中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
12期
908-911
,共4页
甲状腺肿瘤%促甲状腺素%甲状腺结节
甲狀腺腫瘤%促甲狀腺素%甲狀腺結節
갑상선종류%촉갑상선소%갑상선결절
Thyroid Neoplasms%Thyrotropin%Thyroid nodule
目的 探讨血清促甲状腺激素(TSH)水平与甲状腺结节中乳头状甲状腺微小癌(PTMC)发生发展的关系.方法 收集首次行甲状腺结节手术并符合条件者365例,术后病理确诊PTMC者113例(PTMC组),良性结节252例(良性组),回顾性调查两组病史资料,比较两组术前TSH水平及所有入组患者不同TSH水平组间PTMC患病比例;在PTMC患者中,分析术前TSH水平与癌灶大小及淋巴结转移的关系.结果 PTMC组和良性组间术前TSH水平差异无统计学意义(P＞0.05),PTMC组的中位年龄低于良性组(Z=-2.877,P=0.004),而抗甲状腺球蛋白抗体(TGAb)水平高于良性组(Z=-2.887,P=0.004);不同TSH水平组间PTMC患病比例差异无统计学意义(P＞0.05),logistic回归分析显示仅年龄是PTMC的危险因素(OR=0.971,95％CI:0.953～0.990,P=0.003);PTMC患者中,TSH水平与癌灶大小呈正相关(r=0.218,P=0.025),但不同TSH水平组间淋巴结转移比例差异无统计学意义(P＞0.05).结论 血清TSH水平可能与PTMC的新发无关,但可能参与了已存在的PTMC的增长.
目的 探討血清促甲狀腺激素(TSH)水平與甲狀腺結節中乳頭狀甲狀腺微小癌(PTMC)髮生髮展的關繫.方法 收集首次行甲狀腺結節手術併符閤條件者365例,術後病理確診PTMC者113例(PTMC組),良性結節252例(良性組),迴顧性調查兩組病史資料,比較兩組術前TSH水平及所有入組患者不同TSH水平組間PTMC患病比例;在PTMC患者中,分析術前TSH水平與癌竈大小及淋巴結轉移的關繫.結果 PTMC組和良性組間術前TSH水平差異無統計學意義(P＞0.05),PTMC組的中位年齡低于良性組(Z=-2.877,P=0.004),而抗甲狀腺毬蛋白抗體(TGAb)水平高于良性組(Z=-2.887,P=0.004);不同TSH水平組間PTMC患病比例差異無統計學意義(P＞0.05),logistic迴歸分析顯示僅年齡是PTMC的危險因素(OR=0.971,95％CI:0.953～0.990,P=0.003);PTMC患者中,TSH水平與癌竈大小呈正相關(r=0.218,P=0.025),但不同TSH水平組間淋巴結轉移比例差異無統計學意義(P＞0.05).結論 血清TSH水平可能與PTMC的新髮無關,但可能參與瞭已存在的PTMC的增長.
목적 탐토혈청촉갑상선격소(TSH)수평여갑상선결절중유두상갑상선미소암(PTMC)발생발전적관계.방법 수집수차행갑상선결절수술병부합조건자365례,술후병리학진PTMC자113례(PTMC조),량성결절252례(량성조),회고성조사량조병사자료,비교량조술전TSH수평급소유입조환자불동TSH수평조간PTMC환병비례;재PTMC환자중,분석술전TSH수평여암조대소급림파결전이적관계.결과 PTMC조화량성조간술전TSH수평차이무통계학의의(P＞0.05),PTMC조적중위년령저우량성조(Z=-2.877,P=0.004),이항갑상선구단백항체(TGAb)수평고우량성조(Z=-2.887,P=0.004);불동TSH수평조간PTMC환병비례차이무통계학의의(P＞0.05),logistic회귀분석현시부년령시PTMC적위험인소(OR=0.971,95％CI:0.953～0.990,P=0.003);PTMC환자중,TSH수평여암조대소정정상관(r=0.218,P=0.025),단불동TSH수평조간림파결전이비례차이무통계학의의(P＞0.05).결론 혈청TSH수평가능여PTMC적신발무관,단가능삼여료이존재적PTMC적증장.
Objective To explore the relationship between serum level of thyroxin-stimulating hormone (TSH) and development and progression of papillary thyroid microcarcinoma (PTMC) in nodular thyroid disease.Methods A total of 365 eligible patients with thyroid nodules undergoing initial thyroidectomy were enrolled,including 113 patients with PTMC diagnosed by postoperative pathology (PTMC group) and 252 patients with benign thyroid nodules (BTN group).Their clinical data were retrospectively reviewed.The serum levels of TSH in two groups and the proportion of PTMC in different serum TSH level groups in all patients were compared respectively.The relationship of preoperative serum TSH levels with tumor size and lymphatic metastasis in patients with PTMC were analyzed.Results No significant difference existed in serum TSH levels between PTMC and BTN groups (P ＞ 0.05).The median age was younger in PTMC group than that in BTN group (Z =-2.877,P =0.004).And the TGAb levels were higher in PTMC group than those in BTN group (Z =-2.887,P =0.004).They were divided into 6 groups according to the serum TSH levels,and there weren't significant difference in the proportion of PTMC among those group (P ＞ 0.05).Binary logistic regression analysis showed age was the only risk factor of PTMC (OR =0.971,95％ CI:0.953-0.990,P =0.003).The serum TSH levels were positively correlated with tumor size in patients with PTMC (r =0.218,P =0.025).However,the proportions of lymphatic metastasis were comparable among different TSH levels groups in patients with PTMC (P ＞ 0.05).Conclusion Serum TSH is probably associated with the de novo oncogenesis of PTMC.However,serum TSH may be involved in the growth of preexisting PTMC.
