Iodine and thyroid cancer Iodine is an essential trace element, iodine deficiency leads to reduced synthesis of thyroid hormones, increased levels of thyroid-stimulating hormone (TSH), stimulating thyroid follicle hyperplasia and hypertrophy, thyroid enlargement, thyroid hormones, increasing the incidence of thyroid cancer, and the current opinion is not unanimous. And high iodine diet may increase the incidence of papillary thyroid cancer. Radiation and thyroid cancer: X-ray irradiation of the thyroid gland of experimental rats can promote the occurrence of thyroid cancer in animals, with the deformation of cell nuclei and the synthesis of thyroxine greatly reduced, leading to cancer; on the other hand, the thyroid gland will be destroyed and can not produce endocrine hormone, and the large amount of TSH secretion caused by the result can also promote the cancer of the thyroid cells. 3.Chronic stimulation of thyroid stimulating hormone and thyroid cancer Thyroid follicles are highly differentiated and have the functions of iodine polymerization and synthesis of thyroglobulin. TSH also regulates the growth of thyroid follicular cells through cAMP-mediated signaling pathway, which may lead to thyroid cancer. Increased level of serum TSH induces nodular goiter, and follicular carcinoma of thyroid gland may be induced by giving mutagens and stimulation of TSH. Moreover, clinical studies have shown that TSH inhibition therapy plays an important role in the treatment of differentiated thyroid cancer after surgery, but whether TSH stimulation is a causative factor in the development of thyroid cancer remains to be confirmed. 4. Role of sex hormone and thyroid cancer Since there are more women than men in well-differentiated thyroid cancer patients, the relationship between sex hormone and thyroid cancer has been paid attention to. When comparing the tumor size of well-differentiated thyroid cancer in clinic, it is found that the tumors of young people are usually bigger than those of adults, and the cervical lymph node metastasis or distant metastasis of young people occurring in thyroid cancer is earlier than those of adults, but the prognosis is better than that of adults. 10 years of age, the incidence of women increases significantly. After the age of 10 years, the incidence of female increased significantly, it is possible that the increase of estrogen secretion is related to the occurrence of young people’s thyroid cancer, so some people study the sex hormone receptor in thyroid cancer tissues, and found that there are sex hormone receptors in thyroid tissues: estrogen receptor (ER) and progesterone receptor (PR), and the thyroid cancer tissues of the ER, but the effect of sex hormones on thyroid cancer has not been conclusive so far. 5, goiter-generating substances and thyroid cancer Animal experiments have confirmed that prolonged use of goiter-generating substances can induce thyroid cancer, but also impede the synthesis of thyroid hormones, so that TSH secretion increases, stimulate thyroid follicular hyperplasia, which may produce new organisms of the thyroid gland, accompanied by the diffuse enlargement of the thyroid gland, which can lead to thyroid tumors. 6.Other thyroid diseases and thyroid cancer (1) Nodular goiter has always been emphasized as a risk factor for the development of thyroid cancer, and the incidence of thyroid cancer in nodular goiter can be as high as 4%~17%. However, the interrelationship between nodular goiter and thyroid cancer has always been controversial, and the relationship between the progression of benign nodules to well differentiated cancers is not clear. The relationship between benign nodules and well-differentiated cancer is unclear. (2) The relationship between thyroid hyperplasia and thyroid cancer is not clear. Some reports found that congenital hyperplastic goiter without proper treatment for a long time eventually develops thyroid cancer, so it is very important to find congenital hyperplastic goiter in time and give thyroid hormone replacement therapy to eliminate the long-term stimulation of TSH. (3) Thyroid adenoma Most people think that thyroid cancer occurs with solitary thyroid adenoma, and if thyroid cancer is secondary to thyroid adenoma, the type of thyroid cancer should be mainly follicular carcinoma, but the fact is that papillary carcinoma of thyroid accounts for the majority of the patients, and patients with follicular carcinoma of thyroid often have the history of the previous existence of adenoma, but it is quite difficult to confirm the relationship between the two, and it is difficult to confirm the relationship between the two, even if the histological observation is used. Even with histologic observation, it is difficult to confirm the relationship between them. (4) Chronic lymphocytic thyroiditis In recent years, there have been more and