放射性治疗甲状腺功能障碍和癌症发生率和死亡率之间的关联
Harry D Momo1, Megan R Haymart2, Xu Shi3
1Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
The Journal of clinical endocrinology and metabolism
|February 17, 2026
概括
放射性 (RAI) 治疗甲状腺功能障碍症并没有增加整体癌症风险,但与女性乳腺癌发病率较高和胰腺癌死亡率有关. 长期安全监测对于接受RAI治疗的患者至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 自20世纪40年代以来,放射性 (RAI) 已成为甲状腺功能障碍的主要治疗方法.
- 长期的安全性,特别是癌症风险,仍然是争论的主题.
- 这项研究调查了RAI与癌症发病率/死亡率之间的关联.
研究的目的:
- 评估放射性 (RAI) 治疗甲状腺功能障碍症的长期安全性.
- 评估RAI治疗与整体和特定癌症发病率和死亡率之间的关联.
- 为了比较用RAI治疗的患者与抗甲状腺药物或甲状腺切除术治疗的患者的癌症风险.
主要方法:
- 使用非识别电子健康记录的回顾性队列研究 (2006-2019).
- 包括新出现甲状腺功能障碍的成年人 (≥18岁),以前没有癌症,接受RAI治疗,抗甲状腺药物治疗或甲状腺切除术.
- 时间依赖的考克斯模型分析了癌症发病率和死亡率,对共变量进行调整;追踪到2022年12月.
主要成果:
- RAI治疗与整体癌症发病率 (mv HR=1.02) 或死亡率 (mv HR=0.81) 无关.
- 在女性 (mv HR=2.24),尤其是绝经后妇女 (mv HR=2.65) 中,RAI显著增加了乳腺癌风险.
- 随着≥2年的随访 (年龄-adj HR=4.05) 观察到胰腺癌死亡率显著增加.
结论:
- RAI治疗与乳腺癌发病率的增加有关,而不是总体癌症发病率或死亡率.
- 胰腺癌死亡率的发现需要进一步调查.
- 强调需要在接受RAI治疗的患者中继续进行长期安全监测.
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