甲状腺功能亢进症合并甲状腺癌的 研究进展
Research Progress of Hyperthyroidism Complicated with Thyroid Cancer
DOI: 10.12677/acm.2026.1662412, PDF,   
作者: 李 扬, 于 波, 徐 宁, 姚佳兴, 樊伟业, 李松埔, 窦福林, 赵颖洁, 李泽诚:齐齐哈尔市第一医院甲状腺外一科,黑龙江 齐齐哈尔
关键词: 甲状腺功能亢进症甲状腺癌手术治疗Hyperthyroidism Thyroid Cancer Surgical Treatment
摘要: 甲状腺功能亢进症合并甲状腺癌(Thyroid Carcinoma, TC)很少见,早期研究结果显示,甲状腺功能亢进症对TC具有保护作用,但最近的研究表明,甲状腺功能亢进症患者TC的发病率更高。随着当前医学技术水平的不断提高,对甲状腺功能亢进合并TC的诊断方法越来越科学、高效,明显降低了患者进行二次手术的风险。为了临床医师能更好地了解甲状腺功能亢进症合并TC的特点,本文主要从其发病情况、发病机制、诱发因素、诊断、治疗几个方面阐述相关研究进展。
Abstract: Hyperthyroidism combined with thyroid cancer is rare. Early research results indicated that hy-perthyroidism has a protective effect on thyroid cancer, but recent studies have shown that the in-cidence of thyroid cancer is higher in hyperthyroidism patients. With the continuous improvement of current medical technology, the diagnostic methods for hyperthyroidism combined with thyroid cancer have become increasingly scientific and efficient, significantly reducing the risk of patients undergoing secondary surgery. In order to help clinicians better understand the characteristics of hyperthyroidism combined with thyroid cancer, this article mainly elaborates on the research progress in several aspects including its incidence, pathogenesis, inducing factors, diagnosis, and treatment.
文章引用:李扬, 于波, 徐宁, 姚佳兴, 樊伟业, 李松埔, 窦福林, 赵颖洁, 李泽诚. 甲状腺功能亢进症合并甲状腺癌的 研究进展[J]. 临床医学进展, 2026, 16(6): 1917-1926. https://doi.org/10.12677/acm.2026.1662412

参考文献

[1] Ma, Q., Li, Y., An, L., Guo, L. and Liu, X. (2023) Assessment of Causal Association between Differentiated Thyroid Cancer and Disordered Serum Lipid Profile: A Mendelian Randomization Study. Frontiers in Endocrinology, 14, Article ID: 1291445. [Google Scholar] [CrossRef] [PubMed]
[2] English, C. (2024) Improving Care for Head-and-Neck and Thyroid Cancer Patients. British Journal of Nursing, 33, Article No. 48. [Google Scholar] [CrossRef] [PubMed]
[3] Cao, J., He, X., Li, X., Sun, Y., Zhang, W., Li, Y., et al. (2023) The Potential Association of Peripheral Inflammatory Biomarkers in Patients with Papillary Thyroid Cancer before Radioiodine Therapy to Clinical Outcomes. Frontiers in Endocrinology, 14, Article ID: 1253394. [Google Scholar] [CrossRef] [PubMed]
[4] Gabriele, R., Letizia, C., Borghese, M., De Toma, G., Celi, M., Izzo, L., et al. (2003) Thyroid Cancer in Patients with Hyperthyroidism. Hormone Research in Paediatrics, 60, 79-83. [Google Scholar] [CrossRef] [PubMed]
[5] Sokal, J.E. (1954) Incidence of Malignancy in Toxic and Nontoxic Nodular Goiter. Journal of the American Medical Association, 154, 1321-1325. [Google Scholar] [CrossRef] [PubMed]
[6] Rieger, R., Pimpl, W., Money, S., et al. (1989) Hyperthyroidism and Concurrent Thyroid Malignancies. Surgery, 106, 6-10.
