a pilot study. Support Care Cancer 2014; 23:411-8. [PMID: 25120011 DOI: 10.1007/s00520-014-2381-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 07/31/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to assess whether incorporation of an original reproductive health assessment and algorithm into breast cancer care helps providers appropriately manage patient reproductive health goals and to follow laboratory markers for fertility and correlate these with menstruation. METHODS This prospective observational pilot study was set in an urban, public hospital. Newly diagnosed premenopausal breast cancer patients between 18 and 49 years old were recruited for this study prior to chemotherapy initiation. As the intervention, these patients received a reproductive health assessment and care per the study algorithm at 3-month intervals for 24 months. Blood samples were also collected at the same time intervals. The main outcome measures were to assess if the reproductive health management was consistent with patient goals and to track any follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH) level changes throughout treatment and post-treatment period. RESULTS Two patients were pregnant at study initiation. They received obstetric consultations, opted to continue pregnancies, and postpone treatment; both delivered at term without complications. One woman desired future childbearing and received fertility preservation counseling. All women received family planning consultations and received/continued effective contraceptive methods. Seventy-three percent used long-term contraception, 18 % remained abstinent, and 9 % used condoms. During chemotherapy, FSH rose to menopausal levels in 82 % of patients and TSH rose significantly in 9 %. While 82 % of women experienced amenorrhea, 44 % of these women resumed menstruation after chemotherapy. CONCLUSIONS The assessment and algorithm were useful in managing patients' reproductive health needs. Chemotherapy-induced endocrine disruption impacted reproductive health.
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Affiliation(s)
- Ashlesha Patel
- Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, 1900 W. Polk St., Room #435, Chicago, IL, 60612, USA,
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Park CM, Lee YD, Oh EM, Kim KI, Park HK, Ko KP, Chung YS. The prognosis and treatment of primary thyroid cancer occurred in breast cancer patients: comparison with ordinary thyroid cancer. Ann Surg Treat Res 2014; 86:169-76. [PMID: 24783175 PMCID: PMC3996722 DOI: 10.4174/astr.2014.86.4.169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 10/13/2013] [Accepted: 10/24/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Due to the increased prevalence of thyroid cancer, it has been frequently detected in breast cancer patients recently. The aim of this study was to evaluate the clinicopathologic characteristics of thyroid cancer in breast cancer patients with respect to prognosis and treatment. METHODS From August 1998 to September 2012, 101 breast cancer patients were diagnosed with thyroid cancer (BT group). One hundred ninety-three female patients with a thyroid malignancy that underwent thyroidectomy in 2008 were recruited as controls (oT group). The clinicopathologic results of these two groups were compared. RESULTS Patients were older (51.40 vs. 47.16, P < 0.001), mean tumor size was smaller (0.96 cm vs. 1.43 cm, P < 0.001), and extrathyroidal extension was less common in the BT group. In both groups, papillary thyroid carcinoma was the most common type of thyroid malignancy. T and N classifications of thyroid cancer were less severe in the BT group, but group TNM stages were similar. Endoscopic thyroid surgery was performed in 12.9% of patients in the BT group and in 6.7% of patients in the oT group. Postoperative radioactive iodine ablation was performed less often in the BT group (P < 0.001). Group recurrence rates were not significantly different. CONCLUSION Thyroid cancer in breast cancer patients was diagnosed at earlier status than ordinary thyroid cancer. However, the prognosis of thyroid cancer in breast cancer patients was not superior to that in patients with thyroid cancer alone. Radioactive iodine ablation was performed less often and endoscopic surgery could be performed in breast cancer patients.
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Affiliation(s)
- Chang Min Park
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea
| | - Young Don Lee
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea. ; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Eun Mee Oh
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kwan-Il Kim
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Heung Kyu Park
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea. ; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Kwang-Pil Ko
- Department of Preventive Medicine, Gachon University School of Medicine, Gachon University, Incheon, Korea
| | - Yoo Seung Chung
- Department of Surgery, Gachon University School of Medicine, Gachon University, Incheon, Korea. ; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
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Thyroid hormone status interferes with estrogen target gene expression in breast cancer samples in menopausal women. ISRN ENDOCRINOLOGY 2014; 2014:317398. [PMID: 24701358 PMCID: PMC3950583 DOI: 10.1155/2014/317398] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/11/2014] [Indexed: 11/21/2022]
Abstract
We investigated thyroid hormone levels in menopausal BrC patients and verified the action of triiodothyronine on genes regulated by estrogen and by triiodothyronine itself in BrC tissues. We selected 15 postmenopausal BrC patients and a control group of 18 postmenopausal women without BrC. We measured serum TPO-AB, TSH, FT4, and estradiol, before and after surgery, and used immunohistochemistry to examine estrogen and progesterone receptors. BrC primary tissue cultures received the following treatments: ethanol, triiodothyronine, triiodothyronine plus 4-hydroxytamoxifen, 4-hydroxytamoxifen, estrogen, or estrogen plus 4-hydroxytamoxifen. Genes regulated by estrogen (TGFA, TGFB1, and PGR) and by triiodothyronine (TNFRSF9, BMP-6, and THRA) in vitro were evaluated. TSH levels in BrC patients did not differ from those of the control group (1.34 ± 0.60 versus 2.41 ± 1.10 μU/mL), but FT4 levels of BrC patients were statistically higher than controls (1.78 ± 0.20 versus 0.95 ± 0.16 ng/dL). TGFA was upregulated and downregulated after estrogen and triiodothyronine treatment, respectively. Triiodothyronine increased PGR expression; however 4-hydroxytamoxifen did not block triiodothyronine action on PGR expression. 4-Hydroxytamoxifen, alone or associated with triiodothyronine, modulated gene expression of TNFRSF9, BMP-6, and THRA, similar to triiodothyronine treatment. Thus, our work highlights the importance of thyroid hormone status evaluation and its ability to interfere with estrogen target gene expression in BrC samples in menopausal women.
