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Jia X, Li J, Jiang Z. Association between thyroid disorders and extra-thyroidal cancers, a review. Clin Transl Oncol 2024:10.1007/s12094-024-03434-3. [PMID: 38491294 DOI: 10.1007/s12094-024-03434-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
Thyroid hormone has been shown to have both tumor-promoting and tumor-suppressing actions, which has led to significant debate over its involvement in the development of cancer. Proliferation, apoptosis, invasiveness, and angiogenesis are all aspects of cancer that are affected by the thyroid hormones T3 and T4, according to research conducted in animal models and in vitro experiments. The effects of thyroid hormones on cancer cells are mediated by many non-genomic mechanisms, one of which involves the activation of the plasma membrane receptor integrin αvβ3. Typically, abnormal amounts of thyroid hormones are linked to a higher occurrence of cancer. Both benign and malignant thyroid disorders were found to be associated with an increased risk of extra-thyroidal malignancies, specifically colon, breast, prostate, melanoma, and lung cancers. The purpose of this review was to shed light on this link to define which types of cancer are sensitive to thyroid hormones and, as a result, are anticipated to respond favorably to treatment of the thyroid hormone axis.
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Affiliation(s)
- Xin Jia
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, 410005, China
| | - Jingru Li
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, 410005, China.
| | - Zongliang Jiang
- Department of Nursing, Zhengzhou Health Vocational College, Zhengzhou, 410005, China
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2
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Li D, Zhang Z, Zhang C, Guo Q, Chen C, Peng X. Unraveling the connection between Hashimoto's Thyroiditis and non-alcoholic fatty liver disease: exploring the role of CD4 +central memory T cells through integrated genetic approaches. Endocrine 2024:10.1007/s12020-024-03745-z. [PMID: 38400881 DOI: 10.1007/s12020-024-03745-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE Exploring the connection between Hashimoto's thyroiditis (HT) and non-alcoholic fatty liver disease (NAFLD) through integrated genetic approaches. METHODS We utilized integrated genetic approaches, such as single-cell RNA sequencing (scRNA-seq) data analysis, Mendelian Randomization (MR), colocalization analysis, cell communication, and metabolic analyses, to investigate potential correlations between HT and NAFLD. RESULTS Through the integrated analysis of scRNA-seq data from individuals with HT, NAFLD, and healthy controls, we observed an upregulation in the proportion of CD4+central memory (CD4+CM) T cells among T cells in both diseases. A total of 63 differentially expressed genes (DEGs) were identified in the CD4+CM cells after the differential analysis. By using MR, 8 DEGs (MAGI3, CSGALNACT1, CAMK4, GRIP1, TRAT1, IL7R, ERN1, and MB21D2) were identified to have a causal relationship with HT, and 4 DEGs (MAGI3, RCAN3, DOCK10, and SAMD12) had a causal relationship with NAFLD. MAGI3 was found to be causally linked to both HT and NAFLD. Therefore, MAGI3 was designated as the marker gene. Reverse MR and Steiger filtering showed no evidence of reverse causality. Colocalization analyses further indicated close links between MAGI3 and HT as well as NAFLD. Finally, based on the expression levels of MAGI3, we stratified CD4+CM cells into two subsets: MAGI3+CD4+CM cells and MAGI3-CD4+CM cells. Functional analyses revealed significant differences between the two subsets, potentially related to the progression of the two diseases. CONCLUSION This study delves into the potential connections between HT and NAFLD through integrated genetic methods. Our research reveals an elevated proportion of CD4+CM cells within T cells in both HT and NAFLD. Through MR and colocalization analysis, we identify specific genes causally linked to HT and NAFLD, such as MAGI3. Ultimately, based on MAGI3 expression levels, we categorize CD4+CM cells into MAGI3+CD4+CM cells and MAGI3-CD4+CM cells, uncovering significant differences between them through functional analyses.
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Affiliation(s)
- Dairui Li
- Department of Thyroid Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zeji Zhang
- Department of Thyroid Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Cheng Zhang
- Department of Thyroid Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Qiannan Guo
- Department of Thyroid Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Chen Chen
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xinzhi Peng
- Department of Thyroid Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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3
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Du Q, Zheng Z, Wang Y, Yang L, Zhou Z. Genetically predicted thyroid function and risk of colorectal cancer: a bidirectional Mendelian randomization study. J Cancer Res Clin Oncol 2023; 149:14015-14024. [PMID: 37543542 DOI: 10.1007/s00432-023-05233-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Observational studies have reported an association between thyroid function and colorectal cancer (CRC), with conflicting results. Elucidating the causal relationship between thyroid function and CRC facilitates the development of new preventive strategies to reduce CRC incidence. METHOD We applied a two-sample Mendelian randomization (MR) method to evaluate the causal relationship between five thyroid-related indexes, including hyperthyroidism, hypothyroidism, thyroid stimulating hormone (TSH), free thyroxine (FT4) and basal metabolic rate (BMR), and CRC. Genome-wide association study statistics for thyroid-related phenotypes were obtained from the ThyroidOmics consortium, and summary statistics for genetic associations with CRC were obtained from the FinnGen consortium. We set a series of criteria to screen single nucleotide polymorphisms (SNPs) as instrumental variables and then performed bidirectional MR analysis, stratified analysis and extensive sensitivity analysis. Multiplicative random-effects inverse variance weighted was the primary analysis method, supplemented by weighted median and MR-Egger. RESULT We identified 12 SNPs for hyperthyroidism, 10 SNPs for hypothyroidism, 41 SNPs for TSH, 18 SNPs for FT4, and 556 SNPs for BMR. Genetically predicted hyperthyroidism, hypothyroidism, TSH, and FT4 were not associated with CRC risk (all P > 0.05). Sensitivity analysis revealed no heterogeneity or pleiotropy. Genetically predicted BMR was significantly associated with increased CRC risk after removing outlier (OR = 1.30, P = 0.0029). Stratified analysis showed that BMR was significantly associated with colon cancer (OR = 1.33, P = 0.0074) but not rectal cancer. In the reverse analysis, there was no evidence of an effect of CRC on thyroid function (all P > 0.05). CONCLUSION Our bidirectional MR analysis provides new insights into the relationship between thyroid function and CRC. CRC prevention may benefit from enhanced screening of high BMR populations.