[7] Pazaitou-Panayiotou, K., Michalakis, K. and Paschke, R. (2012) Thyroid Cancer in Patients with Hyperthyroidism. Hormone and Metabolic Research, 44, 255-262. [Google Scholar] [CrossRef] [PubMed]
[8] Keskin, C., Sahin, M., Hasanov, R., Aydogan, B.I., Demir, O., Emral, R., et al. (2020) Frequency of Thyroid Nodules and Thyroid Cancer in Thyroidectomized Patients with Graves’ Disease. Archives of Medical Science, 16, 302-307. [Google Scholar] [CrossRef] [PubMed]
[9] Ross, D.S., Burch, H.B., Cooper, D.S., Greenlee, M.C., Laurberg, P., Maia, A.L., et al. (2016) 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid®, 26, 1343-1421. [Google Scholar] [CrossRef] [PubMed]
[10] El, M. (1990) Thyroid Cancer and Graves’ Disease. The Journal of Clinical Endocrinology & Metabolism, 70, 826-829.
[11] Cappelli, C., Braga, M., Martino, E.D., Castellano, M., Gandossi, E., Agosti, B., et al. (2006) Outcome of Patients Surgically Treated for Various Forms of Hyperthyroidism with Differentiated Thyroid Cancer: Experience at an Endocrine Center in Italy. Surgery Today, 36, 125-130. [Google Scholar] [CrossRef] [PubMed]
[12] Pellegriti, G. (1998) Outcome of Differentiated Thyroid Cancer in Graves’ Patients. Journal of Clinical Endocrinology & Metabolism, 83, 2805-2809. [Google Scholar] [CrossRef] [PubMed]
[13] MacFarland, S.P., Bauer, A.J., Adzick, N.S., Surrey, L.F., Noyes, J., Kazahaya, K., et al. (2018) Disease Burden and Outcome in Children and Young Adults with Concurrent Graves Disease and Differentiated Thyroid Carcinoma. The Journal of Clinical Endocrinology & Metabolism, 103, 2918-2925. [Google Scholar] [CrossRef] [PubMed]
[14] Ozaki, O., Ito, K., Kobayashi, K., Toshima, K., Iwasaki, H. and Yashiro, T. (1990) Thyroid Carcinoma in Graves’ Disease. World Journal of Surgery, 14, 437-440. [Google Scholar] [CrossRef] [PubMed]
[15] Chen, Y., Lin, C., Chang, Y., Cheng, F.T., Peng, C., Sung, F., et al. (2013) Cancer Risk in Patients with Graves’ Disease: A Nationwide Cohort Study. Thyroid, 23, 879-884. [Google Scholar] [CrossRef] [PubMed]
[16] Papanastasiou, A., Sapalidis, K., Goulis, D.G., Michalopoulos, N., Mareti, E., Mantalovas, S., et al. (2019) Thyroid Nodules as a Risk Factor for Thyroid Cancer in Patients with Graves’ Disease: A Systematic Review and Meta‐Analysis of Observational Studies in Surgically Treated Patients. Clinical Endocrinology, 91, 571-577. [Google Scholar] [CrossRef] [PubMed]
[17] Premoli, P., Tanda, M.L., Piantanida, E., Veronesi, G., Gallo, D., Masiello, E., et al. (2020) Features and Outcome of Differentiated Thyroid Carcinoma Associated with Graves’ Disease: Results of a Large, Retrospective, Multicenter Study. Journal of Endocrinological Investigation, 43, 109-116. [Google Scholar] [CrossRef] [PubMed]
[18] Belfiore, A., Garofalo, M.R., Giuffrida, D., Runello, F., Filetti, S., Fiumara, A., et al. (1990) Increased Aggressiveness of Thyroid Cancer in Patients with Graves’ Disease. The Journal of Clinical Endocrinology & Metabolism, 70, 830-835. [Google Scholar] [CrossRef] [PubMed]