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Estrogen-responsive genes overlap with triiodothyronine-responsive genes in a breast carcinoma cell line. ScientificWorldJournal 2014; 2014:969404. [PMID: 24587767 PMCID: PMC3920670 DOI: 10.1155/2014/969404] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 10/19/2013] [Indexed: 11/18/2022] Open
Abstract
It has been well established that estrogen plays an important role in the progression and treatment of breast cancer. However, the role of triiodothyronine (T₃) remains controversial. We have previously shown its capacity to stimulate the development of positive estrogen receptor breast carcinoma, induce the expression of genes (PR, TGF-alpha) normally stimulated by estradiol (E₂), and suppress genes (TGF-beta) normally inhibited by E₂. Since T₃ regulates growth hormones, metabolism, and differentiation, it is important to verify its action on other genes normally induced by E₂. Therefore, we used DNA microarrays to compare gene expression patterns in MCF-7 breast adenocarcinoma cells treated with E₂ and T₃. Several genes were modulated by both E₂ and T₃ in MCF-7 cells (Student's t-test, P < 0.05). Specifically, we found eight genes that were differentially expressed after treatment with both E₂ and T₃, including amphiregulin, fibulin 1, claudin 6, pericentriolar material 1, premature ovarian failure 1B, factor for adipocyte differentiation-104, sterile alpha motif domain containing 9, and likely ortholog of rat vacuole membrane protein 1 (fold change > 2.0, pFDR < 0.05). We confirmed our microarray results by real-time PCR. Our findings reveal that certain genes in MCF-7 cells can be regulated by both E₂ and T₃.
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Jung SJ, Song M, Choi JY, Song N, Park SK, Yoo KY, Kang D. Association of selected medical conditions with breast cancer risk in Korea. J Prev Med Public Health 2013; 46:346-52. [PMID: 24349656 PMCID: PMC3859856 DOI: 10.3961/jpmph.2013.46.6.346] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/17/2013] [Indexed: 12/11/2022] Open
Abstract
Objectives To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study. Methods The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer. Results Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer. Conclusions Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.
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Affiliation(s)
- Sun Jae Jung
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Minkyo Song
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Ji-Yeob Choi
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Nan Song
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Sue Kyung Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Keun-Young Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
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Associations between adjuvant endocrine therapy and onset of physical and emotional concerns among breast cancer survivors. Support Care Cancer 2013; 22:937-45. [PMID: 24271937 DOI: 10.1007/s00520-013-2041-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 10/28/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Breast cancer survivors often receive long-term adjuvant endocrine therapy (AET) to reduce recurrence risk. Adherence to AET is suboptimal, which may be due to the experience of symptoms and/or concerns. Few studies have comprehensively assessed self-reported concerns between those who currently, previously or have never received AET. The study objective is to describe self-reported physical and emotional concerns of breast cancer survivors who are current, prior, or never-recipients of AET. METHODS Secondary analysis was performed on a subset of survey data collected in the 2010 LIVESTRONG Survey. Breast cancer survivors (n = 1,013, mean 5.4 years post-diagnosis) reported on 14 physical and eight emotional concerns that began after diagnosis and were experienced within 6 months of participation in the survey. Bivariate analyses examined the prevalence of each concern by AET status. The relationships between AET and burden of physical or emotional concerns were modeled with logistic regression. RESULTS More than 50% of the participants reported currently experiencing cognitive issues, fatigue, fear of recurrence, emotional distress, and identity/grief issues. Thyroid dysfunction and stigma concerns were more common among participants with prior AET (p < 0.01), while fear of recurrence, emotional distress, and concern about appearance were more common among those currently receiving AET (p < 0.01). Fatigue, sexual dysfunction, and pain were more common among prior and current AET recipients (p < 0.01). In adjusted models, receipt of AET was associated with a higher number of physical, but not emotional concerns. A higher number of concerns was associated with younger age, having children, receipt of chemotherapy, longer duration of cancer treatment, and shorter time since diagnosis (p < 0.01). CONCLUSIONS Breast cancer survivors who received AET were at risk of developing a variety of physical and emotional concerns, many of which persisted after treatment. These findings suggest the importance of developing individualized, supportive resources for breast cancer survivors.