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Affiliation(s)
- Qiang Du
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China
| | - Zhaoyang Zheng
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China
| | - Yong Wang
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China
| | - Lie Yang
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.
- State Key Laboratory of Biotherapy and Cancer Center, Institute of Digestive Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Zongguang Zhou
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China
- State Key Laboratory of Biotherapy and Cancer Center, Institute of Digestive Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
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4
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Gagliardi F, Baldini E, Lori E, Cardarelli S, Pironi D, Lauro A, Tripodi D, Palumbo P, D’armiento E, Cavallaro G, Polistena A, D’orazi V, Sibio S, Fallahi P, Antonelli A, D’andrea V, Ulisse S, Sorrenti S. Insights on the Association between Thyroid Diseases and Colorectal Cancer. J Clin Med 2023; 12:2234. [PMID: 36983233 PMCID: PMC10056144 DOI: 10.3390/jcm12062234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/22/2023] [Accepted: 03/11/2023] [Indexed: 03/15/2023] Open
Abstract
Benign and malignant thyroid diseases (TDs) have been associated with the occurrence of extrathyroidal malignancies (EMs), including colorectal cancers (CRCs). Such associations have generated a major interest, as their characterization may provide useful clues regarding diseases’ etiology and/or progression, with the possible identification of shared congenital and environmental elements. On the other hand, elucidation of the underlying molecular mechanism(s) could lead to an improved and tailored clinical management of these patients and stimulate an increased surveillance of TD patients at higher threat of developing EMs. Here, we will examine the epidemiological, clinical, and molecular findings connecting TD and CRC, with the aim to identify possible molecular mechanism(s) responsible for such diseases’ relationship.
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5
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Sorrenti S, Lauro A, Pironi D, Calò PG, Ulisse S. Editorial: Differential diagnoses of thyroid neoplasms: Molecular and histological features and the impact on follow-up. Front Oncol 2023; 13:1125887. [PMID: 36798815 PMCID: PMC9927641 DOI: 10.3389/fonc.2023.1125887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/19/2023] [Indexed: 02/04/2023] Open
Affiliation(s)
| | - Augusto Lauro
- Department of Surgery, “Sapienza” University of Rome, Rome, Italy
| | - Daniele Pironi
- Department of Surgery, “Sapienza” University of Rome, Rome, Italy
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, University of Cagliari, Monserrato, Cagliari, Italy
| | - Salvatore Ulisse
- Department of Surgery, “Sapienza” University of Rome, Rome, Italy,*Correspondence: Salvatore Ulisse,
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Anedda G, Cappellacci F, Canu GL, Farris S, Calò PG, Dessena M, Medas F. Axillary Treatment Management in Breast Cancer during COVID-19 Pandemic (Association between ACOSOG Z0011 Criteria and OSNA Test). J Pers Med 2023; 13:jpm13020241. [PMID: 36836475 PMCID: PMC9960710 DOI: 10.3390/jpm13020241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The outbreak of the SARS-COVID-2 pandemic (COVID-19) had a significant effect on the organisation of healthcare systems. Surgical units saw a significant reduction in the volume of surgical procedures performed, with lengthening waiting lists as a consequence. We assessed the surgical activity in relation to breast cancer that took place at the University Hospital of Cagliari, Italy, from February 2018 to March 2022. Two phases were identified based on the epidemiological circumstances: Phase 1-February 2018 to February 2020; Phase 2-March 2020 to March 2022. The surgery performed in the two phases was then compared. All the patients in our sample underwent a breast surgical procedure involving a lymph node biopsy using OSNA associated with the ACOSOG Z0011 criteria. In the study period overall at our facility, there were 4214 procedures, 417 of which involved breast surgery. In Phase 2, 91 procedures were performed using the OSNA method and ACOSOG Z0011 criteria, enabling the intraoperative staging of axillary nodes. Axillary treatment in breast cancer using this approach resulted in a significant reduction in the number of reoperations for the radicalisation of metastatic sentinel lymph nodes.
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Affiliation(s)
- Giacomo Anedda
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
- Correspondence: ; Tel.: +39-3335351390
| | | | - Gian Luigi Canu
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Stefania Farris
- Polispecialistyc Surgery Unit, Policlinico Universitario “Duilio Casula”, 09042 Cagliari, Italy
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Massimo Dessena
- Polispecialistyc Surgery Unit, Policlinico Universitario “Duilio Casula”, 09042 Cagliari, Italy
| | - Fabio Medas
- Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy
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Sherief A, Thambi SM, Susan Joy Philip D, Menon A, A S. Lymphoma and Differentiated Thyroid Cancer: A Case Series. Cureus 2023; 15:e34429. [PMID: 36874657 PMCID: PMC9979098 DOI: 10.7759/cureus.34429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/01/2023] Open
Abstract
Occurrences of lymphoma and differentiated thyroid cancer are rare. Usually, involvement of the thyroid gland is seen as a part of extranodal involvement or as a part of radiation-induced malignant transformation in previously treated lymphoma patients. The incidence of synchronous hematological malignancy with differentiated thyroid cancer is 7%. The synchronous occurrence of differentiated thyroid cancer and lymphoma poses a significant diagnostic and treatment dilemma. Here we report a case series of four patients with lymphoma and differentiated thyroid cancer. All four patients had lymphoma treated first followed by definitive management of thyroid malignancy.