[19] Ergin, A.B., Saralaya, S. and Olansky, L. (2014) Incidental Papillary Thyroid Carcinoma: Clinical Characteristics and Prognostic Factors among Patients with Graves’ Disease and Euthyroid Goiter, Cleveland Clinic Experience. American Journal of Otolaryngology, 35, 784-790. [Google Scholar] [CrossRef] [PubMed]
[20] Ferrari, S.M., Fallahi, P., Elia, G., Ragusa, F., Ruffilli, I., Paparo, S.R., et al. (2020) Thyroid Autoimmune Disorders and Cancer. Seminars in Cancer Biology, 64, 135-146. [Google Scholar] [CrossRef] [PubMed]
[21] Ichikawa, Y., Saito, E., Abe, Y., Homma, M., Muraki, T. and Ito, K. (1976) Presence of TSH Receptor in Thyroid Neoplasms. The Journal of Clinical Endocrinology & Metabolism, 42, 395-398. [Google Scholar] [CrossRef] [PubMed]
[22] Schorr, I., Hinshaw, H.T., Cooper, M.A., Mahaffee, D. and Ney, R.L. (1972) Adenyl Cyclase Hormone Responses of Certain Human Endocrine Tumors. The Journal of Clinical Endocrinology & Metabolism, 34, 447-451. [Google Scholar] [CrossRef] [PubMed]
[23] Belfiore, A., Russo, D., Vigneri, R. and Filetti, S. (2001) Graves’ Disease, Thyroid Nodules and Thyroid Cancer. Clinical Endocrinology, 55, 711-718. [Google Scholar] [CrossRef] [PubMed]
[24] Filetti, S., Belfiore, A., Amir, S.M., Daniels, G.H., Ippolito, O., Vigneri, R., et al. (1988) The Role of Thyroid-Stimulating Antibodies of Graves’ Disease in Differentiated Thyroid Cancer. New England Journal of Medicine, 318, 753-759. [Google Scholar] [CrossRef] [PubMed]
[25] Katz, S.B., García, A.J. and Niepomniszcze, H. (1997) Development of Graves’ Disease Nine Years after Total Thyroidectomy Due to Follicular Carcinoma of the Thyroid. Thyroid, 7, 909-911. [Google Scholar] [CrossRef] [PubMed]
[26] 季晓昕. 原发性甲状腺功能亢进症合并甲状腺癌的诊断和治疗进展[J]. 临床肿瘤学杂志, 2003(1): 72-74.
[27] Gursoy, A. (2010) Rising Thyroid Cancer Incidence in the World Might Be Related to Insulin Resistance. Medical Hypotheses, 74, 35-36. [Google Scholar] [CrossRef] [PubMed]
[28] Liu, Y., Huang, Y., Mo, G., Zhou, T., Hou, Q., Shi, C., et al. (2022) Combined Prognostic Value of Preoperative Serum Thyrotrophin and Thyroid Hormone Concentration in Papillary Thyroid Cancer. Journal of Clinical Laboratory Analysis, 36, e24503. [Google Scholar] [CrossRef] [PubMed]
[29] Kim, J., Kim, M.K., Baek, K., Song, K., Han, K. and Kwon, H. (2022) Repeated Low High-Density Lipoprotein Cholesterol and the Risk of Thyroid Cancer: A Nationwide Population-Based Study in Korea. Endocrinology and Metabolism, 37, 303-311. [Google Scholar] [CrossRef] [PubMed]
[30] Schmid, D., Ricci, C., Behrens, G. and Leitzmann, M.F. (2015) Adiposity and Risk of Thyroid Cancer: A Systematic Review and Meta‐Analysis. Obesity Reviews, 16, 1042-1054. [Google Scholar] [CrossRef] [PubMed]
[31] Lun, Y., Wu, X., Xia, Q., Han, Y., Zhang, X., Liu, Z., et al. (2013) Hashimoto’s Thyroiditis as a Risk Factor of Papillary Thyroid Cancer May Improve Cancer Prognosis. OtolaryngologyHead and Neck Surgery, 148, 396-402. [Google Scholar] [CrossRef] [PubMed]
[32] Navarro Silvera, S.A., Miller, A.B. and Rohan, T.E. (2005) Risk Factors for Thyroid Cancer: A Prospective Cohort Study. International Journal of Cancer, 116, 433-438. [Google Scholar] [CrossRef] [PubMed]
