中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2014年
8期
669-672
,共4页
闫慧娴%谷伟军%杨国庆%巴建明%王先令%杜锦%欧阳金芝%金楠%吕朝晖%窦京涛%母义明%陆菊明
閆慧嫻%穀偉軍%楊國慶%巴建明%王先令%杜錦%歐暘金芝%金楠%呂朝暉%竇京濤%母義明%陸菊明
염혜한%곡위군%양국경%파건명%왕선령%두금%구양금지%금남%려조휘%두경도%모의명%륙국명
分化型甲状腺癌%甲状腺乳头状微小癌%促甲状腺激素
分化型甲狀腺癌%甲狀腺乳頭狀微小癌%促甲狀腺激素
분화형갑상선암%갑상선유두상미소암%촉갑상선격소
Differentiated thyroid cancer%Ppapillary thyroid microcarcinoma%Thyrotropin
目的：分析血中促甲状腺激素( TSH)水平与甲状腺乳头状微小癌之间的相关性。方法回顾性分析1999年10月至2011年2月在解放军总医院收治的1707例甲状腺结节患者临床资料,术后经病理证实良性结节1070例、分化型甲状腺癌637例,按照病灶最大直径分为>10 mm和≤10 mm分化型甲状腺癌组,并对各组血清TSH水平进行比较分析。分化型甲状腺癌中直径≤10 mm的242例均为甲状腺乳头状微小癌。结果(1)分化型甲状腺癌患者血清TSH水平显著高于良性结节组[1.99(1.25~3.19)对1.48(0.85~2.32) mU/L, P<0.01]；其中直径>10 mm分化型甲状腺癌患者血清TSH水平显著高于直径>10 mm良性结节组[2.04(1.26~3.36)对1.45(0.83~2.30) mU/L, P<0.01]；直径≤10 mm分化型甲状腺癌组血清TSH水平与直径≤10 mm良性结节组之间无显著性差异。(2)随着血清TSH水平的逐渐升高,甲状腺结节中分化型甲状腺癌患病率逐渐增加(P<0.01),直径>10 mm甲状腺结节患者中分化型甲状腺癌患者患病率随着血清TSH水平增加而呈增加趋势(P<0.05),但直径≤10 mm结节患者中分化型甲状腺癌患者患病率无此趋势(P>0.05)。(3)logistic回归分析显示血清TSH是分化型甲状腺癌的独立危险因素；按甲状腺结节直径分组进行logistic回归分析显示血清TSH是直径>10 mm分化型甲状腺癌的独立危险因素；而血清TSH与直径≤10 mm分化型甲状腺癌之间无明显相关性。结论血清TSH是预测分化型甲状腺癌风险的指标之一,血清TSH可以对直径大于10 mm分化型甲状腺癌的风险进行预测,但它并不是甲状腺乳头状微小癌良好的预测因子。
目的：分析血中促甲狀腺激素( TSH)水平與甲狀腺乳頭狀微小癌之間的相關性。方法迴顧性分析1999年10月至2011年2月在解放軍總醫院收治的1707例甲狀腺結節患者臨床資料,術後經病理證實良性結節1070例、分化型甲狀腺癌637例,按照病竈最大直徑分為>10 mm和≤10 mm分化型甲狀腺癌組,併對各組血清TSH水平進行比較分析。分化型甲狀腺癌中直徑≤10 mm的242例均為甲狀腺乳頭狀微小癌。結果(1)分化型甲狀腺癌患者血清TSH水平顯著高于良性結節組[1.99(1.25~3.19)對1.48(0.85~2.32) mU/L, P<0.01]；其中直徑>10 mm分化型甲狀腺癌患者血清TSH水平顯著高于直徑>10 mm良性結節組[2.04(1.26~3.36)對1.45(0.83~2.30) mU/L, P<0.01]；直徑≤10 mm分化型甲狀腺癌組血清TSH水平與直徑≤10 mm良性結節組之間無顯著性差異。(2)隨著血清TSH水平的逐漸升高,甲狀腺結節中分化型甲狀腺癌患病率逐漸增加(P<0.01),直徑>10 mm甲狀腺結節患者中分化型甲狀腺癌患者患病率隨著血清TSH水平增加而呈增加趨勢(P<0.05),但直徑≤10 mm結節患者中分化型甲狀腺癌患者患病率無此趨勢(P>0.05)。(3)logistic迴歸分析顯示血清TSH是分化型甲狀腺癌的獨立危險因素；按甲狀腺結節直徑分組進行logistic迴歸分析顯示血清TSH是直徑>10 mm分化型甲狀腺癌的獨立危險因素；而血清TSH與直徑≤10 mm分化型甲狀腺癌之間無明顯相關性。結論血清TSH是預測分化型甲狀腺癌風險的指標之一,血清TSH可以對直徑大于10 mm分化型甲狀腺癌的風險進行預測,但它併不是甲狀腺乳頭狀微小癌良好的預測因子。