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Affiliation(s)
- Amitha Sherief
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, IND
| | - Sugeeth M Thambi
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, IND
| | | | - Abhilash Menon
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, IND
| | - Sreekumar A
- Department of Nuclear Medicine, Regional Cancer Centre, Trivandrum, IND
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8
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Bellini MI, Lori E, Forte F, Lauro A, Tripodi D, Amabile MI, Cantisani V, Varanese M, Ferent IC, Baldini E, Ulisse S, D’Andrea V, Pironi D, Sorrenti S. Thyroid and renal cancers: A bidirectional association. Front Oncol 2022; 12:951976. [PMID: 36212468 PMCID: PMC9538481 DOI: 10.3389/fonc.2022.951976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/22/2022] [Indexed: 12/01/2022] Open
Abstract
There is a deep interrelation between the thyroid gland and the kidney parenchyma, with dysfunction of the first leading to significant changes in renal metabolism and vice versa. Given the recognition of cancer as a systemic disease, the raise of thyroid tumors and the common association of several malignancies, such as breast cancer, prostate cancer, colorectal cancer, and other, with an increased risk of kidney disease, public health alert for these conditions is warranted. A systematic review of the current evidence on the bidirectional relationship between thyroid and renal cancers was conducted including 18 studies, highlighting patient’s characteristics, histology, time for secondary malignancy to develop from the first diagnosis, treatment, and follow-up. A total of 776 patients were identified; median age was 64 years (range: 7–76 years). Obesity and family history were identified as the most common risk factors, and genetic susceptibility was suggested with a potential strong association with Cowden syndrome. Controversy on chemo and radiotherapy effects was found, as not all patients were previously exposed to these treatments. Men were more likely to develop kidney cancer after a primary thyroid malignancy, with 423/776 (54%) experiencing renal disease secondarily. Median time after the first malignancy was 5.2 years (range: 0–20 years). With the advancement of current oncological therapy, the prognosis for thyroid cancer patients has improved, although there has been a corresponding rise in the incidence of multiple secondary malignancy within the same population, particularly concerning the kidney. Surgery can achieve disease-free survival, if surveillance follow-up allows for an early localized form, where radical treatment is recommended.
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Affiliation(s)
- Maria Irene Bellini
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
- *Correspondence: Maria Irene Bellini,
| | - Eleonora Lori
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Flavio Forte
- Department of Urology, M. G. Vannini Hospital, Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Tripodi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Vito Cantisani
- Department of Radiological, Anatomopathological and Oncological Sciences, Sapienza University of Rome, Rome, Italy
| | - Marzia Varanese
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Enke Baldini
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Ulisse
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Vito D’Andrea
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
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9
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Ulisse S, Baldini E, Pironi D, Gagliardi F, Tripodi D, Lauro A, Carbotta S, Tarroni D, D’Armiento M, Morrone A, Forte F, Frattaroli F, Persechino S, Odorisio T, D’Andrea V, Lori E, Sorrenti S. Is Melanoma Progression Affected by Thyroid Diseases? Int J Mol Sci 2022; 23:ijms231710036. [PMID: 36077430 PMCID: PMC9456309 DOI: 10.3390/ijms231710036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Clinical and epidemiological evidence indicate a relationship between thyroid diseases and melanoma. In particular, the hypothyroidism condition appears to promote melanoma spread, which suggests a protective role of thyroid hormones against disease progression. In addition, experimental data suggest that, in addition to thyroid hormones, other hormonal players of the hypothalamic–pituitary–thyroid (HPT) axis, namely the thyrotropin releasing hormone and the thyrotropin, are likely to affect melanoma cells behavior. This information warrants further clinical and experimental studies in order to build a precise pattern of action of the HPT hormones on melanoma cells. An improved knowledge of the involved molecular mechanism(s) could lead to a better and possibly personalized clinical management of these patients.
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Affiliation(s)
- Salvatore Ulisse
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
- Correspondence:
| | - Enke Baldini
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Federica Gagliardi
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Domenico Tripodi
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Sabino Carbotta
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Danilo Tarroni
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Matteo D’Armiento
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, 00144 Rome, Italy
| | - Flavio Forte
- Urology Department, M.G. Vannini Hospital, 00177 Rome, Italy
| | - Flaminia Frattaroli
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Severino Persechino
- Department of Neurosciences, Mental Health and Sensory Organs, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Teresa Odorisio
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Vito D’Andrea
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Eleonora Lori
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
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10
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Ben Thayer M, Khanchel F, Helal I, Chiboub D, Ben Lazreg K, Hedhli R, Ben Brahim E, Jouini R, Cheddli‐Debbich A. Incidental discovery of a Hodgkin lymphoma synchronous to a papillary thyroid carcinoma. Clin Case Rep 2022; 10:e6246. [PMID: 35957786 PMCID: PMC9361809 DOI: 10.1002/ccr3.6246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022] Open
Abstract
Papillary thyroid carcinoma is the most common type of thyroid cancer and accounts for almost 89.4% of all thyroid carcinomas. Hodgkin lymphoma is a heterogeneous group of neoplasms and represents 10% of lymphomas. These two cancers do not share the same risk factors. Some studies have reported the association of thyroid papillary carcinoma with lymphomas, mainly Hodgkin's lymphoma, treated with radiotherapy. However, to our knowledge less than 10 cases have illustrated synchronous papillary thyroid carcinoma and Hodgkin lymphoma with no history of radiotherapy. We present the case of a 49‐year‐old female patient, with no history of past exposure to radiation, who was incidentally diagnosed with Hodgkin lymphoma during the work up for papillary thyroid carcinoma. Our patient had total thyroïdectomy with cervical lymphadenectomy. The histopathologic examination concluded to a papillary thyroid carcinoma of classical variant. And the lymph node dissection enabled us to diagnose not only papillary thyroid carcinoma's lymph node metastasis, but also Hodgkin Lymphoma. This discovery of the Hodgkin lymphoma was totally incidental. The discovery of synchronous tumors in patients with papillary thyroid carcinoma has been reported in the literature. However, the diagnosis of Hodgkin through lymph node dissection for papillary thyroid carcinoma is extremely rare. This underlines the singularity and the importance of our case. The synchronous papillary thyroid carcinoma and Hodgkin lymphoma is a rare condition, which may pose significant diagnostic and treatment dilemmas. To date, there is no standardized approach due to lack of experience. The molecular mechanisms of this link are poorly understood and yet remain to be elucidated.
