甲状腺功能亢进症与乳腺癌发病风险关系的Meta分析

Association of hyperthyroidism with the risk of breast cancer:a meta-analysis

目的系统评价甲状腺功能亢进症(简称甲亢)与乳腺癌发病风险的关系,为乳腺癌的病因研究及一级预防提供理论依据。方法计算机检索Pub Med、Embase、CENTRAL、Web of Science、CBM、CNKI、VIP和WanFang Data等数据库中有关甲亢与乳腺癌的研究,检索日期为建库至2018年4月。采用纽卡斯尔-渥太华量表(the Newcastle-Ottawa quality scale,NOS)对纳入研究进行质量评价,使用RevMan 5.3软件进行Meta分析。结果共纳入17项研究(病例对照研究10项、队列研究7项),共66 116例乳腺癌患者。Meta分析结果显示:(1)病例对照研究中未校正OR合并结果显示,甲亢不会增加乳腺癌的发病风险(OR=1.25,95%CI:0.92～1.70,P=0.150);校正OR合并结果显示,甲亢可增加乳腺癌的发病风险(OR=1.11,95%CI:1.03～1.19,P=0.004)。(2)队列研究中未校正OR和校正OR合并结果均显示,甲亢可增加乳腺癌的发病风险(OR未校正=1.17,95%CI:1.07～1.27,P<0.001;OR校正=1.11,95%CI:1.07～1.15,P<0.001)。结论甲亢可能增加乳腺癌的发病风险,但不同地区人群甲亢与乳腺癌发病风险的关系不尽相同。

Objective To systematically evaluate the correlation between hyperthyroidism and the risk of breast cancer,to provide the theoretical basis for etiological study and primary prevention of breast cancer. Methods Data of case-control studies and cohort studies of hyperthyroidism and breast cancer were collected by searching 8 electronic databases from inception to April 2018. The Newcastle-Ottawa quality scale(NOS) was used to evaluate the quality of inclusion study and a Meta-analysis was conducted by RevMan 5.3 software. Results Finally 17 studies were included in the meta-analysis,which including 10 case-control studies and7 cohort studies,with a total of 66,116 cases. The concrete results were as follows:⑴case-control study:the results of unadjusted OR showed that hyperthyroidism couldn’t increase the risk of breast cancer(OR=1.25,95%CI:0.92-1.70,P=0.150);the results of adjusted OR showed that hyperthyroidism could increase the risk of breast cancer(OR=1.11,95%CI:1.03-1.19),P=0.004). ⑵cohort study:unadjusted OR and adjusted OR combined results showed that hyperthyroidism could increase the risk of breast cancer(unadjusted OR =1.17,95% CI:1.07-1.27,P <0.001;adjusted OR =1.11,95% CI:1.07-1.15,P <0.001). Conclusions Hyperthyroidism may increase the risk of breast cancer. However,the relationship between and breast cancer risk in different regions is not exactly the same.