Clin Cancer Res：甲状腺激素替代治疗使乳腺癌患者预后不良

2020-10-24 星云 MedSci原创

甲状腺疾病是女性乳腺癌(BC)常见的合并症，许多患者需要甲状腺激素(TH)替代治疗(THRT)。研究人员推测THRT可通过激素相互作用、核受体交叉和高危BC基因上调等机制产生有害的临床效应，因而开展了

甲状腺疾病是女性乳腺癌(BC)常见的合并症，许多患者需要甲状腺激素(TH)替代治疗(THRT)。研究人员推测THRT可通过激素相互作用、核受体交叉和高危BC基因上调等机制产生有害的临床效应，因而开展了一项观察性研究，对此进行验证。

该研究观察分析淋巴结阴性（LN-）的BC患者(n=820和n=160)，以测试THRT与临床、组织学、预后和治疗变量之间的交互作用。对比两组间的患者数量、治疗时间、随访时间、肿瘤大小、发生率、肿瘤类型和治疗药物的方案及剂量。并在体内和体外模型中用芯片和分子方法来研究THRT效应的潜在机制。

THRT治疗的影响

在两项长期观察研究中，THRT均显著且独立地降低了类固醇受体(SR)阳性(与SR阴性相比)LN-患者的无病和BC特异性的总生存率。

他莫西芬（Tam）治疗的影响

采用THRT和他莫西芬治疗的SR+ LN- BC患者在所有治疗组中的存活时间最短。

芳香化酶抑制剂（ICI）治疗的影响

在第二个队列患者中，THRT和芳香化酶抑制剂之间的相互作用较弱。在体内外模型中，TH处理增强了雌激素和TH相关基因的表达，增强了ER和THR的核共定位，还激活了临床用于预测SR+ BC肿瘤侵袭性的基因，包括IGF-IR、WNT和TGFβ通路。

综上所述，该研究提示在SR+ LN- BC患者中，THRT、雌激素和致癌信号之间存在显著的不良相互作用。

原始出处：

Ann D Thor, et al. Exogenous Thyroid Hormone is Associated with Shortened Survival and Upregulation of High Risk Gene Expression Profiles in Steroid Receptor Positive Breast Cancers. Clin Cancer Res. October 23 2020 DOI:10.1158/1078-0432.CCR-20-2647

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2021-03-20 wfang555

#替代治疗#

39 0
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2020-12-09 ck822376544

希望医学越来越进步#肿瘤#

125 0
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2021-02-15 bnurmamat

#患者预后#

32 0
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2020-10-29 lovetcm

#甲状腺激素#替代治疗使#乳腺癌#患者预后不良，但是，还没有临床证据！

147 0
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2020-10-26 caoliehu

#预后不良#

31 0
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2020-10-26 hanhaisha2013

#乳腺癌患者#

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