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Affiliation(s)
- Maissa Ben Thayer
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Fatma Khanchel
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Imen Helal
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Dorra Chiboub
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Department of Otorhinolaryngology‐Head and neck surgery Habib Thameur's Hospital Tunis Tunisia
| | | | - Raweh Hedhli
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Ehsen Ben Brahim
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Raja Jouini
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Aschraf Cheddli‐Debbich
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
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11
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Canu GL, Medas F, Cappellacci F, Giordano ABF, Gurrado A, Gambardella C, Docimo G, Feroci F, Conzo G, Testini M, Calò PG. Risk of Complications in Patients Undergoing Completion Thyroidectomy after Hemithyroidectomy for Thyroid Nodule with Indeterminate Cytology: An Italian Multicentre Retrospective Study. Cancers (Basel) 2022; 14:cancers14102472. [PMID: 35626075 PMCID: PMC9139447 DOI: 10.3390/cancers14102472] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/09/2022] [Accepted: 05/14/2022] [Indexed: 12/19/2022] Open
Abstract
Simple Summary The increasing use of high-quality imaging techniques together with improved access to healthcare has led to an increase in the detection of thyroid nodules. Fine-needle aspiration cytology (FNAC) is currently considered the most accurate examination for the assessment of thyroid nodular disease. However, in about 25% of cases, FNAC leads to the diagnosis of an indeterminate thyroid nodule, which represents a problem because malignancy, although relatively low (up to 30%), cannot be excluded with certainty. According to the 2015 American Thyroid Association guidelines, patients with thyroid nodular disease with an indeterminate cytology can undergo, based on established factors, a total thyroidectomy or a hemithyroidectomy. However, if an intermediate or high-risk differentiated thyroid carcinoma is detected after the hemithyroidectomy, through histological examination, the above-mentioned guidelines recommend performing a completion thyroidectomy. The main aim of this study was to assess the rate of complications in patients undergoing a completion thyroidectomy after a hemithyroidectomy for a thyroid nodule with an indeterminate cytology. Abstract There is still controversy as to whether patients undergoing a completion thyroidectomy after a hemithyroidectomy for a thyroid nodule with an indeterminate cytology have a comparable, increased or decreased risk of complications compared to those submitted to primary thyroid surgery. The main aim of this study was to investigate this topic. Patients undergoing a thyroidectomy for thyroid nodular disease with an indeterminate cytology in four high-volume thyroid surgery centres in Italy, between January 2017 and December 2020, were retrospectively analysed. Based on the surgical procedure performed, four groups were identified: the TT Group (total thyroidectomy), HT Group (hemithyroidectomy), CT Group (completion thyroidectomy) and HT + CT Group (hemithyroidectomy with subsequent completion thyroidectomy). A total of 751 patients were included. As for the initial surgery, 506 (67.38%) patients underwent a total thyroidectomy and 245 (32.62%) a hemithyroidectomy. Among all patients submitted to a hemithyroidectomy, 66 (26.94%) were subsequently submitted to a completion thyroidectomy. No statistically significant difference was found in terms of complications comparing both the TT Group with the HT + CT Group and the HT Group with the CT Group. The risk of complications in patients undergoing a completion thyroidectomy after a hemithyroidectomy for a thyroid nodule with an indeterminate cytology was comparable to that of patients submitted to primary thyroid surgery (both a total thyroidectomy and hemithyroidectomy).
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Affiliation(s)
- Gian Luigi Canu
- Department of Surgical Sciences, University of Cagliari, 09042 Monserrato, CA, Italy; (F.M.); (F.C.); (P.G.C.)
- Correspondence:
| | - Fabio Medas
- Department of Surgical Sciences, University of Cagliari, 09042 Monserrato, CA, Italy; (F.M.); (F.C.); (P.G.C.)
| | - Federico Cappellacci
- Department of Surgical Sciences, University of Cagliari, 09042 Monserrato, CA, Italy; (F.M.); (F.C.); (P.G.C.)
| | | | - Angela Gurrado
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, BA, Italy; (A.G.); (M.T.)
| | - Claudio Gambardella
- Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, NA, Italy; (C.G.); (G.D.)
| | - Giovanni Docimo
- Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, NA, Italy; (C.G.); (G.D.)
| | - Francesco Feroci
- Department of General and Oncologic Surgery, Santo Stefano Hospital, 59100 Prato, PO, Italy; (A.B.F.G.); (F.F.)
| | - Giovanni Conzo
- Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, NA, Italy;
| | - Mario Testini
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, BA, Italy; (A.G.); (M.T.)
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, University of Cagliari, 09042 Monserrato, CA, Italy; (F.M.); (F.C.); (P.G.C.)
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12
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Baldini E, Lauro A, Tripodi D, Pironi D, Amabile MI, Ferent IC, Lori E, Gagliardi F, Bellini MI, Forte F, Pacini P, Cantisani V, D’andrea V, Sorrenti S, Ulisse S. Thyroid Diseases and Breast Cancer. J Pers Med 2022; 12:156. [PMID: 35207645 PMCID: PMC8876618 DOI: 10.3390/jpm12020156] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 01/27/2023] Open
Abstract
Epidemiological studies aimed at defining the association of thyroid diseases with extra-thyroidal malignancies (EM) have aroused considerable interest in the possibility of revealing common genetic and environmental factors underlying disease etiology and progression. Over the years, multiple lines of evidence indicated a significant relationship between thyroid carcinomas and other primary EM, especially breast cancer. For the latter, a prominent association was also found with benign thyroid diseases. In particular, a meta-analysis revealed an increased risk of breast cancer in patients with autoimmune thyroiditis, and our recent work demonstrated that the odds ratio (OR) for breast cancer was raised in both thyroid autoantibody-positive and -negative patients. However, the OR was significantly lower for thyroid autoantibody-positive patients compared to the negative ones. This is in agreement with findings showing that the development of thyroid autoimmunity in cancer patients receiving immunotherapy is associated with better outcome and supports clinical evidence that breast cancer patients with thyroid autoimmunity have longer disease-free interval and overall survival. These results seem to suggest that factors other than oncologic treatments may play a role in the initiation and progression of a second primary malignancy. The molecular links between thyroid autoimmunity and breast cancer remain, however, unidentified, and different hypotheses have been proposed. Here, we will review the epidemiological, clinical, and experimental data relating thyroid diseases and breast cancer, as well as the possible hormonal and molecular mechanisms underlying such associations.
