Scientific letter
Statin therapy does not influence in the form onset of differentiated thyroid carcinoma
El tratamiento con estatinas no influye en la forma de presentación del carcinoma diferenciado de tiroides
Carles Zafon
, Gabriel Obiols, Jordi Mesa
Corresponding author
Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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In thyroids, statins have shown their ability to induce anaplastic carcinomas cell line redifferentiation.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">2–4</span></a> It has also been described that these drugs reduce both the incidence and size of thyroid nodules.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">5,6</span></a> In this work we shall analyse whether the use of statins is associated with a different profile of differentiated thyroid cancer (DTC) presentation. A total of 192 cases were included retrospectively. The sample was divided in 2 groups. Group 1: Patients receiving on going statin treatment for at least a whole year before the intervention, and who continued to receive statins by the time the thyroidectomy was performed. Group 2: Patients who did not take the drug during the 3 years prior to the surgery. Both groups were compared in terms of demographics, presence of diabetes mellitus, smoking habits, pre-surgical levels of thyrotropin (TSH), and the characteristics of the tumour at the time of the intervention: histological type (papillary carcinoma [PTC] and follicular carcinoma [FTC]), size, percentage, percentage of microcarcinoma, multifocal quality, nodal metastasis, associated thyroidism and distant metastasis. The statistical analysis was made according to the chi-square and Mann–Whitney <span class="elsevierStyleItalic">U</span> tests.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Group 1 included 36 cases (29 females and 7 males, average age 63.7 [12.5] years). In group 2 there were 156 subjects (121 females and 35 males, average age 49.3 [15.6] years). Differences were not significant in terms of gender but in terms of age, with a majority of subjects treated with hypolipidemic agents (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). Likewise, group 1 presented a larger number of patients with diabetes mellitus type 2 (18 [50%] as opposed to 14 [9%]; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). No differences were observed in terms of pre-surgical THS levels, tumour size, tumour multicentricity, and presence of lymph-nodes or distant metastasis. The incidence of FTC was higher among patients who received statin treatment. Thus, 8 of 36 cases (22%) from group 1 were FTC, while only 13 of 156 patients (8.3%) from group 2 presented this histological variant (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02). However, patients with FTC were older than those affected with PTC (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.01), therefore differences disappeared age-wise.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Different works have displayed a possible relation between statins and the thyroid gland. Gullu et al.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> have shown that the drug reduces TSH and increases thyroid hormones in patients with hypothyroidism. Yandell et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a> suggested that statins might show blood reduction of false negative TSH result. On the other hand, some studies have revealed the protective effect of statins in the development of certain types of cancers<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a>, even though a recent meta-analysis concluded that drugs offer a neutral effect in relation to cancer incidence and death risk.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> In some cases, the DTC suffers a tumour non-differentiation process, making it refractory to conventional treatments. Loss of differentiation entails a deterioration in the patient's prognosis. Different strategies have been implemented for years to try and revert the process (re-differentiation process). Among many of the drugs used, statins have shown, in <span class="elsevierStyleItalic">in vitro</span> experiments, that they can induce differentiation and apoptosis, and they can inhibit the invasive component in cell lines in thyroid non-differentiated and anaplastic cancer.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">2–4</span></a> In view of these findings, statins have been proposed as an adjuvant therapy to treat advanced DTC. The non-proliferative effect of statins has been corroborated not just in experimental studies and in relation to thyroid cancer, but also in clinical studies and in relation to benign thyroid diseases. In their published work, Capelli et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> showed that dyslipidemic patients treated with statins for at least 5 years presented a lower prevalence of thyroid nodular disease and a reduction in the number and volume of thyroid nodules, in comparison to the control group. The reduction in nodular number and size is related to the daily drug dose administered. Chon et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> have verified the same results in elderly patients with diabetes mellitus type 2. In spite of the aforementioned evidence, there is no study, to date, that has analysed the relation between statin treatment and the TDC presentation form. In this study we have assessed the influence of hypolipidemic treatment over variables widely used as bad prognosis markers for this type of cancer. In our sample we have not been able to associate the treatment with a less aggressive profile of tumour, according to the meta-analysis result published by Dale et al. Thus, unlike the findings published in relation to benign thyroid disease, statin treatment is not associated with a different TDC profile presentation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Zafon C, Obiols G, Mesa J. El tratamiento con estatinas no influye en la forma de presentación del carcinoma diferenciado de tiroides. Med Clin (Barc). 