期刊
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE
卷 106, 期 6, 页码 -出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/jnci/dju097
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资金
- World Cancer Research Fund [2009/92]
- European Commission (DG-SANCO)
- International Agency for Research on Cancer
- Danish Cancer Society, Denmark
- Ligue Contre le Cancer, France
- Institut Gustave Roussy, France
- Mutuelle Generale de l'Education Nationale, France
- Institut National de la Sante et de la Recherche Medicale, France
- Deutsche Krebshilfe, Germany
- Deutsches Krebsforschungszentrum, Germany
- Federal Ministry of Education and Research, Germany
- Hellenic Health Foundation, Greece
- Italian Association for Research on Cancer
- National Research Council, Italy
- Dutch Ministry of Public Health, Welfare and Sports, the Netherlands
- Netherlands Cancer Registry, the Netherlands
- LK Research Funds, the Netherlands
- Dutch Prevention Funds, the Netherlands
- Dutch ZON (Zorg Onderzoek Nederland), the Netherlands
- World Cancer Research Fund, London, UK
- Statistics Netherlands, the Netherlands
- European Research Council, Norway
- Health Research Fund, Regional Government of Andalucia [6236]
- Health Research Fund, Regional Government of Asturias [6236]
- Health Research Fund, Regional Government of Basque Country [6236]
- Health Research Fund, Regional Government of Murcia [6236]
- Health Research Fund, Regional Government of Navarra
- ISCIII RETIC, Spain [RD06/0020/0091]
- Swedish Cancer Society, Sweden
- Swedish Scientific Council, Sweden
- Regional Government of Skane, Sweden
- Regional Government of Vasterbotten, Sweden
- Cancer Research United Kingdom
- Medical Research Council, United Kingdom
- Stroke Association, United Kingdom
- British Heart Foundation, United Kingdom
- Department of Health, Food Standards Agency, United Kingdom
- Wellcome Trust
- United Kingdom
- Cancer Research UK [16491, 14136] Funding Source: researchfish
- Medical Research Council [G0401527, G1000143] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114] Funding Source: researchfish
Background Increased levels of thyroglobulin (Tg) and thyroid-stimulating hormone (TSH) are associated with differentiated thyroid carcinoma (TC) risk, but strong epidemiological evidence is lacking. Methods Three hundred fifty-seven incident TC case patients (n = 300 women and 57 men; mean age at blood collection = 51.5 years) were identified in the EPIC cohort study and matched with 2 (women) or 3 (men) control subjects using incidence density sampling. Matching included study center, sex, age, date, time, and fasting status at blood collection. Levels of total and free (f) thyroxine (T4) and triiodo-thyronine (T3), TSH, Tg, and anti-Tg antibodies (TgAb) were measured by commercially available immunoassays. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using conditional logistic regression. All statistical tests were two-sided. Results TC risk was positively associated with Tg (OR for the highest vs lowest quartile = 9.15; 95% CI = 5.28 to 15.90; P < .001) and negatively associated with TSH level (OR = 0.56; 95% CI = 0.38 to 0.81; P = .001). Odds ratios were not modified by adjustment for weight and height and were consistent across sexes, age groups, and countries. The association with Tg was stronger in follicular than papillary TC. The odds ratio for TgAb-positivity was 1.50 (95% CI = 1.05 to 2.15; P = .03). Among case patients, TSH level was stable over time, whereas Tg level was higher in proximity to TC diagnosis. Areas under the receiver operating characteristic curve were 57% and 74% for TSH and Tg level, respectively. Conclusions High Tg levels precede by up to 8 years the detection of TC, pointing to a long sojourn time of the disease. Low TSH levels may predispose to TC onset. Neither marker has sufficient accuracy to be a screening test.
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