more reports of thyroid cancer found in HT, with an incidence rate of 4.3% to 24%, which varies considerably, and the actual incidence is more difficult to estimate because HT mostly does not require surgical treatment; HT and thyroid cancer can be two unrelated diseases coexisting in the thyroid gland at the same time, and, on the other hand, focal HT may be the result of the body’s On the other hand, focal HT may also be the body’s immune response to thyroid cancer, and HT may lead to destruction of thyroid follicular cells, hypothyroidism, and decreased secretion of thyroid hormones, which in feedback causes TSH to increase, and TSH continues to stimulate thyroid follicular cells, which then become cancerous due to over proliferation of follicular cells; or TSH may act as a promoter of cancerous lesions at the same time as the overexpression of the thyroid oncogenes; and it is also believed that HT shares a common autoimmune response with thyroid cancer. thyroid cancer share a common background of autoimmune abnormalities. (5) Due to the low level of serum TSH in patients with hyperthyroidism, it was previously believed that thyroid cancer did not occur in patients with hyperthyroidism or that the incidence of thyroid cancer was consistent between patients with hyperthyroidism and the general population (0.6% to 1.6%), and the incidence of thyroid cancer could be 2.5% to 9.6%, whereas the incidence of hyperthyroidism could range from 3.3% to 19% in patients with hyperthyroidism, and surgically treated The patients with hyperthyroidism are either due to the larger thyroid gland or because of the existing thyroid nodules, so the actual incidence rate is not clear, and most of them are treated with medication. Therefore, the clinical situation of hyperthyroidism combined with thyroid cancer should be emphasized, and the presence of thyroid cancer should be more vigilant. 7.Family factors and thyroid cancer Thyroid cancer is less common as an independent familial syndrome, but can be part of a familial syndrome or hereditary disease, a few families have a tendency to suffer from multifocal well-differentiated thyroid cancer, thyroid cancer and familial colonic polyposis (e.g., Gardner’s syndrome), including adenomatous polyps of the colon combined with soft tissues to fibromatosis is the most common, combined with fibrosarcoma, which It is an autosomal dominant disease, caused by mutations in the APC gene located on chromosome 5q21 to q22, the latter being a signaling protein involved in the regulation of cell proliferation, and a minority of individuals may develop cancerous thyroid cancer under TSH stimulation. Clinical manifestations Masses found in the thyroid gland with hard and fixed texture and uneven surface are common manifestations of all types of cancer. The gland has little up and down mobility during swallowing. Undifferentiated carcinoma may present the above symptoms in a short period of time, which is accompanied by the characteristic of invasion of surrounding tissues in addition to the obvious growth of the mass. In advanced stage, hoarseness, difficulty in whistling and swallowing and sympathetic nerve compression may cause Horner’s syndrome and invasion of cervical plexus with pain in ear, occiput and shoulder and local lymph node and distant organ metastasis. Cervical lymph node metastasis occurs earlier in undifferentiated cancer. In some patients, thyroid lumps are not obvious, and when metastases are found and they seek medical treatment, the possibility of thyroid cancer should be thought of. Patients with medullary carcinoma should be excluded from type II multiple endocrine adenoma syndrome. Attention should be paid to the combined family history and the presence of diarrhea, facial flushing, and hypokalemia. Diagnosis: Thyroid cancer should be suspected if the thyroid mass is hard and fixed, the cervical lymph nodes are enlarged, or there are symptoms of compression, or the thyroid mass that has existed for many years is rapidly enlarged in a short period of time. Surgery The surgical treatment of thyroid cancer includes surgery of thyroid gland itself and cervical lymph node dissection. The scope of thyroidectomy is still divided, the smallest scope is lobectomy plus isthmus resection, and the largest scope is total thyroidectomy. 2.Endocrine therapy Those who have secondary or total resection of thyroid cancer should take thyroxine tablets for life, in order to prevent hypothyroidism and inhibit TSH. papillary adenocarcinoma and follicular adenocarcinoma have TSH receptor, and TSH can affect the growth of thyroid cancer through its receptor. Radionuclide therapy: For papillary adenocarcinoma and follicular adenocarcinoma, postoperative 131 iodine radiation therapy is suitable for patients over 45 years old, multiple cancer foci, locally invasive tumors and distant metastases.