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Chen YK, Lin CL, Chang YJ, Cheng FTF, Peng CL, Sung FC, Cheng YH, Kao CH. Cancer risk in patients with Graves' disease: a nationwide cohort study. Thyroid 2013; 23:879-84. [PMID: 23421548 PMCID: PMC3704114 DOI: 10.1089/thy.2012.0568] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The possibility of an association of Graves' disease (GD) with subsequent cancers has been previously reported. METHODS Our study used the Taiwanese National Health Insurance Research Database (NHIRD), which identified 5025 newly diagnosed GD patients from 1997 to 2010, and 20,100 frequency matched non-GD patients. The risk of developing cancer for GD patients was measured using the Cox proportional hazard model. RESULTS The incidence of developing cancer in the GD cohort was 4.92 per 1000 person-years and was 1.37-fold higher than in the comparison cohort (p<0.001). Compared with patients aged 20-34 years, older age groups demonstrated a higher risk of developing cancer (35-49 years: hazard ratio (HR)=4.15; 50-64 years: HR=7.39;≥65 years: HR=13.4). After adjusting for sex, age, and comorbidities, the HR for developing breast cancer and thyroid cancer was 1.58- and 10.4-fold higher for patients with GD. Furthermore, the incidence rates (IRR) were the highest in the first three years: 2.06 [confidence interval (CI)=1.87-2.27] and 15.6 [CI=13.9-17.5] in breast cancer and thyroid cancer with GD respectively. Specifically, a 16-fold hazard of developing thyroid cancer was present in the first three years in the GD cohort compared to the non-GD cohort [CI=7.95-32.1]. CONCLUSIONS GD patients have a higher risk of cancer, particularly thyroid and breast cancer sequent within six and three years respectively. Strategies for preventing thyroid and breast cancer are proposed.
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Affiliation(s)
- Yen-Kung Chen
- Department of Nuclear Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of PET Center, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University, Taichung, Taiwan
| | - Yen-Jung Chang
- Management Office for Health Data, China Medical University, Taichung, Taiwan
| | - Fiona Tsui-Fen Cheng
- Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Surgery, National Defense Medical Center, Taipei, Taiwan
| | - Chiao-Ling Peng
- Management Office for Health Data, China Medical University, Taichung, Taiwan
| | - Fung-Chang Sung
- Department of Public Health, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ya-Hsin Cheng
- Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Autoimmune thyroid disorders. ISRN ENDOCRINOLOGY 2013; 2013:509764. [PMID: 23878745 PMCID: PMC3710642 DOI: 10.1155/2013/509764] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 06/04/2013] [Indexed: 11/25/2022]
Abstract
Purpose of Review. Studies have been published in the field of autoimmune thyroid diseases since January 2005. The review is organized into areas of etiology, autoimmune features, autoantibodies, mechanism of thyroid cell injury, B-cell responses, and T-cell responses. Also it reviews the diagnosis and the relationship between autoimmune thyroid disease, neoplasm, and kidney disorders. Recent Findings. Autoimmune thyroid diseases have been reported in people living in different parts of the world including North America, Europe, Baalkans, Asia, Middle East, South America, and Africa though the reported figures do not fully reflect the number of people infected per year. Cases are unrecognized due to inaccurate diagnosis and hence are treated as other diseases. However, the most recent studies have shown that the human autoimmune thyroid diseases (AITDs) affect up to 5% of the general population and are seen mostly in women between 30 and 50 years. Summary. Autoimmune thyroid disease is the result of a complex interaction between genetic and environmental factors. Overall, this review has expanded our understanding of the mechanism involved in pathogenesis of AITD and the relationship between autoimmune thyroid disease, neoplasm, and kidney disease. It has opened new lines of investigations that will ultimately result in a better clinical practice.
