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Studies on dys function of hypothalamic pituitary thyroid axis part 2 studies on dys function of hypothalamic pituitary thyroid axis in breast cancer



Studies on dys function of hypothalamic pituitary thyroid axis part 2 studies on dys function of hypothalamic pituitary thyroid axis in breast cancer



Medical Journal of Kobe University 36(3): 9-16



To study the pituitary-thyroid axis in breast cancer, plasma thyrotropin (TSH) and triiodothyronine (T3) levels were measured before and after the single i.v. administration of 500 .mu.g synthetic thyrotropin-releasing hormone (TRH) in 31 patients with breast cancer (31 early, 5 advanced and 8 adreno-oophorectomized patients with breast cancer). As controls, 13 normal women of similar ages were also studied. Serum T4 levels in patients with early breast cancer, advanced breast cancer and advanced breast cancer who underwent adreno-oophorectomy, were 8.6 .+-. 0.38, 7.5 .+-. 0.96 and 7.9 .+-. 0.83 .mu.g/dl (Mean .+-. SEM), respectively, which were slightly, but insignificantly lower than in normal subjects. ETR [effective thyroxine ratio] values in patients with breast cancer also tended to be low, ranging from 0.85-1.2 throughout all stages. Mean T3 levels in patients with early breast cancer, advanced breast cancer and adreno-oophorectomized patients were 111.7 .+-. 5.85, 110.8 .+-. 9.96 and 105.0 .+-. 10.92 ng/dl (Mean .+-. SEM), respectively, which were not significantly different from that of control subjects. Some breast cancer patients had plasma T3 levels below the 2 standard deviation from the mean of normal subjects. Plasma T3 did not rise up to 120 min after TRH injection in 6 of 18 patients with early breast cancer, 2 of 5 advanced breast cancer and 3 of 8 adreno-oophorectomized patients. Plasma T3 response to endogenous TSH, as assessed by .DELTA.T3/.DELTA.TSH (the increment after TRH of plasma T3 from basal level divided by the increment of plasma TSH), was low in 4 of 18 patients with early breast cancer, 2 of 5 advanced breast cancer and 5 of 8 adreno-oophorectomized patients. Some breast cancer patients have latent hypothyroidism which is primary thyroid origin. The etiology and significance of hypothyroidism in breast cancer remain to be clarified.

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