甲状腺癌和自身免疫性结缔组织疾病。

Endokrynologia Polska Pub Date : 2024-01-01 Epub Date: 2024-10-08 DOI:10.5603/ep.101007
Maria Aleksandra Komisarz-Calik, Alicja Hubalewska-Dydejczyk, Bogdan Batko, Małgorzata Trofimiuk-Müldner
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引用次数: 0

摘要

大量数据证实,包括结缔组织病(CTD)在内的自身免疫性疾病与甲状腺恶性肿瘤风险增加之间存在关联。结缔组织病和甲状腺癌可能作为两种独立的疾病并存,因为它们在人群中的发病率相对较高。由于特发性炎症性肌炎、类风湿性关节炎、系统性硬化症、原发性斯约格伦综合征和系统性红斑狼疮患者罹患甲状腺癌的风险增加,这两种疾病可能互为因果。此外,在一些罕见病例中,CTD 可能会成为甲状腺癌的副肿瘤综合征。CTD的存在可能会影响诊断过程,尤其是使影像学检查结果失真,或错误地显示甲状腺球蛋白或降钙素增加。最后,抑制促甲状腺激素是治疗分化型甲状腺癌的关键因素,它可能会通过加速骨转换和缩短骨重塑周期来降低骨矿物质密度并增加骨质疏松症的风险。本综述旨在强调这种相互关系的重要方面。作者讨论了这一现象,旨在解释可能的关联机制。文中介绍了某些 CTD 对甲状腺癌治疗的影响,以及癌症治疗对骨骼健康可能产生的影响。
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Thyroid cancer and autoimmune connective tissue disorders.

There are substantial data confirming the association between autoimmune disorders, including connective tissue diseases (CTDs), and an increased risk of thyroid malignancy. CTDs and thyroid cancer may co-exist as 2 separate diseases because of their relatively high incidence rates in the population. They can arise from each other due to the increased risk of thyroid cancer in patients with idiopathic inflammatory myositis, rheumatoid arthritis, systemic sclerosis, primary Sjögren's syndrome, and systemic lupus erythematosus. Moreover, in some scarce cases, CTDs may act as the paraneoplastic syndromes of thyroid cancer. The presence of CTDs may impact the diagnostic process, especially distorting the results of imaging tests or falsely indicating the increase of thyroglobulin or calcitonin. Finally, TSH suppression is a crucial element of the treatment of differentiated thyroid cancer, which may decrease bone mineral density and increase the risk of osteoporosis by accelerating bone turnover and shortening the bone remodeling cycle. The aim of this review is to emphasise the vital aspects of this interrelationship. The authors discuss this phenomenon aiming at the explanation of possible linking mechanisms. The impact of selected CTDs on thyroid cancer management is presented, as well as the possible effects of cancer therapy on skeletal health.

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