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Szychta P, Szychta W, Gesing A, Lewiński A, Karbownik-Lewińska M. TSH receptor antibodies have predictive value for breast cancer - retrospective analysis. Thyroid Res 2013; 6:8. [PMID: 23680448 PMCID: PMC3662571 DOI: 10.1186/1756-6614-6-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 05/05/2013] [Indexed: 11/22/2022] Open
Abstract
Background Associations between breast cancer and thyroid disorders are reported in numerous studies. Relationships between thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and breast cancer have been previously demonstrated. However, no analysis has been performed concerning an association between thyrotropin (TSH) receptor antibodies (TSHRAb) and breast cancer. The aim of the study was to evaluate the prevalence of breast cancer or benign breast tumors in patients with Graves’ disease and to analyze a possible relationship between Graves’ disease and these two groups of breast diseases with emphasis to epidemiology and laboratory findings. Patients and methods Clinical and laboratory details of 2003 women hospitalized for endocrine disorders were retrospectively analyzed, using an unpaired Student’s t-test, logistic regression analysis, χ2 test of independence or the two-sided ratio comparison test. Results The coexistence of Graves’ disease and breast cancer was statistically significant. We observed TSHRAb and TgAb more frequently in patients with breast cancer. We found that TSHRAb is the only variable possessing predictive value for breast cancer. Conclusions The strong relationship between Graves’ disease and breast cancer is proposed. We suggest that TSHRAb could be described as a positive determinant of breast cancer. The present data call attention to the usefulness of screening for breast cancer in long-term follow-up of patients with autoimmune thyroid disorders, especially of those with Graves’ disease. Similarly, screening for autoimmune thyroid disorders should be performed in patients with nodular breast disease. Additionally, the article draws ideas for further research in order to develop targeted treatment for more successful outcome in patients with breast cancer.
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Affiliation(s)
- Paweł Szychta
- Department of Oncological Endocrinology, Medical University of Lodz, 7/9 Zeligowski St,, 90-752, Lodz, Poland.
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Abstract
BACKGROUND Autoimmune thyroid disease (AITD), a common organ specific autoimmune disorder is seen mostly in women between 30-50 yrs of age. Thyroid autoimmunity can cause several forms of thyroiditis ranging from hypothyroidism (Hashimoto's thyroiditis) to hyperthyroidism (Graves'Disease). Prevalence rate of autoimmune mediated hypothyroidism is about 0.8 per 100 and 95% among them are women. Graves' disease is about one tenth as common as hypothyroidism and tends to occur more in younger individuals. Both these disorders share many immunologic features and the disease may progress from one state to other as the autoimmune process changes. Genetic, environmental and endogenous factors are responsible for initiation of thyroid autoimmunity. At present the only confirmed genetic factor lies in HLA complex (HLA DR-3) and the T cell regulatory gene (CTLA 4). A number of environmental factors like viral infection, smoking, stress & iodine intake are associated with the disease progression. The development of antibodies to thyroid peroxidase (TPO) thyroglobulin (TG) and Thyroid stimulating hormone receptor (TSH R) is the main hallmark of AITD. Circulating T Lymphocytes are increased in AITD and thyroid gland is infiltrated with CD4+ and CD8+ T Cells. Wide varieties of cytokines are produced by infiltrated immune cells, which mediate cytotoxicity leading to thyroid cell destruction. Circulating antibodies to TPO and TG are measured by immunofluorescense, hemagglutination, ELISA & RIA. TSHR antibodies of Graves' disease can be measured in bioassays or indirectly in assays that detect antibody binding to the receptor.
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Affiliation(s)
- Manorama Swain
- Department of Biochemistry, M.K.C.G. Medical College, 760 004 Berhampur
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Muller I, Pinchera A, Fiore E, Belardi V, Rosellini V, Giustarini E, Giani C. High prevalence of breast cancer in patients with benign thyroid diseases. J Endocrinol Invest 2011; 34:349-52. [PMID: 20595798 DOI: 10.1007/bf03347458] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In patients with breast cancer (BC) a high prevalence of benign thyroid diseases (BTD) has been described, Hashimoto's thyroiditis accounting to a large extent for this association. The aim of this study was to evaluate the prevalence of BC in a large group of patients with BTD. PATIENTS Clinical records of 622 consecutive patients with BTD were examined. BC prevalence in BTD patients was compared with BC frequency in general population living in the same country. RESULTS BC prevalence in patients with BTD (38/622; 6.11%) was significantly higher (p=0.0002) compared to BC frequency in general population (2.07%). When patients were divided according to the age of menopause, in females older than 49 yr BC frequency in BTD was significantly higher than in age-matched population (7.6 vs 3.3%; p=0.006), while in females aged 30-49 yr BC frequency in BTD was higher, but not statistically significantly, than in agematched population (3.7 vs 0.5%; p=0.06). No significant difference in BC prevalence was found when patients were grouped according to the diagnosis of thyroid disorders: Graves' disease, Hashimoto's thyroiditis, nodular goiter associated or not associated with serum thyroid autoantibodies (TAb). No significant difference in BC frequency was observed between TAb+ (26/377; 6.9%) and TAb- (12/245; 4.9%) patients. The distribution of known risk factors for breast malignancies was similar in patients with or without BC. CONCLUSION In patients with BTD the prevalence of BC is significantly higher than the expected, showing the usefulness of screening for breast malignancy of patients with BTD.