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13
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Losada-García A, Cortés-Ramírez SA, Cruz-Burgos M, Morales-Pacheco M, Cruz-Hernández CD, Gonzalez-Covarrubias V, Perez-Plascencia C, Cerbón MA, Rodríguez-Dorantes M. Hormone-Related Cancer and Autoimmune Diseases: A Complex Interplay to be Discovered. Front Genet 2022; 12:673180. [PMID: 35111194 PMCID: PMC8801914 DOI: 10.3389/fgene.2021.673180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
Neoplasic transformation is a continuous process that occurs in the body. Even before clinical signs, the immune system is capable of recognizing these aberrant cells and reacting to suppress them. However, transformed cells acquire the ability to evade innate and adaptive immune defenses through the secretion of molecules that inhibit immune effector functions, resulting in tumor progression. Hormones have the ability to modulate the immune system and are involved in the pathogenesis of autoimmune diseases, and cancer. Hormones can control both the innate and adaptive immune systems in men and women. For example androgens reduce immunity through modulating the production of pro-inflammatory and anti-inflammatory mediators. Women are more prone than men to suffer from autoimmune diseases such as systemic lupus erythematosus, psoriasis and others. This is linked to female hormones modulating the immune system. Patients with autoimmune diseases consistently have an increased risk of cancer, either as a result of underlying immune system dysregulation or as a side effect of pharmaceutical treatments. Epidemiological data on cancer incidence emphasize the link between the immune system and cancer. We outline and illustrate the occurrence of hormone-related cancer and its relationship to the immune system or autoimmune diseases in this review. It is obvious that some observations are contentious and require explanation of molecular mechanisms and validation. As a result, future research should clarify the molecular pathways involved, including any causal relationships, in order to eventually allocate information that will aid in the treatment of hormone-sensitive cancer and autoimmune illness.
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Affiliation(s)
- A Losada-García
- Laboratorio de Oncogenomica Instituto Nacional de Medicina Genomica, Mexico City, Mexico
| | - SA Cortés-Ramírez
- Laboratorio de Oncogenomica Instituto Nacional de Medicina Genomica, Mexico City, Mexico
| | - M Cruz-Burgos
- Laboratorio de Oncogenomica Instituto Nacional de Medicina Genomica, Mexico City, Mexico
| | - M Morales-Pacheco
- Laboratorio de Oncogenomica Instituto Nacional de Medicina Genomica, Mexico City, Mexico
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología-Facultad de Química, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | | | | | - Carlos Perez-Plascencia
- Unidad de Genómica y Cáncer, Subdirección de Investigación Básica, INCan, SSA and Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - MA Cerbón
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología-Facultad de Química, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - M Rodríguez-Dorantes
- Laboratorio de Oncogenomica Instituto Nacional de Medicina Genomica, Mexico City, Mexico
- *Correspondence: M Rodríguez-Dorantes,
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14
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Ulisse S, Baldini E, Lauro A, Pironi D, Tripodi D, Lori E, Ferent IC, Amabile MI, Catania A, Di Matteo FM, Forte F, Santoro A, Palumbo P, D'Andrea V, Sorrenti S. Papillary Thyroid Cancer Prognosis: An Evolving Field. Cancers (Basel) 2021; 13:5567. [PMID: 34771729 DOI: 10.3390/cancers13215567] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Over the last couple of decades, the prognostic stratification systems of differentiated thyroid cancer (DTC) patients have been revised several times in an attempt to achieve a tailored clinical management reflecting the single patients’ needs. Such revisions are likely to continue in the near future, since the prognostic value of a number of promising clinicopathological features and new molecular biomarkers are being evaluated. Here, we will review the current staging systems of thyroid cancer patients and discuss the most relevant clinicopathological parameters and new molecular markers that are potentially capable of refining the prognosis. Abstract Over the last few years, a great advance has been made in the comprehension of the molecular pathogenesis underlying thyroid cancer progression, particularly for the papillary thyroid cancer (PTC), which represents the most common thyroid malignancy. Putative cancer driver mutations have been identified in more than 98% of PTC, and a new PTC classification into molecular subtypes has been proposed in order to resolve clinical uncertainties still present in the clinical management of patients. Additionally, the prognostic stratification systems have been profoundly modified over the last decade, with a view to refine patients’ staging and being able to choose a clinical approach tailored on single patient’s needs. Here, we will briefly discuss the recent changes in the clinical management of thyroid nodules, and review the current staging systems of thyroid cancer patients by analyzing promising clinicopathological features (i.e., gender, thyroid auto-immunity, multifocality, PTC histological variants, and vascular invasion) as well as new molecular markers (i.e., BRAF/TERT promoter mutations, miRNAs, and components of the plasminogen activating system) potentially capable of ameliorating the prognosis of PTC patients.
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15
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Cayres LCDF, de Salis LVV, Rodrigues GSP, Lengert AVH, Biondi APC, Sargentini LDB, Brisotti JL, Gomes E, de Oliveira GLV. Detection of Alterations in the Gut Microbiota and Intestinal Permeability in Patients With Hashimoto Thyroiditis. Front Immunol 2021; 12:579140. [PMID: 33746942 PMCID: PMC7973118 DOI: 10.3389/fimmu.2021.579140] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/04/2021] [Indexed: 12/11/2022] Open
Abstract
Hashimoto thyroiditis (HT) is the most common autoimmune disease worldwide, characterized by chronic inflammation and circulating autoantibodies against thyroid peroxidase and thyroglobulin. Patients require hormone replacement with oral levothyroxine, and if untreated, they can develop serious adverse health effects and ultimately death. There is a lot of evidence that the intestinal dysbiosis, bacterial overgrowth, and increased intestinal permeability favor the HT development, and a thyroid–gut axis has been proposed, which seems to impact our entire metabolism. Here, we evaluated alterations in the gut microbiota in Brazilian patients with HT and correlated this data with dietary habits, clinical data, and systemic cytokines and zonulin concentrations. Stool samples from 40 patients with HT and 53 controls were analyzed using real-time PCR, the serum cytokine levels were evaluated by flow cytometry, zonulin concentrations by ELISA, and the dietary habits were recorded by a food frequency questionnaire. We observed a significant increase (p < 0.05) in the Bacteroides species and a decrease in Bifidobacterium in samples of patients with HT. In addition, Lactobacillus species were higher in patients without thyroid hormone replacement, compared with those who use oral levothyroxine. Regarding dietary habits, we demonstrated that there are significant differences in the consumption of vegetables, fruits, animal-derived proteins, dairy products, saturated fats, and carbohydrates between patients and control group, and an inverse correlation between animal-derived protein and Bacteroides genus was detected. The microbiota modulation by diet directly influences the inflammatory profile due to the generated microbiota metabolites and their direct or indirect action on immune cells in the gut mucosa. Although there are no differences in systemic cytokines in our patients with HT, we detected increased zonulin concentrations, suggesting a leaky gut in patients with HT. These findings could help understand the development and progression of HT, while further investigations to clarify the underlying mechanisms of the diet–microbiota–immune system axis are still needed.
