DOI: https://doi.org/10.18370/2309-4117.2019.47.20-24

Thyroid carcinoma in woman. gynecologist view

Т. Ф. Татарчук, Л. В. Калугіна, А. О. Данилова

Abstract


Over the past decade the incidence of thyroid cancer in Ukraine has increased 1.5 times, and the average age of diagnosis among women is 36 years. Thyroid cancer is the most common endocrine cancer, occurs in 5–10% of patients with thyroid nodules. Papillary carcinoma is 80% of all thyroid malignant neoplasms and is three times more common in women than in men. The peak incidence in women is observed in 40–49 years, while in men the peak is 60–69 years.

In addition to established risk factors such as female sex, exposure to ionizing radiation, a history of benign thyroid disease, deficiency or excess of iodine in the diet, somatic mutations BRAFV600E, RET/PTC, NTRK, remain relevant studies of the role of estrogen imbalance and progesterone and progesterone expression of their receptors sensitive in the development of thyroid carcinogenesis.

Recent studies devoted to improving the diagnosis of thyroid cancer, surgical intervention techniques, subsequent radioactive iodine therapy and duration of thyroid stimulating hormone suppression. Thanks to this patients with thyroid papillary carcinoma have favorable prognoses, because the 5-year survival rate is more than 98%.

According to the American Thyroid Association a modern approach to the treatment of papillary thyroid cancer has several stages and depends on the recurrence risk in a patient. Thus, patients in accordance with the tumor size, the presence of local, distant metastases, BRAF V600E mutations, etc. are divided into three groups: low, medium and high risk of developing a relapse.

At the first stage of treatment surgical intervention (thyroidectomy or lobectomy) is performed, followed by histopathological verification of the diagnosis, radioiodine diagnosis of the presence of metastases, evaluation of risk factors for recurrence, and the decision to conduct a course of radioiodine therapy during the second stage of treatment. The further management of these patients also depends on the risk group and includes the long-term suppressive treatment of thyroid stimulating hormone with levothyroxine.


Keywords


thyroid gland; thyroid cancer; radioiodine therapy; suppressive therapy

References


Weiss, W. “Chernobyl thyroid cancer: 30 years of follow-up overview.” Radiat Prot Dosimetry 182.1 (2018): 58–61.

Bazyka, D., et al. “Epidemiology of Late Health Effects in Ukrainian Chornobyl Cleanup Workers.” Health Phys 115.1 (2018): 161–9.

National cancer register of Ukraine. “2018 operational information about thyroid gland C73.”

Schneider, M.D.F., Chen, H. “New Developments in the Diagnosis and Treatment of Thyroid Cancer.” CA Cancer J Clin 63.6 (2013): 373–94.

National Cancer Institute. “Thyroid Cancer – Cancer Stat Facts.” Available from: [https://seer.cancer.gov/statfacts/html/thyro.html], last accessed Mar 29, 2019.

Kilfoy, B.A., et al. “Gender is an age-specific effect modifier for papillary cancers of the thyroid gland.” Cancer Epidemiol Biomarkers Prev 18.4 (2009): 1092–100.

Rahbari, R., Zhang, L., Kebebew, E. “Thyroid cancer gender disparity.” Future Oncol 6.11 (2010): 1771–9.

Banach, R., et al. “Results of the Thyroid Cancer Alliance international patient/survivor survey: Psychosocial/informational support needs, treatment side effects and international differences in care.” Hormones 12.3 (2013): 428–38.

Sakafu, L.L., Mselle, T.F., Mwaiselage, J.D., et al. “Thyroid Cancer and Iodine Deficiency Status: A 10-Year Review at a Single Cancer Center in Tanzania.” OTO Open 2.2 (2018): 2473974X1877723.

Shibru,D., Chung, K.-W., Kebebew, E. “Recent developments in the clinical application of thyroid cancer biomarkers.” Curr Opin Oncol 20.1 (2008): 13–8.

