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目的研究血清促甲状腺激素(thyroid stimulating hormone,TSH)水平与甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)患者的临床病理学特征间的关系。方法收集近5年来收住笔者所在医院科室首次行手术切除的甲状腺病变患者806例,其中术后病理学检查确诊为PTMC 403例,甲状腺良性病变403例,回顾性分析人选病例的病史资料,并比较2组患者术前TSH及抗甲状腺球蛋白抗体(thyroid globulin antibody,TGAb)水平,以及比较不同TSH水平之间PTMC患者所占比例,对PTMC的危险因素进行单因素和多因素的logistic回归分析。结果 2组患者术前TSH水平的差异有统计学意义(Z=-6.233,P=0.001);2组间男女构成比差异无统计学意义(χ~2=3.246,P=0.072);2组间年龄差异有统计学意义(Z=-5.855,P=0.001);2组间民族构成比差异有统计学意义(χ~2=38.961,P=0.001)。logistic回归分析显示:年龄和TSH水平是PTMC的独立危险因素(年龄:OR=0.914,P=0.027;TSH:OR=4.662,P=0.008)。结论 PTMC患者血清TSH水平较甲状腺良性结节患者高,血清TSH水平的高低可能与PTMC的发生有关,血清TSH是预测甲状腺乳头状癌风险的指标之一。
Objective To study the relationship between serum thyroid stimulating hormone (TSH) level and clinicopathological features in patients with papillary thyroid microcarcinoma (PTMC). Methods Eighty-six patients with thyroid lesions who underwent surgical resection in our hospital department for the first time in the past five years were collected. Among them, 403 cases were diagnosed as PTMC by post-operative pathology and 403 cases with benign thyroiditis by retrospective analysis. The levels of preoperative TSH and thyroglobulin antibody (TGAb) in the two groups were compared, and the proportion of PTMC between different TSH levels was compared. The risk factors of PTMC were analyzed by single factor and multiple logistic regression analysis . Results There was significant difference in preoperative TSH levels between the two groups (Z = -6.233, P = 0.001). There was no significant difference between the two groups in sex composition ratio (χ ~ 2 = 3.246, P = 0.072) There was significant difference between the two groups (Z = -5.855, P = 0.001). There was a significant difference in ethnic composition between the two groups (χ ~ 2 = 38.961, P = 0.001). Logistic regression analysis showed that age and TSH level were independent risk factors of PTMC (age: OR = 0.914, P = 0.027; TSH: OR = 4.662, P = 0.008). Conclusions Serum TSH levels in patients with PTMC are higher than those in patients with benign thyroid nodules. The level of serum TSH may be related to the occurrence of PTMC. Serum TSH is one of the indicators to predict the risk of thyroid papillary carcinoma.