2015;144:44–45.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Statins and cancer prevention" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.F. Demierre" 1 => "P.D. Higgins" 2 => "S.B. Gruber" 3 => "E. Hawk" 4 => "S.M. Lippman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrc1751" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Cancer" "fecha" => "2005" "volumen" => "5" "paginaInicial" => "930" "paginaFinal" => "942" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16341084" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lovastatin-induced apoptosis in thyroid cells: Involvement of cytochrome c and lamin B" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Di Matola" 1 => "F. D’Ascoli" 2 => "C. Luongo" 3 => "M. Bifulco" 4 => "G. Rossi" 5 => "G. Fenzi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Endocrinol" "fecha" => "2001" "volumen" => "145" "paginaInicial" => "645" "paginaFinal" => "650" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11720884" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lovastatin inhibits proliferation of anaplastic thyroid cancer cells through up-regulation of p27 by interfering with the Rho/ROCK-mediated pathway" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W.B. Zhong" 1 => "S.P. Hsu" 2 => "P.Y. Ho" 3 => "Y.C. Liang" 4 => "T.C. Chang" 5 => "W.S. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bcp.2011.08.021" "Revista" => array:6 [ "tituloSerie" => "Biochem Pharmacol" "fecha" => "2011" "volumen" => "82" "paginaInicial" => "1663" "paginaFinal" => "1672" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21907187" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rosuvastatin induces apoptosis in cultured human papillary thyroid cancer cells" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.D. Zeybek" 1 => "N.E. Gulcelik" 2 => "F.F. Kaymaz" 3 => "C. Sarisozen" 4 => "I. Vural" 5 => "E. Bodur" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/JOE-10-0411" "Revista" => array:6 [ "tituloSerie" => "J Endocrinol" "fecha" => "2011" "volumen" => "210" "paginaInicial" => "105" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21478229" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reduced thyroid volume and nodularity in dyslipidaemic patients on statin treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Cappelli" 1 => "M. Castellano" 2 => "I. Pirola" 3 => "E. de Martino" 4 => "E. Gandossi" 5 => "A. Delbarba" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Endocrinol (Oxf)" "fecha" => "2008" "volumen" => "68" "paginaInicial" => "16" "paginaFinal" => "21" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of long-term statin use in type 2 diabetic patients on thyroid nodularity in iodine-sufficient area" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.G. Chon" 1 => "J.H. Suk" 2 => "K.H. Oh" 3 => "K.I. Kim" 4 => "Y.J. Kim" 5 => "H.G. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0031-1283123" "Revista" => array:6 [ "tituloSerie" => "Exp Clin Endocrinol Diabetes" "fecha" => "2011" "volumen" => "119" "paginaInicial" => "497" "paginaFinal" => "501" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21915844" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In vivo and in vitro effects of statins on lymphocytes in patients with Hashimoto's thyroiditis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Gullu" 1 => "R. Emral" 2 => "M. Bastemir" 3 => "A.B. Parkes" 4 => "J.H. Lazarus" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/eje.1.01941" "Revista" => array:6 [ "tituloSerie" => "Eur J Endocrinol" "fecha" => "2005" "volumen" => "153" "paginaInicial" => "41" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15994744" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radioiodine studies, low serum thyrotropin, and the influence of statin drugs" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.D. Yandell" 1 => "W.C. Harvey" 2 => "N.J. Fernandes" 3 => "P.W. Barr" 4 => "M. Feldman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2008.0129" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2008" "volumen" => "18" "paginaInicial" => "1039" "paginaFinal" => "1042" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18800872" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Statins and cancer risk: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K.M. Dale" 1 => "C.I. Coleman" 2 => "N.N. Henyan" 3 => "J. Kluger" 4 => "C.M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2017 October | 6 | 3 | 9 |
| 2017 September | 9 | 9 | 18 |
| 2017 August | 2 | 4 | 6 |
| 2017 July | 2 | 2 | 4 |
| 2017 June | 4 | 10 | 14 |
| 2017 May | 1 | 6 | 7 |
| 2017 April | 9 | 11 | 20 |
| 2017 March | 8 | 5 | 13 |
| 2017 February | 3 | 1 | 4 |
| 2017 January | 0 | 3 | 3 |