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Affiliation(s)
- I Muller
- Department of Endocrinology, University of Pisa, Via Paradisa 2, 56100 Pisa, Italy.
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Mutation of thyroid hormone receptor-β in mice predisposes to the development of mammary tumors. Oncogene 2011; 30:3381-90. [PMID: 21399657 DOI: 10.1038/onc.2011.50] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Correlative data suggest that thyroid hormone receptor-β (TRβ) mutations could increase the risk of mammary tumor development, but unequivocal evidence is still lacking. To explore the role of TRβ mutants in vivo in breast tumor development and progression, we took advantage of a knock-in mouse model harboring a mutation in the Thrb gene encoding TRβ (Thrb(PV) mouse). Although in adult nulliparous females, a single ThrbPV allele did not contribute to mammary gland abnormalities, the presence of two ThrbPV alleles led to mammary hyperplasia in ∼36% Thrb(PV/PV) mice. The ThrbPV mutation further markedly augmented the risk of mammary hyperplasia in a mouse model with high susceptibility to mammary tumors (Pten(+/-) mouse), as demonstrated by the occurrence of mammary hyperplasia in ∼60% of Thrb(PV/+)Pten(+/-) and ∼77% of Thrb(PV/PV)Pten(+/-) mice versus ∼33% of Thrb(+/+)Pten(+/-) mice. The Thrb(PV) mutation increased the activity of signal transducer and activator of transcription (STAT5) to increase cell proliferation and the expression of the STAT5 target gene encoding β-casein in the mammary gland. We next sought to understand the molecular mechanism underlying STAT5 overactivation by TRβPV. Cell-based studies with a breast cancer cell line (T47D cells) showed that thyroid hormone (T3) repressed STAT5 signaling in TRβ-expressing cells through decreasing STAT5-mediated transcription activity and target gene expression, whereas sustained STAT5 signaling was observed in TRβPV-expressing cells. Collectively, these findings show for the first time that a TRβ mutation promotes the development of mammary hyperplasia via aberrant activation of STAT5, thereby conferring a fertile genetic ground for tumorigenesis.
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Carrera-González MP, Ramírez-Expósito MJ, de Saavedra JMA, Sánchez-Agesta R, Mayas MD, Martínez-Martos JM. Hypothalamus-pituitary-thyroid axis disruption in rats with breast cancer is related to an altered endogenous oxytocin/insulin-regulated aminopeptidase (IRAP) system. Tumour Biol 2011; 32:543-9. [PMID: 21207221 DOI: 10.1007/s13277-010-0149-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 12/13/2010] [Indexed: 11/24/2022] Open
Abstract
Associations of breast cancer with diseases of the thyroid have been repeatedly reported, but the mechanism underlying this association remains to be elucidated. It has been reported that oxytocin (OXT) attenuates the thyroid-stimulating hormone (TSH) release in response to thyrotrophin-releasing hormone (TRH) and decreased plasma levels of TSH as well as the thyroid hormones by an effect mediated by the central nervous system. Oxytocinase (IRAP) is the regulatory proteolytic enzyme reported to hydrolyze OXT. Changes in IRAP activity have been reported in both human breast cancer and N-methyl-nitrosourea (NMU)-induced rat mammary tumours. Here, we measure IRAP activity fluorometrically using cystyl-β-naphthylamide as the substrate, in the hypothalamus-pituitary-thyroid axis together with the circulating levels of OXT, and its relationship with circulating levels of TSH and free thyroxine (fT4), as markers of thyroid function in control rats and rats with breast cancer induced by NMU. We found decreased thyroid function in rats with breast cancer induced by NMU, supported by the existence of lower serum circulating levels of both TSH and fT4 than their corresponding controls. Concomitantly, we found a decrease of hypothalamic IRAP activity and an increase in circulating levels of OXT. We propose that breast cancer increases OXT pituitary release by decreasing its hypothalamic catabolism through IRAP activity, probably due to the alteration of the estrogenic endocrine status. Thus, high circulating levels of OXT decreased TSH release from the pituitary, and therefore, of thyroid hormones from the thyroid, supporting the association between breast cancer and thyroid function disruption.
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Affiliation(s)
- María Pilar Carrera-González
- Experimental and Clinical Physiopathology Research Group, Department of Health Sciences, Faculty of Experimental and Health Sciences, University of Jaén, Campus Universitario Las Lagunillas, 23071, Jaén, Spain.