[33] Wang, G., Ren, N., Wang, S., Zhang, X., Li, Y., Sun, N., et al. (2021) Serum TSH Is Not a Risk Factor for Malignancy of Pediatric Thyroid Nodules. Endocrine-Related Cancer, 28, 247-255. [Google Scholar] [CrossRef] [PubMed]
[34] Franceschi, S. (2009) Iodine Intake and Thyroid Carcinoma—A Potential Risk Factor. Experimental and Clinical Endocrinology & Diabetes, 106, S38-S44. [Google Scholar] [CrossRef] [PubMed]
[35] Hu, M., Zhao, H., Li, G., Zhang, H., He, J. and Huang, F. (2021) Body Mass Index and Weight Gain after Middle Adulthood Are Associated with Risk of Papillary Thyroid Cancer: A Case-Control Study. Cancer Epidemiology, 75, Article ID: 102039. [Google Scholar] [CrossRef] [PubMed]
[36] Seo, S., Park, S., Lee, D.N., Cha, E.S., Park, S. and Jin, Y.W. (2021) Increased Incidence of Thyroid Cancer in Occupational Radiation Epidemiology: Attribution to Screening among Radiation Workers. Radiation Research, 195, 397-400. [Google Scholar] [CrossRef] [PubMed]
[37] Takamura, N., Orita, M., Saenko, V., Yamashita, S., Nagataki, S. and Demidchik, Y. (2016) Radiation and Risk of Thyroid Cancer: Fukushima and Chernobyl. The Lancet Diabetes & Endocrinology, 4, Article No. 647. [Google Scholar] [CrossRef] [PubMed]
[38] Yeo, Y., Ma, S., Hwang, Y., Horn-Ross, P.L., Hsing, A., Lee, K., et al. (2014) Diabetes Mellitus and Risk of Thyroid Cancer: A Meta-Analysis. PLOS ONE, 9, e98135. [Google Scholar] [CrossRef] [PubMed]
[39] Iglesias, M.L., Schmidt, A., Ghuzlan, A.A., Lacroix, L., Vathaire, F.d., Chevillard, S., et al. (2017) Radiation Exposure and Thyroid Cancer: A Review. Archives of Endocrinology and Metabolism, 61, 180-187. [Google Scholar] [CrossRef] [PubMed]
[40] Zhao, J., Wang, H., Zhang, Z., Zhou, X., Yao, J., Zhang, R., et al. (2019) Vitamin D Deficiency as a Risk Factor for Thyroid Cancer: A Meta-Analysis of Case-Control Studies. Nutrition, 57, 5-11. [Google Scholar] [CrossRef] [PubMed]
[41] Li, J., Wang, X. and Dong, J. (2016) Association of Rs6983267 Polymorphism and Thyroid Cancer Susceptibility: A Systematic Review and Meta-Analysis. Medical Science Monitor, 22, 1866-1871. [Google Scholar] [CrossRef] [PubMed]
[42] Yeo, Y., Shin, D.W., Han, K., Kim, D., Kim, T.H., Chun, S., et al. (2022) Smoking, Alcohol Consumption, and the Risk of Thyroid Cancer: A Population-Based Korean Cohort Study of 10 Million People. Thyroid®, 32, 440-448. [Google Scholar] [CrossRef] [PubMed]
[43] Rakhlin, L. and Fish, S. (2018) Pregnancy as a Risk Factor for Thyroid Cancer Progression. Current Opinion in Endocrinology, Diabetes & Obesity, 25, 326-329. [Google Scholar] [CrossRef] [PubMed]
[44] Li, C., Li, J., Li, S., Zhao, Y., Liu, G., Du, R., et al. (2022) Prognostic Significance of Inflammatory Markers LMR, PLR, MPV, FIB in Intermediate-And High-Risk Papillary Thyroid Carcinoma. Frontiers in Endocrinology, 13, Article ID: 984157. [Google Scholar] [CrossRef] [PubMed]
[45] Vigneri, R., Malandrino, P. and Vigneri, P. (2015) The Changing Epidemiology of Thyroid Cancer: Why Is Incidence Increasing? Current Opinion in Oncology, 27, 1-7. [Google Scholar] [CrossRef] [PubMed]
[46] 吴建飞, 陆林法, 李福新. 原发性甲状腺功能亢进症合并甲状腺癌七例报告[J]. 临床外科杂志, 2001(2): 122.