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Affiliation(s)
| | - Larissa Vedovato Vilela de Salis
- Microbiology Program, Institute of Biosciences, Humanities and Exact Sciences (IBILCE), São Paulo State University (UNESP), São Paulo, Brazil
| | | | | | | | | | - João Luiz Brisotti
- Microbiome Study Group, School of Health Sciences Dr. Paulo Prata, São Paulo, Brazil
| | - Eleni Gomes
- Microbiology Program, Institute of Biosciences, Humanities and Exact Sciences (IBILCE), São Paulo State University (UNESP), São Paulo, Brazil
| | - Gislane Lelis Vilela de Oliveira
- Microbiome Study Group, School of Health Sciences Dr. Paulo Prata, São Paulo, Brazil.,Microbiology Program, Institute of Biosciences, Humanities and Exact Sciences (IBILCE), São Paulo State University (UNESP), São Paulo, Brazil.,Food Engineering and Technology Department, Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto, Brazil
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16
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Hung CH, Lin YC, Chang YH, Lin YC, Huang HY, Yeh WJ, Wu TY, Hou MF. The effect of NSAIDs exposure on breast cancer risk in female patients with autoimmune diseases. Eur J Cancer Prev 2020; 28:428-434. [PMID: 30339576 DOI: 10.1097/cej.0000000000000476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Both breast cancer and autoimmune diseases (ADs) are predominant in women. NSAIDs are common medications for AD. Evidence on the association between NSAIDs use and breast cancer risk is controversial. We investigated the association between NSAIDs exposure and breast cancer risk in female patients with AD. AD patients older than 18 years of age were enrolled from Taiwan Longitudinal Health Insurance Database 2005. The NSAID users were defined as AD patients who had ever taken NSAIDs for at least 3 months between 2000 and 2009. All individuals were followed from the date of first diagnosis of AD to the end of 2013 to evaluate the risk of breast cancer. We estimated the adjusted hazard ratio (HR) using Cox proportional hazard regression after adjusting for age, comorbidities and medications. A total of 12 331 NSAID users and 12 331 non-NSAID users were included in this study after 1: 1 individual matching. The NSAID users were less likely to develop breast cancer than the non-NSAID users (adjusted HR: 0.37; 95% confidence interval: 0.27-0.50; P < 0.001), even if they used NSAIDs with low cumulative defined daily doses (adjusted HR: 0.42; 95% confidence interval: 0.34-0.53; P < 0.001). The incidence of new-onset breast cancer in NSAID users was significantly decreased in users taking selective cyclooxygenase 2 inhibitors, diclofenac, ibuprofen and piroxicam. Lower cumulative hazard rates were found in the AD patients who used NSAIDs (P < 0.001). NSAID exposure is associated with a decreased risk of breast cancer in female AD patients.
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Affiliation(s)
- Chih-Hsing Hung
- Department of Pediatrics.,Research Center for Environmental Medicine.,Graduate Institute of Medicine.,Department of Pediatrics.,Department of Pediatrics
| | - Yi-Ching Lin
- Department of Pediatrics.,Department of Laboratory Medicine.,Research Center for Environmental Medicine.,Department of Laboratory Medicine
| | - Yu-Han Chang
- Teaching and Research Center,Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Yu-Chih Lin
- Department of Internal Medicine, Division of General Internal Medicine.,Department of Medical Humanities and Education, School of Medicine
| | - Hsin-Yi Huang
- Teaching and Research Center,Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Wei-Ju Yeh
- Teaching and Research Center,Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Ting-Yi Wu
- Teaching and Research Center,Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Ming-Feng Hou
- Department of Surgery, Division of Breast Surgery, Kaohsiung Medical University Hospital.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University.,Department of Surgery
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17
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Muller I, Barrett-Lee PJ. The antigenic link between thyroid autoimmunity and breast cancer. Semin Cancer Biol 2019; 64:122-134. [PMID: 31128301 DOI: 10.1016/j.semcancer.2019.05.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/17/2019] [Accepted: 05/21/2019] [Indexed: 02/06/2023]
Abstract
The association between breast cancer and benign thyroid disorders, in particular thyroid autoimmunity, has been debated for decades. Autoantibodies to thyroid peroxidase, the hallmark of thyroid autoimmunity, have a higher prevalence among patients with breast cancer compared with the general population. Furthermore a correlation between their positivity and a better prognosis of breast cancer was found in several independent small-scale studies, even if such observation was not confirmed in a subsequent retrospective study conducted on the largest patient cohort to date. The thyroid and mammary glands present several biological similarities, therefore the hypothesis of an immune response to shared thyroid/breast antigens could in part explain the association between thyroid autoimmunity and breast cancer. The sodium iodide symporter is expressed in both glands, however it seems unlikely to be the key common antigen, considering that autoantibodies targeting it are rare. Instead thyroid peroxidase, one of the major thyroid autoantigens, is also expressed in breast tissue and therefore represents the main antigenic link between thyroid autoimmunity and breast cancer. Furthermore lactoperoxidase, an enzyme of the same family that shares structural similarities with thyroid peroxidase, is expressed in neoplastic breast cells and is responsible for the cross-reactivity with some autoantibodies to thyroid peroxidase. Novel strategies for the diagnosis and treatment of breast cancer might take advantage of the antigenic link between thyroid and breast tissues.
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Affiliation(s)
- Ilaria Muller
- Thyroid Research Group, Division of Infection & Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom.
