Extra-thyroidal Cancers in Euthyroid Hashimoto’s Patients Under Levothyroxine Treatment: Outlook A Single Tertiary Center Cases

Öz

We aimed to investigate the frequency of extra-thyroidal cancer (ETC) in euthyroid Hashimoto’s patients under levothyroxine (LT4) treatment. Moreover, we determined whether cancer development could be related to demographic, clinical, biochemical, and metabolic parameters. Consecutive participants in the follow-up above 18 years old diagnosed with hypothyroidism caused by Hashimoto’s thyroiditis (HT) in a single tertiary center between 2016 December and 2023 December were included in the study. A total of 577 Hashimoto’s patients were analyzed retrospectively. The study population was divided into two subgroups according to presence or absence of ETC. Demographic, clinical, biochemical, and metabolic parameters were compared in patients with and without cancer. Mean age was 52.6±13.5 years. Of the 577 patients, 87.3% were female and 12.7% were male. The most prevalent two comorbidities accompanying HT were metabolic syndrome (36.4%) and obesity (31.2%). The frequency of concomitant appearance of ETC with HT was 13.3%. The most common two cancers were breast (46.2%) and ovary (8.7%). In multivariate analysis, older age (OR 1.030, 95% CI 1.012-1.049, p=0.001), positive family history for cancer (OR 1.859, 95% CI 1.117-3.092, p=0.017), and elevated fasting blood glucose (OR 1.022, 95% CI 1.007-1.037, p=0.005) were found to be significantly positively correlated with increased risk of cancer. This study revealed that the frequency of ETC was 13.3% in euthyroid Hashimoto’s patients under LT4 treatment. Breast cancer was the most common cancer affecting study population. Older age, positive family history for cancer and elevated fasting blood glucose were defined as independent risk factors for cancer development.

Anahtar Kelimeler

• Hashimoto’s thyroiditis
• hypothyroidism
• extra-thyroidal cancers

Levotiroksin Tedavisi Alan Ötiroid Hashimoto Hastalarında Tiroid Dışı Kanserler: Tek Bir Tersiyer Merkezin Hastalarına Bakış

Öz

Levotiroksin (LT4) tedavisi alan ötiroid Hashimoto hastalarında tiroid dışı kanser (TDK) sıklığını araştırmayı amaçladık. Ayrıca kanser gelişiminin demografik, klinik, biyokimyasal ve metabolik parametrelerle ilişkili olup olmadığını da belirledik. Aralık 2016 ile Aralık 2023 tarihleri arasında tek bir tersiyer merkezde Hashimoto tiroiditi (HT) kaynaklı hipotiroidi tanısı alan 18 yaş üzeri takipteki ardışık katılımcılar çalışmaya dahil edildi. Toplam 577 Hashimoto hastası retrospektif olarak analiz edildi. Çalışma popülasyonu TDK olup olmamasına göre iki alt gruba ayrıldı. Kanserli ve kansersiz hastalarda demografik, klinik, biyokimyasal ve metabolik parametreler karşılaştırıldı.Bulgular: Ortalama yaş 52,6±13,5 yıldı. Beş yüz yetmiş yedi hastanın %87,3'ü kadın, %12,7'si erkekti. HT’ne eşlik eden en sık iki komorbidite metabolik sendrom (%36,4) ve obezite (%31,2) idi. HT ile TDK’in birlikte görülme sıklığı %13,3 idi. En sık görülen iki kanser meme (%46,2) ve over (%8,7) oldu. Çok değişkenli analizde, ileri yaşın (OR 1,030, %95 CI 1,012-1,049, p=0,001), pozitif aile öyküsünün (OR 1,859, %95 CI 1,117-3,092, p=0,017) ve yüksek açlık kan şekerinin (OR) 1,022, %95 CI 1,007-1,037, p=0,005) artan kanser riski ile anlamlı pozitif korelasyona sahip olduğu bulunmuştur. Bu çalışma, LT4 tedavisi alan ötiroid Hashimoto hastalarında TDK sıklığının %13,3 olduğunu ortaya çıkardı. Meme kanseri, çalışma popülasyonunu etkileyen en yaygın kanserdi. İleri yaş, pozitif aile öyküsü ve yüksek açlık kan şekeri, kanser gelişimi için bağımsız risk faktörleri olarak tanımlandı.

Anahtar Kelimeler

• Hashimoto tiroiditi
• hipotiroidi
• tiroid dışı kanserler

Kaynakça

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