Moleti, M., Sturniolo, G., Di Mauro, M., et al. “Female Reproductive Factors and Differentiated Thyroid Cancer.” Front Endocrinol (Lausanne) 8 (2017): 111.

Gandini, S., et al. “The risk of extra-ovarian malignancies among women with endometriosis: A systematic literature review and meta-analysis.” Crit Rev Oncol Hematol 134 (2019): 72–81.

Molteni, A., Warpeha, R.L., Brizio-Molteni, L., Fors, E.M. “Estradiol receptor-binding protein in head and neck neoplastic and normal tissue.” Arch Surg 116.2 (1981): 207–10.

Jensen, E.V., DeSombre, E.R. “Estrogen-receptor interaction.” Science 182.4108 (1973): 126–34.

Mosselman, S., Polman, J., Dijkema, R. “ERβ: Identification and characterization of a novel human estrogen receptor.” FEBS Lett 392.1 (1996): 49–53.

Santin, A.P., Furlanetto, T.W. “Role of estrogen in thyroid function and growth regulation.” J Thyroid Res 2011 (2011): 875125.

Chen, G.G., Vlantis, A.C., Zeng, Q., van Hasselt, C.A. “Regulation of cell growth by estrogen signaling and potential targets in thyroid cancer.” Curr Cancer Drug Targets 8.5 (2008): 367–77.

Zeng, Q., Chen, G.G., Vlantis, A.C., van Hasselt, C.A. “Oestrogen mediates the growth of human thyroid carcinoma cells via an oestrogen receptor – ERK pathway.” Cell Prolif 40.6 (2007): 921–35.

Di Vito, M., et al. “Overexpression of estrogen receptor-α in human papillary thyroid carcinomas studied by laser-capture microdissection and molecular biology.” Cancer Sci 102.10 (2011): 1921–7.

Huang, Y., Dong, W., Li, J., et al. “Differential expression patterns and clinical significance of estrogen receptor-α and β in papillary thyroid carcinoma.” BMC Cancer 14 (2014): 383.

Meng, X.-Y., Liu, Z.-H., Liu, J., et al. “Serum levels of sex hormones and expression of their receptors in thyroid tissue in female patients with various types of thyroid neoplasms.” Pathol Res Pract 210.12 (2014): 830–5.

Vannucchi, G., et al. “Impact of estrogen and progesterone receptor expression on the clinical and molecular features of papillary thyroid cancer.” Eur J Endocrinol 173.1 (2015): 29–36.

Banu, S.K., Govindarajulu, P., Aruldhas, M.M. “Testosterone and estradiol differentially regulate TSH-induced thyrocyte proliferation in immature and adult rats.” Steroids 67.7 (2002): 573–9.

Manole, D., Schildknecht, B., Gosnell, B., et al. “Estrogen Promotes Growth of Human Thyroid Tumor Cells by Different Molecular Mechanisms.” J Clin Endocrinol Metab 86.3 (2001): 1072–7.

Rajoria, S., et al. “Estrogen Induced Metastatic Modulators MMP-2 and MMP-9 Are Targets of 3,3′-Diindolylmethane in Thyroid Cancer.” PLoS One 6.1 (2011): e15879.

Dong, W., et al. “Estrogen Induces Metastatic Potential of Papillary Thyroid Cancer Cells through Estrogen Receptor α and β.” Int J Endocrinol 2013 (2013): 941568.

Rajoria, S., et al. “Metastatic Phenotype Is Regulated by Estrogen in Thyroid Cells.” Thyroid 20.1 (2010): 33–41.

Derwahl, M., Nicula, D. “Estrogen and its role in thyroid cancer.” Endocr Relat Cancer 21.5 (2014): T273–T283.

Zahid, M., Goldner, W., Beseler, C.L., et al. “Unbalanced estrogen metabolism in thyroid cancer.” Int J Cancer 133.11 (2013): 2642–9.