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18
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Brčić L, Barić A, Gračan S, Torlak V, Brekalo M, Škrabić V, Zemunik T, Barbalić M, Punda A, Boraska Perica V. Genome-wide association analysis suggests novel loci underlying thyroid antibodies in Hashimoto's thyroiditis. Sci Rep 2019; 9:5360. [PMID: 30926877 PMCID: PMC6440971 DOI: 10.1038/s41598-019-41850-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 03/18/2019] [Indexed: 01/01/2023] Open
Abstract
Thyroid antibodies against thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) are key markers of Hashimoto's thyroiditis (HT), the most common autoimmune thyroid disorder. Genetic determinants of thyroid antibodies are still poorly known, especially as they were not studied in patients with thyroid diseases. We performed the first genome-wide association analysis of thyroid antibodies in 430 HT patients that may be considered as population extremes for thyroid antibodies distribution. We detected two suggestively associated genetic variants with TgAb, rs6972286 close to ANKRD7 and LSM8 (P = 2.34 × 10-7) and rs756763 inside CA10 (P = 6.05 × 10-7), and one with TPOAb, rs12507813 positioned between TRIM61 and TRIM60 (P = 4.95 × 10-7). Bivariate analysis resulted with three suggestively associated genetic variants that predispose to both antibodies: rs13190616 inside RP11-138J23.1 (P = 2.01 × 10-6), rs561030786 close to DUBR (P = 7.33 × 10-6) and rs12713034 inside FSHR (P = 7.66 × 10-6). All identified genomic regions have a substantial literature record of involvement with female-related traits, immune-mediated diseases and personality traits that are all characterized by increased thyroid antibody levels. Our findings demonstrate the existence of genetic overlap between thyroid autoimmunity in HT and different non-thyroid diseases characterized by the presence of thyroid antibodies. We also suggest that genetic variants that regulate antibody levels may differ between HT patients and individuals with normal thyroid function.
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Affiliation(s)
- Luka Brčić
- Department of Medical Biology, University of Split, School of Medicine, Split, Croatia
| | - Ana Barić
- Department of Nuclear Medicine, University Hospital Split, Split, Croatia
| | - Sanda Gračan
- Department of Nuclear Medicine, University Hospital Split, Split, Croatia
| | - Vesela Torlak
- Department of Nuclear Medicine, University Hospital Split, Split, Croatia
| | - Marko Brekalo
- Department of Nuclear Medicine, University Hospital Split, Split, Croatia
| | - Veselin Škrabić
- Department of Pediatrics, University Hospital Split, Split, Croatia
| | - Tatijana Zemunik
- Department of Medical Biology, University of Split, School of Medicine, Split, Croatia
| | - Maja Barbalić
- Department of Medical Biology, University of Split, School of Medicine, Split, Croatia
| | - Ante Punda
- Department of Nuclear Medicine, University Hospital Split, Split, Croatia
| | - Vesna Boraska Perica
- Department of Medical Biology, University of Split, School of Medicine, Split, Croatia.
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19
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Criscitiello C, Bagnardi V, Esposito A, Gelao L, Santillo B, Viale G, Rotmensz N, Goldhirsch A, Curigliano G. Impact of autoimmune diseases on outcome of patients with early breast cancer. Oncotarget 2016; 7:51184-92. [PMID: 27323400 DOI: 10.18632/oncotarget.9966] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/28/2016] [Indexed: 11/25/2022] Open
Abstract
Our aim was to analyze the impact of a concurrent autoimmune disease on outcome of patients with early breast cancer. We reviewed medical charts of patients with a diagnosis of autoimmune diseases (AD) among a population of 17.153 cases. We categorized ADs as endocrine, rheumatic, systemic, neurological diseases and vasculitis. For each patient in the study group, we matched 2 patients. The events to determine overall survival (OS) and disease free survival (DFS) were identified from follow-up data. We identified 279 (1.62%) patients with early breast cancer and concurrent ADs. The median follow-up was 7.0 years. The 10-year OS rate was 86% (95% CI, 80% to 91%) in the study group and 90% (95% CI, 86% to 93%) for the control group (p = 0.011). In patients with ER positive/HER2 negative subtype a worse OS was observed in the study group when compared to the control group (p = 0.0046); this difference remained statistically significant when the analysis was restricted to breast cancer mortality (p = 0.045). The 10-year DFS rate was 69% (95% CI, 61% to 76%) in the study group and 72% (95% CI, 66% to 77%) for the control group (p = 0.22). Autoimmunity at diagnosis of early breast cancer is associated with worse survival.
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20
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Abstract
RATIONALE Differentiated thyroid cancer is the most common endocrine malignancy with concomitant hematological malignancy in 7%. PATIENT CONCERNS We present a case of a synchronous papillary thyroid cancer and a follicular variant of non-Hodgkin lymphoma and discuss the possible diagnostic and treatment dilemmas. DIAGNOSIS A 48-year-old female was reffered to our hospital with diagnosis "thyroid cancer". Due to a history compatable of synchronous lymphoproliferative disease we performed a computed tomography, which revealed multiple enlarged lymph nodes in the neck, mediastinum, axilla and abdomen. INTERVENTIONS A total thyroidectomy with dissection of the central compartment was performed. The microscopic examination of thyroid gland revealed multifocal papilary thyroid cancer and metastaes from the same cancer plus aggressive follicular B-cell non-Hodgkin lymphoma in the lymph nodes. Despite the classic approach "solid cancer first", due to the advanced stage of lymphoma we first started the chemotherapy of NHL. She received 8 cycles of CHOP and I therapy with 129 mCi. Because of incomplete response 4 cycles Mabthera plus Bendamustin were added. The follow-up PET scan revealed complete remission of lymphoma and bilaterally enlarged single cervical lymph nodes, previously known to be iodine positive on I-SPECT/CT. She was sheduled for bilateral radical neck LND. OUTCOMES Complete remission of NHL and residual single metastatic cervical lymph nodes requiring bilateral radical neck LND. LESSONS The synchronous DTC and NHL is rare. To date, there is no standardized approach due to lack of experience. We suggest lymphoma first approach with synchronized and tailored multidisciplinary efforts. The molecular mechanisms of this link are poorly understood and yet remain to be elucidated.