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Tosovic A, Bondeson AG, Bondeson L, Ericsson UB, Malm J, Manjer J. Prospectively measured triiodothyronine levels are positively associated with breast cancer risk in postmenopausal women. Breast Cancer Res 2010; 12:R33. [PMID: 20540734 PMCID: PMC2917028 DOI: 10.1186/bcr2587] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 05/13/2010] [Accepted: 06/11/2010] [Indexed: 12/19/2022] Open
Abstract
Introduction The potential association between hypo- and hyperthyroid disorders and breast cancer has been investigated in a large number of studies during the last decades without conclusive results. This prospective cohort study investigated prediagnostic levels of thyrotropin (TSH) and triiodothyronine (T3) in relation to breast cancer incidence in pre- and postmenopausal women. Methods In the Malmö Preventive Project, 2,696 women had T3 and/or TSH levels measured at baseline. During a mean follow-up of 19.3 years, 173 incident breast cancer cases were retrieved using record linkage with The Swedish Cancer Registry. Quartile cut-points for T3 and TSH were based on the distribution among all women in the study cohort. A Cox's proportional hazards analysis was used to estimate relative risks (RR), with a confidence interval (CI) of 95%. Trends over quartiles of T3 and TSH were calculated considering a P-value < 0.05 as statistically significant. All analyses were repeated for pre- and peri/postmenopausal women separately. Results Overall there was a statistically significant association between T3 and breast cancer risk, the adjusted RR in the fourth quartile, as compared to the first, was 1.87 (1.12 to 3.14). In postmenopausal women the RRs for the second, third and fourth quartiles, as compared to the first, were 3.26 (0.96 to 11.1), 5.53 (1.65 to 18.6) and 6.87 (2.09 to 22.6), (P-trend: < 0.001). There were no such associations in pre-menopausal women, and no statistically significant interaction between T3 and menopausal status. Also, no statistically significant association was seen between serum TSH and breast cancer. Conclusions This is the first prospective study on T3 levels in relation to breast cancer risk. T3 levels in postmenopausal women were positively associated with the risk of breast cancer in a dose-response manner.
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Affiliation(s)
- Ada Tosovic
- Department of Surgery, Skåne University Hospital Malmö, Malmö, Sweden.
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Rennert G, Rennert HS, Pinchev M, Gruber SB. A case-control study of levothyroxine and the risk of colorectal cancer. J Natl Cancer Inst 2010; 102:568-72. [PMID: 20305129 DOI: 10.1093/jnci/djq042] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Levothyroxine is a synthetic T(4) hormone commonly used to treat thyroid disease. Increased incidence of mostly autoimmune thyroid disease has been associated with breast and other malignancies, and thyroid hormone levels might also be associated with risk of colorectal cancer (CRC). In this population-based matched case-control study (2566 pairs) of CRC in northern Israel, use of levothyroxine for at least 5 years was assessed using structured interviews and validated by prescription records. The analysis included use of statins, aspirin, and hormone replacement therapy; CRC family history; physical activity; vegetable consumption; ethnicity; age; and sex. All statistical tests were two-sided. The use of levothyroxine was associated with a statistically significantly reduced relative risk of CRC (odds ratio = 0.59, 95% confidence interval = 0.43 to 0.82, P = .001). This association remained statistically significant after adjustment for age, sex, use of aspirin and statins, sports activity, family history of CRC, ethnic group, and level of vegetable consumption (odds ratio = 0.60, 95% confidence interval = 0.44 to 0.81, P = .001). No statistically significant interactions were seen between use of levothyroxine and aspirin, statins, or hormone replacement therapy.
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Affiliation(s)
- Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa 34362, Israel.
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40
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Erdman SE, Rao VP, Olipitz W, Taylor CL, Jackson EA, Levkovich T, Lee CW, Horwitz BH, Fox JG, Ge Z, Poutahidis T. Unifying roles for regulatory T cells and inflammation in cancer. Int J Cancer 2010; 126:1651-65. [PMID: 19795459 DOI: 10.1002/ijc.24923] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Activities of CD4(+) regulatory (T(REG)) cells restore immune homeostasis during chronic inflammatory disorders. Roles for T(REG) cells in inflammation-associated cancers, however, are paradoxical. It is widely believed that T(REG) function in cancer mainly to suppress protective anticancer responses. However, we demonstrate here that T(REG) cells also function to reduce cancer risk throughout the body by efficiently downregulating inflammation arising from the gastrointestinal (GI) tract. Building on a "hygiene hypothesis" model in which GI infections lead to changes in T(REG) that reduce immune-mediated diseases, here we show that gut bacteria-triggered T(REG) may function to inhibit cancer even in extraintestinal sites. Ability of bacteria-stimulated T(REG) to suppress cancer depends on interleukin (IL)-10, which serves to maintain immune homeostasis within bowel and support a protective antiinflammatory T(REG) phenotype. However, under proinflammatory conditions, T(REG) may fail to provide antiinflammatory protection and instead contribute to a T helper (Th)-17-driven procarcinogenic process; a cancer state that is reversible by downregulation of inflammation. Consequently, hygienic individuals with a weakened IL-10 and T(REG)-mediated inhibitory loop are highly susceptible to the carcinogenic consequences of elevated IL-6 and IL-17 and show more frequent inflammation-associated cancers. Taken together, these data unify seemingly divergent disease processes such as autoimmunity and cancer and help explain the paradox of T(REG) and inflammation in cancer. Enhancing protective T(REG) functions may promote healthful longevity and significantly reduce risk of cancer.
