自身免疫性甲状腺疾病与乳腺癌的关系

Relationship between autoimmune thyroid disease and breast cancer

自身免疫性甲状腺疾病（AITD）与乳腺癌密切相关，AITD尤其是低游离rr4（FT4）患者易发生乳腺癌。甲状腺抗体阳性率是鉴别良、恶性乳腺结节、预测乳腺癌转归的标志。甲状腺B超可诊断乳腺癌患者是否合并AITD，也可预测乳腺癌的转归。其确切机制还不清楚，可能涉及甲状腺和乳腺存在某些相同的生理基础，如碘转运（钠／碘转运体，NIS）、促甲状腺激素释放激素（TRH）及部分垂体前叶激素的作用；碘缺乏；以趋化因子CXCL10为代表的免疫异常。靶点为乳腺细胞中NIS的放射性碘治疗、作用于Ras和CXCL10／CXCR3的免疫调节药物在未来都可能成为治疗乳腺癌的新手段。

Autoimmune thyroid disease （AITD） is associated with breast cancer closely. It is shown that patients with AITD, especially those with lower free T4 , are prone to having breast cancer. The positive rate of thyroid antibody is a distinguishing marker between benign with malignant nodules, and also a marker of the breast cancer prognosis. Thyroid uhrasonography can help to diagnose AITD in patients with breast cancer,also to predict the prognosis of breast cancer. The mechanisms of breast cancer accompanying with AITD are unclear, maybe include some common physiological bases in thyroid and breast, such as iodic transfer （sodium iodide symporter, NIS）,the effect of TRH and part anterior pituitary hormones;deficiency of iodide;immune abnormalities representing by chemokine CXCL10. It is suggests that radioiodine（ targeting NIS in breast） and some immune drugs（targetlng Ras and CXCLIO/CXCR3）hold promise for the new treatment of breast cancer.