Ramazan COŞAR, Aydın ÇİFCİ, Selim YALÇIN, Aşkın GÜNGÜNEŞ, Şenay ARIKAN DURMAZ

Meme kanseri subgruplarının sıklığı ve otoimmün tiroid hastalığının prognoz üzerine etkisi

Amaç: Bu çalışmanın amacı meme kanseri moleküler subgrup sıklığını belirlemek ve meme kanseri tanısı ile takip ettiğimiz hastalarda otoimmun tiroid hastalığı (OİTH) ile meme kanseri prognostik ve prediktif faktörleri arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Retrospektif tanımlayıcı bir araştırma olarak planlanan bu çalışmaya 01 Ocak 2012–31 Aralık 2015 tarihleri arasında endokrinoloji ve tıbbi onkoloji polikliniklerine başvurmuş, meme kanseri tanısı ile takip edilen 101 hasta dahil edildi, moleküler sınıflandırmaya göre subgruplara ayrıldı. Yüksek serum anti-TPO düzeyi olanlar OİTH pozitif kabul edildi. OİTH’nin eşlik ettiği meme kanseri hastalarında prognostik ve prediktif parametreler (tümör evresi, tümör boyutu, aksiller lenf nodu tutulumu, histolojik derece, lenfovaskuler invazyonu, perinöral invazyonu, hormon reseptör durumu, HER2 ekspresyonu) otoimmün tiroid hastalığının eşlik etmediği meme kanseri hastaları ile karşılaştırıldı. Bulgular: Çalışmaya dahil edilen meme kanseri hastalarında tiroid otoimmunite (yüksek serum anti-TPO düzeyi) prevalansı %23,8 (n=24) olarak saptandı. OİTH pozitif meme kanseri hastalarında aksiller lenf nodu tutulumu (%37,5’e karşı %61; p=0,043) OİTH negatif meme kanseri hastalarına göre daha düşüktü. Diğer parametreler açısından iki grup arasında anlamlı fark izlenmedi. Sonuç: OİTH’nin eşlik ettiği meme kanseri hastalarında önemli bir prognostik parametre olan aksiller lenf nodu tutulum oranı daha düşük bulunmuştur. Bu sonuç tiroid otoimmunitesinin meme kanseri açısından olumlu bir prognostik faktör olduğu görüşünü desteklemektedir. Bunun hangi mekanizma üzerinden etkili olduğu ise yeni çalışmalarla araştırılmalıdır.

Anahtar Kelimeler:

Otoimmün tiroid hastalığı, meme kanseri, prognostik ve prediktif faktörler

The frequency of breast cancer subgroups and the effect of autoimmune thyroid disease on prognosis

Aim: The aim of this study is to determine the frequency of breast cancer molecular subgroups and to investigate the relationship between autoimmune thyroid disease (AITD) and breast cancer prognostic and predictive factors in patients followed up with a diagnosis of breast cancer. Material and Method: This study, which was planned as a retrospective descriptive study, included 101 patients who applied to the endocrinology and medical oncology outpatient clinics between January 01, 2012 and December 31, 2015, followed up with the diagnosis of breast cancer, and were divided into subgroups according to molecular classification. Those with high serum anti-TPO levels were considered AITD positive. Prognostic and predictive parameters (tumor stage, tumor size, axillary lymph node involvement, histological grade, lymphovascular invasion, perineural invasion, hormone receptor status, HER2 expression) in breast cancer patients with AITD were compared with breast cancer patients without autoimmune thyroid disease. Results: The prevalence of thyroid autoimmunity (high serum anti-TPO level) in breast cancer patients included in the study was 23.8% (n=24). Axillary lymph node involvement (37.5% vs. 61%; p=0.043) was lower in AITD-positive breast cancer patients than in AITD-negative breast cancer patients. No significant difference was observed between the two groups in terms of other parameters. Conclusion: Axillary lymph node involvement, which is an important prognostic parameter, was found to be lower in breast cancer patients with AITD. This result supports the view that thyroid autoimmunity is a positive prognostic factor for breast cancer. The mechanism by which this is effective should be investigated with new studies.

Keywords:

Autoimmune thyroid disease, breast cancer, prognostic and predictive factors,

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