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MESH Headings
- Adenomatous Polyposis Coli Protein/physiology
- Animals
- Blotting, Western
- Cytokines/genetics
- Cytokines/metabolism
- DNA-Binding Proteins/physiology
- Disease Models, Animal
- Female
- Flow Cytometry
- Helicobacter Infections/immunology
- Helicobacter Infections/microbiology
- Helicobacter Infections/prevention & control
- Helicobacter hepaticus/pathogenicity
- Immunoenzyme Techniques
- Inflammation/immunology
- Inflammation/microbiology
- Inflammation/prevention & control
- Interleukin-10/physiology
- Mammary Neoplasms, Animal/immunology
- Mammary Neoplasms, Animal/microbiology
- Mammary Neoplasms, Animal/prevention & control
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptor, ErbB-2/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- T-Lymphocytes, Regulatory/immunology
- Tumor Cells, Cultured
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Affiliation(s)
- Susan E Erdman
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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41
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Sabitha, Suneetha, Mohanty S, Rao P. Serum anti - TPO levels in benign and malignant breast tumors. Indian J Clin Biochem 2009; 24:266-8. [PMID: 23105847 DOI: 10.1007/s12291-009-0050-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Breast cancer is a hormone dependent neoplasm. Conflicting results regarding the clinical correlation between breast cancer and thyroid diseases have been reported. The objective of this study was to determine the association of anti - TPO levels in patients having complaints of a lump in breast. Serum samples and Fine needle aspiration cytology (FNAC) samples were collected from 31 female patients with a lump in breast between the age group of 20-75 years. 31 age matched normal healthy controls were also examined for the same parameters. Serum samples were analyzed for its anti - TPO levels. FNAC reports confirmed patients as having duct cell carcinoma. They had raised serum anti - TPO levels compared to controls. FNAC results of others (n=26) were reported as fibroadenoma whose anti - TPO levels were less than the controls.
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Affiliation(s)
- Sabitha
- Kamineni Institute of Medical Sciences, Sreepuram, Narketpally, Nalgonda, 508254 Andhra Pradesh India
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Oh HJ, Chung JK, Kang JH, Kang WJ, Noh DY, Park IA, Jeong JM, Lee DS, Lee MC. The relationship between expression of the sodium/iodide symporter gene and the status of hormonal receptors in human breast cancer tissue. Cancer Res Treat 2005; 37:247-50. [PMID: 19956522 DOI: 10.4143/crt.2005.37.4.247] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2005] [Accepted: 07/02/2005] [Indexed: 11/21/2022] Open
Abstract
PURPOSE It has been reported that the sodium/iodide symporter (NIS) gene is expressed in several breast cancer tissues, suggesting the possibility of radionuclide imaging and therapy. However, the regulatory mechanism of NIS gene expression in breast cancer is not yet understood. To assess the relationship between the hormonal status and the NIS expression in breast cancer tissue, we investigated the NIS expression and correlated it to the expression of the thyrotropin receptor (thyroid stimulating hormone receptor, TSH-R), the estrogen receptor (ER) and the progesterone receptor (PR) in human breast cancer tissues. MATERIALS AND METHODS Breast cancer tissues were obtained from 44 patients. Pathological examination showed 2 cases of Grade I, 17 of Grade II, 22 of Grade III, and 3 of unknown grade. We measured the expression of NIS and TSH-R genes by using RT-PCR and we measured the status of ER and PR by using immunohistochemistry. RESULTS The NIS gene was expressed in 15 (34%) of the 44 breast cancer tissues. The NIS gene was expressed in 32% of the cases with TSH-R gene expression. The NIS gene was expressed in 40% of the breast cancer tissues with a positive PR and in 31% with a negative PR (p>0.05). It was positive for PR in 18% of the cases and negative for PR in 39% of the cases (p>0.05). CONCLUSION The NIS gene is expressed in approximately one-third of the human breast cancer tissues. Its expression was not related to the presence of the TSH-R gene or hormonal receptors, ER and PR.