Heikinheimo, O., et al. “A Nationwide Cohort Study on the risk of non-gynecological cancers in women with surgically verified endometriosis.” Int J Cancer 143.11 (2018): 2725–31.

Nielsen, S.M., et al. “The Breast-Thyroid Cancer Link: A Systematic Review

and Meta-analysis.” Cancer Epidemiol Biomarkers Prev 25.2 (2016): 231–8.

Guenego, A., et al. “Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort.” Clin Endocrinol (Oxf) 90.2 (2019): 360–8.

Tuttle, R.M., et al. “Controversies, Consensus and Collaboration in the Use of I-131 Therapy in Differentiated Thyroid Cancer.” Thyroid 29.4 (2019).

Sawka, A.M., et al. “2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.” Thyroid 26.1 (2015): 1–133.

Alexander, C., Bader, J.B., Schaefer, A., et al. “Intermediate and long-term side effects of high-dose radioiodine therapy for thyroid carcinoma.” J Nucl Med 39.9 (1998): 1551–4.

Sawka, A.M., et al. “A systematic review examining the effects of therapeutic radioactive iodine on ovarian function and future pregnancy in female thyroid cancer survivors.” Clin Endocrinol (Oxf) 69.3 (2008): 479–90.

Manuel García-Quirós Muñoz, J., Martín Hernández, T., Torres Cuadro, A., et al. “Edad de menopausia en pacientes tratadas con I131 por cáncer diferenciado de tiroides.” Endocrinol y Nutr 57.3 (2010): 105–9.

Sioka, C., Fotopoulos, A. “Effects of I-131 therapy on gonads and pregnancy outcome in patients with thyroid cancer.” Fertil Steril 95.5 (2011): 1552–9.

Wu, J.X., et al. “Reproductive outcomes and nononcologic complications after radioactive iodine ablation for well-differentiated thyroid cancer.” Thyroid 25.1 (2015): 133–8.

Evranos, B., Faki, S., Polat, S.B., et al. “Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study.” Thyroid 28.12 (2018): 1702–7.

Tatarchuk, T.F., Solskyi, Y.P. Endocrine gynecology (Clinical essays). Kyiv. Zapovit (2003): 300 p.

Kuchmenko, Т.М. State of the pituitary-ovarian system in women of fertile age after thyroidectomy and radioiodine therapy for thyroid cancer. Thesis review for PhD degree, specialty 14.01.04. Kyiv (2008): 20 p.

Newman, M., et al. “Reproductive and gynecological complication risks among thyroid cancer survivors.” J Cancer Surviv 12.5 (2018): 702–11.

Bozhok, Y.M., Kvachenyuk, A.M., Kuchmenko, T.M., et al. “Dyshormonal states of the reproductive system in women after thyroidectomy and radioiodine therapy for differentiated thyroid carcinoma.” Int J Endocrinol 13.3 (2017): 167–71.

Journy, N.M.Y., Bernier, M.-O., Doody, M.M., et al. “Hyperthyroidism, Hypothyroidism, and Cause-Specific Mortality in a Large Cohort of Women.” Thyroid 27.8 (2017): 1001–10.

Ronckers, C.M., McCarron, P., Ron, E. “Thyroid cancer and multiple primary tumors in the SEER cancer registries.” Int J Cancer 117.2 (2005): 281–8.

Kuo, J.H., Chabot, J.A., Lee, J.A. “Breast cancer in thyroid cancer survivors: An analysis of the Surveillance, Epidemiology, and End Results-9 database.” Surgery 159.1 (2016): 23–30.


GOST Style Citations


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47.       Kuo, J.H., Chabot, J.A., Lee, J.A. “Breast cancer in thyroid cancer survivors: An analysis of the Surveillance, Epidemiology, and End Results-9 database.” Surgery 159.1 (2016): 23–30.





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