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Affiliation(s)
| | - Pavel Bochev
- Clinic of Nuclear medicine, Medical University, Varna
| | | | | | - Mihail Tabakov
- Clinic of Abdominal surgery, University Hospital for Active treatment, Sofia, Bulgaria
| | - Anthony Philipov
- Clinic of Abdominal surgery, University Hospital for Active treatment, Sofia, Bulgaria
| | - Roberto Cirocchi
- General and Surgical Oncology Division, University of Perugia, Perugia, Italy
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21
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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22
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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: 215] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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23
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Oba J, Esmaeli B, Ellerhorst JA, Lyons GR, Milton DR, Wang W, Macedo MP, Lazar AJ, Grimm EA, Chattopadhyay C. Trends in hepatocyte growth factor, insulin-like growth factor 1, thyroid-stimulating hormone, and leptin expression levels in uveal melanoma patient serum and tumor tissues: correlation to disease progression. Melanoma Res 2017; 27:126-33. [DOI: 10.1097/cmr.0000000000000329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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24
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Abstract
Thyroid hormones influence renal development, kidney hemodynamics, glomerular filtration rate and sodium and water homeostasis. Hypothyroidism and hyperthyroidism affect renal function by direct renal effects as well as systemic hemodynamic, metabolic and cardiovascular effects. Hypothyroidism has been associated with increased serum creatinine and decreased glomerular filtration rate. The reverse effects have been reported in thyrotoxicosis. Most of renal manifestations of thyroid dysfunction are reversible with treatment. Kidney disease may also cause thyroid dysfunction by several mechanisms. Nephrotic syndrome has been associated to changes in serum thyroid hormone concentrations. Different forms of glomerulonephritis and tubulointerstitial disease may be linked to thyroid derangements. A high prevalence of thyroid hormone alteration has been reported in acute kidney injury. Thyroid dysfunction is highly prevalent in chronic kidney disease patients. Subclinical hypothyroidism and low triiodothyronine syndrome are common features in patients with chronic kidney disease. Patients treated by both hemodialysis and peritoneal dialysis, and renal transplantation recipients, exhibit thyroid hormone alterations and thyroid disease with higher frequency than that found in the general population. Drugs used in the therapy of thyroid disease may lead to renal complications and, similarly, drugs used in kidney disorders may be associated to thyroid alterations. Lastly, low thyroid hormones, especially low triiodothyronine levels, in patients with chronic kidney disease have been related to a higher risk of cardiovascular disease and all-cause mortality. Interpretation of the interactions between thyroid and renal function is a challenge for clinicians involved in the treatment of patients with thyroid and kidney disease.
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Affiliation(s)
- Pedro Iglesias
- Department of Endocrinology, Hospital Ramón y Cajal, Ctra. De Colmenar, Km 9,100, 28034, Madrid, Spain.
| | - María Auxiliadora Bajo
- Department of Nephrology, Hospital La Paz, Madrid, Spain
- Department of Health Sciences, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rafael Selgas
- Department of Nephrology, Hospital La Paz, Madrid, Spain
- Department of Health Sciences, Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan José Díez
- Department of Endocrinology, Hospital Ramón y Cajal, Ctra. De Colmenar, Km 9,100, 28034, Madrid, Spain
- Department of Medicine, University de Alcalá de Henares, Madrid, Spain
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25
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Czarnecka AM, Matak D, Szymanski L, Czarnecka KH, Lewicki S, Zdanowski R, Brzezianska-Lasota E, Szczylik C. Triiodothyronine regulates cell growth and survival in renal cell cancer. Int J Oncol 2016; 49:1666-78. [PMID: 27632932 DOI: 10.3892/ijo.2016.3668] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/25/2016] [Indexed: 11/05/2022] Open
Abstract
Triiodothyronine plays an important role in the regulation of kidney cell growth, differentiation and metabolism. Patients with renal cell cancer who develop hypothyreosis during tyrosine kinase inhibitor (TKI) treatment have statistically longer survival. In this study, we developed cell based model of triiodothyronine (T3) analysis in RCC and we show the different effects of T3 on renal cell cancer (RCC) cell growth response and expression of the thyroid hormone receptor in human renal cell cancer cell lines from primary and metastatic tumors along with human kidney cancer stem cells. Wild-type thyroid hormone receptor is ubiquitously expressed in human renal cancer cell lines, but normalized against healthy renal proximal tube cell expression its level is upregulated in Caki-2, RCC6, SKRC-42, SKRC-45 cell lines. On the contrary the mRNA level in the 769-P, ACHN, HKCSC, and HEK293 cells is significantly decreased. The TRβ protein was abundant in the cytoplasm of the 786-O, Caki-2, RCC6, and SKRC-45 cells and in the nucleus of SKRC-42, ACHN, 769-P and cancer stem cells. T3 has promoting effect on the cell proliferation of HKCSC, Caki-2, ASE, ACHN, SK-RC-42, SMKT-R2, Caki-1, 786-0, and SK-RC-45 cells. Tyrosine kinase inhibitor, sunitinib, directly inhibits proliferation of RCC cells, while thyroid hormone receptor antagonist 1-850 (CAS 251310‑57-3) has less significant inhibitory impact. T3 stimulation does not abrogate inhibitory effect of sunitinib. Renal cancer tumor cells hypostimulated with T3 may be more responsive to tyrosine kinase inhibition. Moreover, some tumors may be considered as T3-independent and present aggressive phenotype with thyroid hormone receptor activated independently from the ligand. On the contrary proliferation induced by deregulated VHL and or c-Met pathways may transgress normal T3 mediated regulation of the cell cycle.
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Affiliation(s)
- Anna M Czarnecka
- Department of Oncology with Laboratory of Molecular Oncology, Military Institute of Medicine, Warsaw, Poland
| | - Damian Matak
- Department of Oncology with Laboratory of Molecular Oncology, Military Institute of Medicine, Warsaw, Poland
| | - Lukasz Szymanski
- Department of Oncology with Laboratory of Molecular Oncology, Military Institute of Medicine, Warsaw, Poland
| | - Karolina H Czarnecka
- Department of Molecular Bases of Medicine, Medical University of Lodz, Lodz, Poland
| | - Slawomir Lewicki
- Department of Regenerative Medicine, Military Institute of Hygiene and Epidemiology, Warsaw, Poland
| | - Robert Zdanowski
- Department of Regenerative Medicine, Military Institute of Hygiene and Epidemiology, Warsaw, Poland
| | | | - Cezary Szczylik
- Department of Oncology with Laboratory of Molecular Oncology, Military Institute of Medicine, Warsaw, Poland
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26
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CZARNECKA ANNAM, NIEDZWIEDZKA MAGDALENA, PORTA CAMILLO, SZCZYLIK CEZARY. Hormone signaling pathways as treatment targets in renal cell cancer (Review). Int J Oncol 2016; 48:2221-35. [DOI: 10.3892/ijo.2016.3460] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/14/2016] [Indexed: 11/06/2022] Open
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