J Gastric Cancer.  2013 Jun;13(2):106-110.

Goiter Frequency Is More Strongly Associated with Gastric Adenocarcinoma than Urine Iodine Level

• Tabaeizadeh M
• Haghpanah
• Keshtkar A
• Semnani S
• Roshandel
• Adabi K
• Heshmat R
• Rohani D
• Kia A
• Hatami E
• Jahangirrad A
• Nabizadeh
• Larijani B

Abstract

PURPOSE
We designed our study to evaluate the hypothesis that gastric cancer is correlated with iodine deficiency or thyroid dysfunction.
MATERIALS AND METHODS
We investigated the total body iodine reserve, thyroid function status and autoimmune disorder in 40 recently diagnosed gastric adenocarcinoma cases versus 80 healthy controls. The participants came from a region with high gastric cancer rate but sufficient iodine supply due to salt iodination. The investigation included urine iodine level, thyroid gland clinical and ultrasonographic examination, and thyroid function tests.
RESULTS
Goiter was detected more frequently in the case group (P=0.001); such a finding, however, was not true for lower than normal urine iodine levels. The free T3 mean level was significantly lower in the case group compared to the control group (P=0.005).
CONCLUSIONS
The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goiter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma compared to the existing iodine deficiency itself.

Keyword

Stomach neoplasms; Goiter; Iodine; Thyroid function tests; Autoimmune diseases

MeSH Terms

Adenocarcinoma
Autoimmune Diseases
Goiter
Halogenation
Iodine
Porphyrins
Prevalence
Stomach Neoplasms
Thyroid Function Tests
Thyroid Gland
Iodine
Porphyrins

Reference

1. Kurtz RC, Sherlock P. The diagnosis of gastric cancer. Semin Oncol. 1985. 12:11–18.

2. Kamangar F, Dawsey SM, Blaser MJ, Perez-Perez GI, Pietinen P, Newschaffer CJ, et al. Opposing risks of gastric cardia and noncardia gastric adenocarcinomas associated with Helicobacter pylori seropositivity. J Natl Cancer Inst. 2006. 98:1445–1452.

3. Abnet CC, Fan JH, Kamangar F, Sun XD, Taylor PR, Ren JS, et al. Self-reported goiter is associated with a significantly increased risk of gastric noncardia adenocarcinoma in a large population-based Chinese cohort. Int J Cancer. 2006. 119:1508–1510.

4. Venturi S, Venturi A, Cimini D, Arduini C, Venturi M, Guidi A. A new hypothesis: iodine and gastric cancer. Eur J Cancer Prev. 1993. 2:17–23.

5. Venturi S, Grossi L, Marra GA, Venturi A, Venturi M. Iodine, Helicobacter pylori, stomach cancer and evolution. European EPI-Marker. 2003. 7:1–7.

6. Gołkowski F, Szybiński Z, Rachtan J, Sokołowski A, Buziak-Bereza M, Trofimiuk M, et al. Iodine prophylaxis--the protective factor against stomach cancer in iodine deficient areas. Eur J Nutr. 2007. 46:251–256.

7. Gulaboglu M, Yildiz L, Celebi F, Gul M, Peker K. Comparison of iodine contents in gastric cancer and surrounding normal tissues. Clin Chem Lab Med. 2005. 43:581–584.

8. Aceves C, Anguiano B, Delgado G. Is iodine a gatekeeper of the integrity of the mammary gland? J Mammary Gland Biol Neoplasia. 2005. 10:189–196.

9. Kandemir EG, Yonem A, Narin Y. Gastric carcinoma and thyroid status. J Int Med Res. 2005. 33:222–227.

10. Syrigos KN, Konstantoulakis MM, Constantoulakis M, Marafelia P, Koutras D, Golematis BC. Thyroid autoantibodies and thyroid function in patients with gastric cancer. Acta Oncol. 1994. 33:905–907.

11. Behrouzian R, Aghdami N. Urinary iodine/creatinine ratio in patients with stomach cancer in Urmia, Islamic Republic of Iran. East Mediterr Health J. 2004. 10:921–924.

12. Venturi S. Letter to the editor. The thyroid gland. Clin Exp. 1998. 1:23.

13. Dai G, Levy O, Carrasco N. Cloning and characterization of the thyroid iodide transporter. Nature. 1996. 379:458–460.

14. Smanik PA, Liu Q, Furminger TL, Ryu K, Xing S, Mazzaferri EL, et al. Cloning of the human sodium lodide symporter. Biochem Biophys Res Commun. 1996. 226:339–345.

15. Tazebay UH, Wapnir IL, Levy O, Dohan O, Zuckier LS, Zhao QH, et al. The mammary gland iodide transporter is expressed during lactation and in breast cancer. Nat Med. 2000. 6:871–878.

16. Banerjee RK, Bose AK, Chakraborty TK, De SK, Datta AG. Peroxidase-catalysed iodotyrosine formation in dispersed cells of mouse extrathyroidal tissues. J Endocrinol. 1985. 106:159–165.

17. Promotion of iodized salt in the eastern Mediterranean, middleeast and north Africa. In : report of an inter country meeting; 10-12 April 2000; Dubai- United Arab Emirates. WHO.

18. Solbiati L, Charboneau JW, James EM, Hay ID. Rumack CM, Wilson SR, Charboneau JW, editors. The thyroid gland. Diagnostic Ultrasound. 1998. St. Louis: Mosby;704–705.

19. Rossi M, Negri E, Foschi R, Franceschi S, La Vecchia C. Relation between goiter and autoimmune thyroid disease, and gastric cancer. Int J Cancer. 2007. 120:951–952.

20. Andersson M, Takkouche B, Egli I, Allen HE, de Benoist B. Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. Bull World Health Organ. 2005. 83:518–525.

21. World Health Organization. United Nations Children's Fund. International Council for Control of Iodine Deficiency Disorders. Assessment of the iodine deficiency disorders and monitoring their elimination. 2001. 2nd ed. Geneva: World Health Organization;WHO document WHO/NHD/01.1.

22. Gaitan E. Goitrogens in food and water. Annu Rev Nutr. 1990. 10:21–39.

23. Beletskaia OM. The pathophysiological significance of the low triiodothyronine syndrome with increased clearance in cancer of the stomach and large intestine. Lik Sprava. 1996. (3-4):181–184.

24. Guernsey DL, Leuthauser SW. Correlation of thyroid hormone dose-dependent regulation of K-ras protooncogene expression with oncogene activation by 3-methylcholanthrene: loss of thyroidal regulation in the transformed mouse cell. Cancer Res. 1987. 47:3052–3056.

25. Jameson JL, Weetman AP. Kasper DL, Braunwald E, Fauci AS, editors. Disorders of the thyroid gland. Harrison's Principles. Internal Medicine. 2005. 16th ed. New York: McGraw-Hill;2119.