[47] Wang, C., Chang, T., Chang, T., Hsiao, Y., Chen, M. and Huang, S. (2001) Thyroidectomy or Radioiodine? The Value of Ultrasonography and Cytology in the Assessment of Nodular Lesions in Graves’ Hyperthyroidism. The American Surgeon, 67, 721-726. [Google Scholar] [CrossRef
[48] Zanella, E., Rulli, F., Muzi, M., Sianesi, M., Danese, D., Sciacchitano, S., et al. (1998) Prevalence of Thyroid Cancer in Hyperthyroid Patients Treated by Surgery. World Journal of Surgery, 22, 473-478. [Google Scholar] [CrossRef] [PubMed]
[49] Hegedüs, L. (2001) Thyroid Ultrasound. Endocrinology and Metabolism Clinics of North America, 30, 339-360. [Google Scholar] [CrossRef] [PubMed]
[50] Wong, C.K.M. and Wheeler, M.H. (2000) Thyroid Nodules: Rational Management. World Journal of Surgery, 24, 934-941. [Google Scholar] [CrossRef] [PubMed]
[51] 吴华. 核素显像在甲状腺结节性病变诊断中的应用[J]. 临床内科杂志, 2011, 28(3): 155-157.
[52] Park, J.Y., Choi, W., Hong, A.R., Yoon, J.H., Kim, H.K. and Kang, H. (2023) A Comprehensive Assessment of the Harms of Fine-Needle Aspiration Biopsy for Thyroid Nodules: A Systematic Review. Endocrinology and Metabolism, 38, 104-116. [Google Scholar] [CrossRef] [PubMed]
[53] 胡淑阳, 吴艺捷. 甲状腺癌相关基因的研究进展[J]. 医学综述, 2009, 15(13): 1953-1956.
[54] Chao, T., Lin, J. and Chen, M. (2004) Surgical Treatment of Thyroid Cancers with Concurrent Graves Disease. Annals of Surgical Oncology, 11, 407-412. [Google Scholar] [CrossRef] [PubMed]
[55] 邢曙光. 甲状腺全切除治疗原发性甲状腺功能亢进症合并甲状腺癌的临床分析[J]. 世界最新医学信息文摘, 2018, 18(54): 43.
[56] 张宪波, 许践刚, 颜育祥, 等. 原发性甲状腺功能亢进症合并甲状腺癌的治疗[J]. 山东医药, 2008, (10): 48-49.
[57] Haugen, B.R., Alexander, E.K., Bible, K.C., Doherty, G.M., Mandel, S.J., Nikiforov, Y.E., et al. (2016) 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, 1-133. [Google Scholar] [CrossRef] [PubMed]
[58] Xiao, Q., Han, X., Liu, G., Zhou, D., Zhang, L., He, J., et al. (2022) Adenosine Restrains Ilc2-Driven Allergic Airway Inflammation via A2A Receptor. Mucosal Immunology, 15, 338-350. [Google Scholar] [CrossRef] [PubMed]