목적：분석혈중촉갑상선격소( TSH)수평여갑상선유두상미소암지간적상관성。방법회고성분석1999년10월지2011년2월재해방군총의원수치적1707례갑상선결절환자림상자료,술후경병리증실량성결절1070례、분화형갑상선암637례,안조병조최대직경분위>10 mm화≤10 mm분화형갑상선암조,병대각조혈청TSH수평진행비교분석。분화형갑상선암중직경≤10 mm적242례균위갑상선유두상미소암。결과(1)분화형갑상선암환자혈청TSH수평현저고우량성결절조[1.99(1.25~3.19)대1.48(0.85~2.32) mU/L, P<0.01]；기중직경>10 mm분화형갑상선암환자혈청TSH수평현저고우직경>10 mm량성결절조[2.04(1.26~3.36)대1.45(0.83~2.30) mU/L, P<0.01]；직경≤10 mm분화형갑상선암조혈청TSH수평여직경≤10 mm량성결절조지간무현저성차이。(2)수착혈청TSH수평적축점승고,갑상선결절중분화형갑상선암환병솔축점증가(P<0.01),직경>10 mm갑상선결절환자중분화형갑상선암환자환병솔수착혈청TSH수평증가이정증가추세(P<0.05),단직경≤10 mm결절환자중분화형갑상선암환자환병솔무차추세(P>0.05)。(3)logistic회귀분석현시혈청TSH시분화형갑상선암적독립위험인소；안갑상선결절직경분조진행logistic회귀분석현시혈청TSH시직경>10 mm분화형갑상선암적독립위험인소；이혈청TSH여직경≤10 mm분화형갑상선암지간무명현상관성。결론혈청TSH시예측분화형갑상선암풍험적지표지일,혈청TSH가이대직경대우10 mm분화형갑상선암적풍험진행예측,단타병불시갑상선유두상미소암량호적예측인자。
Objective To study whether preoperative serum thyrotropin ( TSH) concentration can be used for risk prediction of papillary thyroid microcarcinoma ( PTMC ) . Methods The cohort of this retrospective study consisted of 1 707 patients who underwent surgery on thyroid nodules at Chinese PLA General Hospital from October 1999toFebruary2011. 37.32%(n=637)ofthesepatientssufferedfromdifferentiatedthyroidcancer(DTC),and 14. 18%(n=242) of patients with DTC suffered from PTMC. Results (1) The mean TSH level in patients with DTC was significantly higher than that in patients with benign thyroid nodules [(1. 99(1. 25-3. 19) vs 1. 48 (0. 85-2. 32) mU/L, P<0. 01]. DTC with diameter greater than 10 mm had higher serum TSH level compared with that in benign thyroid nodules[2. 04(1. 26-3. 36) vs 1. 45(0. 83-2. 30), P<0. 01]. Serum TSH level was not significantly raised in cases where-as the diameter of tumor was 10 mm or less. (2) With the increasing level of TSH, the prevalence of DTC and tumours with diameter greater than 10 mm rose significantly, but the increasing trend was not significant in PTMC. (3) Raised TSH level was an independent risk factor of DTC based on Binary logistic regression. Conclusions Serum TSH is an independent risk predictor of DTC, it is an independent risk predictor of the diameter of DTC greater than 10 mm, but it is not a good risk predictor in PTMC.
