G Cortês Nascimento1,2,3, A G P de Araujo Cortês Nascimento4,5,6, C de Maria Ribeiro Veiga Parente7, V P Rodrigues5,8, R S de Sousa Azulay7,4,5, V C de Carvalho Rocha7,4,5, S da Silva Pereira Damianse7,4,5, M Magalhães4,5, M Dos Santos Faria7,4,5, M B Gomes9. 1. Service of Endocrinology, Presidente Dutra University Hospital, Federal University of Maranhão (UFMA), São Luís, MA, Brazil. gilvancortes@uol.com.br. 2. Clinical Research Center, Presidente Dutra University Hospital, Federal University of Maranhão (UFMA), São Luís, MA, Brazil. gilvancortes@uol.com.br. 3. Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, MA, Brazil. gilvancortes@uol.com.br. 4. Clinical Research Center, Presidente Dutra University Hospital, Federal University of Maranhão (UFMA), São Luís, MA, Brazil. 5. Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís, MA, Brazil. 6. Department of Pathology, Presidente Dutra University Hospital, Federal University of Maranhão (UFMA), São Luís, MA, Brazil. 7. Service of Endocrinology, Presidente Dutra University Hospital, Federal University of Maranhão (UFMA), São Luís, MA, Brazil. 8. Department of Morphology, Federal University of Maranhão (UFMA), São Luís, MA, Brazil. 9. Diabetes Unit-Department of Internal Medicine, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.
Abstract
PURPOSE: It is postulated that patients with different types of pituitary neuroendocrine tumors (PitNETs) may present a higher incidence of cancer. Factors underlying individuals becoming overweight, such as insulin resistance, hyperleptinemia, and low-grade inflammation, may play a role in the risk of differentiated thyroid carcinoma (DTC) in such patients. This study aimed to investigate the frequency of and obesity-related risk factors associated with DTC in patients with PitNETs. METHODS: This cross-sectional study involved 149 patients with nonacromegalic PitNETs (AG group), 71 patients with acromegaly (ACRO group), and 156 controls (CG group). All participants underwent insulin and blood glucose measurements with the determination of the homeostatic model assessment-insulin resistance (HOMA-IR) index, leptin, and high-sensitivity C-reactive protein (hsCRP), and they also underwent thyroid ultrasound. Clinically significant nodules were biopsied for subsequent cytopathological evaluation, and participants were operated on when indicated. RESULTS: Patients in the AG group had high levels of insulin resistance and significantly higher levels of leptin and hsCRP compared with those of patients in the ACRO group. There were no cases of DTC in the AG group; two findings, one incidental, of DTC occurred in the CG group, and three cases of DTC were present in the ACRO group. Acromegaly was associated with DTC after adjusted analysis. CONCLUSIONS: Our findings in patients with nonacromegalic PitNETs do not indicate a high risk for DTC despite the presence of metabolic and inflammatory risk factors for neoplastic events. In contrast, acromegaly promotes a greater risk of DTC.
PURPOSE: It is postulated that patients with different types of pituitary neuroendocrine tumors (PitNETs) may present a higher incidence of cancer. Factors underlying individuals becoming overweight, such as insulin resistance, hyperleptinemia, and low-grade inflammation, may play a role in the risk of differentiated thyroid carcinoma (DTC) in such patients. This study aimed to investigate the frequency of and obesity-related risk factors associated with DTC in patients with PitNETs. METHODS: This cross-sectional study involved 149 patients with nonacromegalic PitNETs (AG group), 71 patients with acromegaly (ACRO group), and 156 controls (CG group). All participants underwent insulin and blood glucose measurements with the determination of the homeostatic model assessment-insulin resistance (HOMA-IR) index, leptin, and high-sensitivity C-reactive protein (hsCRP), and they also underwent thyroid ultrasound. Clinically significant nodules were biopsied for subsequent cytopathological evaluation, and participants were operated on when indicated. RESULTS:Patients in the AG group had high levels of insulin resistance and significantly higher levels of leptin and hsCRP compared with those of patients in the ACRO group. There were no cases of DTC in the AG group; two findings, one incidental, of DTC occurred in the CG group, and three cases of DTC were present in the ACRO group. Acromegaly was associated with DTC after adjusted analysis. CONCLUSIONS: Our findings in patients with nonacromegalic PitNETs do not indicate a high risk for DTC despite the presence of metabolic and inflammatory risk factors for neoplastic events. In contrast, acromegaly promotes a greater risk of DTC.
Authors: Daniel S Olsson; Casper Hammarstrand; Ing-Liss Bryngelsson; Anna G Nilsson; Eva Andersson; Gudmundur Johannsson; Oskar Ragnarsson Journal: Endocr Relat Cancer Date: 2017-03-08 Impact factor: 5.678
Authors: Shereen Ezzat; Sylvia L Asa; William T Couldwell; Charles E Barr; William E Dodge; Mary Lee Vance; Ian E McCutcheon Journal: Cancer Date: 2004-08-01 Impact factor: 6.860