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Affiliation(s)
- Hyun Jung Oh
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
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43
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Fierabracci P, Pinchera A, Tonacchera M, Agretti P, De Marco G, Albertini S, Conforti G, Seregni E, Agresti R, Grasso L, Giani C. Absence of interference of serum IgGs from patients with breast cancer and thyroid autoimmunity on the function of human iodide symporter gene stably transfected in CHO cells. J Endocrinol Invest 2004; 27:862-5. [PMID: 15648551 DOI: 10.1007/bf03346281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The cause of the association between breast cancer (BC) and thyroid autoimmunity is still unknown. Na+/I- symporter (NIS) is highly expressed in BC cells, and previous studies demonstrated that iodine content in BC is lower than in remote normal breast tissue, suggesting a disorder of iodide uptake in BC. In this study, we evaluated the presence of putative serum autoantibodies able to block the function of NIS in BC patients with thyroid autoimmunity. IgGs were obtained from: a) 11 patients with BC and high antithyroglobulin (TgAb) and antithyroperoxidase (TPOAb) autoantibodies serum concentration; b) 34 patients with Hashimoto's thyroiditis (HT) (1 was euthyroid, 4 had subclinical hypothyroidism and 29 were overtly hypothyroid); c) 15 control subjects. The biological activity of NIS was studied using a chinese hamster ovary (CHO) cell line stably expressing NIS (NIS-CHO). The course of iodide accumulation in NIS-CHO was studied after addition of Na125 I in culture medium. The accumulation of iodide linearly increased between 2 and 10 min, reaching a plateau at 45 min. The preincubation of NIS-CHO with IgGs purified from sera of BC with the highest levels of TPOAb and TgAb caused an inhibition of iodine uptake of no more than 5%. Similar results were obtained using IgGs purified from patients with HT and control subjects. Our data showed no interference of autoantibodies on iodine uptake in patients with BC and thyroid autoimmunity and the very low percentage of inhibition of iodine uptake cannot explain the lower content of iodine in BC tissue.
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Affiliation(s)
- P Fierabracci
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy.
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Dülger H, Alıcı S, Algün E, Etlik Ö, Sayarlıoğlu M, Doğan E, Sayarlıoğlu H, Şekeroğlu MR. Antithyroid Antibody Levels in Patients with Breast Cancer. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2004. [DOI: 10.29333/ejgm/82174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
A renewal of the search for a link between breast cancer and thyroid disease has once again demonstrated an increased prevalence of autoimmune thyroid disease in patients with breast cancer. This is the most recent of many studies showing an association between a variety of thyroid disorders and breast cancer. Such an association is not surprising as both diseases are female predominant with a similar postmenopausal peak incidence. The significance of the presence of thyroid autoantibodies, particularly thyroid peroxidase antibodies, in serum from patients with breast cancer is unknown, but it has been suggested that antibody positivity is associated with better prognosis. One area in which thyroid and breast functions overlap is in the uptake and utilization of dietary iodide. Experimental findings showing the ability of iodine or iodine-rich seaweed to inhibit breast tumour development is supported by the relatively low rate of breast cancer in Japanese women who consume a diet containing iodine-rich seaweed. However, there is as yet no direct evidence that iodine, iodinated compounds, or a combination of iodine and selenium is the antimammary carcinogenic element in the Japanese diet. It remains to be resolved whether the perceived breast cancer-thyroid disease relationship is thyroid or iodine related or, in the case of thyroid autoantibodies, is the consequence of an immune response to the carcinoma. Is this response breast specific and does it relate to iodine status? These and many other questions await resolution before a definitive role in the natural history of breast carcinoma can be assigned to the thyroid.
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Affiliation(s)
- Peter P A Smyth
- Endocrine laboratory, Department of Medicine and Therapeutics, and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland.
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Turken O, NarIn Y, DemIrbas S, Onde ME, Sayan O, KandemIr EG, YaylacI M, Ozturk A. Breast cancer in association with thyroid disorders. Breast Cancer Res 2003; 5:R110-3. [PMID: 12927040 PMCID: PMC314421 DOI: 10.1186/bcr609] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2003] [Revised: 04/14/2003] [Accepted: 04/24/2003] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The relationship between breast cancer and thyroid diseases is controversial. Discrepant results have been reported in the literature. The incidences of autoimmune and nonautoimmune thyroid diseases were investigated in patients with breast cancer and age-matched control individuals without breast or thyroid disease. METHODS Clinical and ultrasound evaluation of thyroid gland, determination of serum thyroid hormone and antibody levels, and fine-needle aspiration of thyroid gland were performed in 150 breast cancer patients and 100 control individuals. RESULTS The mean values for anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients than in control individuals (P = 0.030). The incidences of autoimmune and nonautoimmune thyroid diseases were higher in breast cancer patients than in control individuals (38% versus 17%, P = 0.001; 26% versus 9%, P = 0.001, respectively). CONCLUSION Our results indicate an increased prevalence of autoimmune and nonautoimmune thyroid diseases in breast cancer patients.
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Affiliation(s)
- Orhan Turken
- GATA Haydarpasa Training Hospital, Medical Oncology Department, KadIkoy, Istanbul, Turkey.
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Affiliation(s)
- P P Smyth
- Department of Medicine and Therapeutics, University College Dublin, Ireland
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