晚期癌症患者血清甲状腺素水平的变化及其临床预后价值

Serum level of thyroid hormones in patients with advanced tumors and its prognostic value

目的探讨晚期癌症患者血清甲状腺素水平的变化及其临床预后价值。方法以免疫抑制法测定20例临床Ⅳ期癌症患者血清T3、FT3、T4、FT4、促甲状腺素(TSH),同时检测总蛋白(TP)、白蛋白(ALB)、前白蛋白(PALB)和转铁蛋白(TF)。结果19例显示血清FT3水平减低,17例血清T3和FT3同时减低。其中12例也表现血清T4水平减低,并且有6例伴随FT4减低。仅有3例患者显示血清促甲状腺素(TSH)低下。血清白蛋白(ALB)和前白蛋白(pALB)水平分别有18例和16例患者低于正常值范围,其中15例二者同时低下。血清总蛋白(TP)和转铁蛋白(TF)水平分别有13和15例患者表现低下。在11例死亡的患者中,8例表现血清T3、FT3、ALB、pALB、TF 5项检测值均低于正常范围,而9例非死亡的患者中,仅有2例该五项指标一致低下。结论血清甲状腺激素水平联合血清蛋白质等其他指标的检测,将有助于晚期癌症患者的预后判断。

Objective To estimate chnical prognostic value of serum level of thyroid hormones to patients with advanced tumors.Methods Serum T3-triiodothyronine, FT3-free triiedothyronine, T4-thyroxine, FT4-free thyroxine and TSH-thyrotropin in 20 patients with advanced tumors were detected by immunoinhibition assay. Serum total protein（TP）, albumin（ALB ）, prealbumin（pALB） and TF-transferrin were simultaneously measured. Results As compared to normal values, 19 cases presented decreased serum FT3 level. Consistent reduction of T3 and FT3 were observed in 17 patients, in which 12 cases showed low T4 .Decrease of serum ALB,pALB, TP and TF were found in 18,16,13 and 15 patients, respectively. Fifteen cases displayed reduction of both ALB and pALB. Out of 11 patients who died later,eight presented simultaneous decrease of serum T3, FT3, ALB, pALB and TF. However, abnormahty of all these five indices was seen in only 2 out of 9 survival patients. Conclusions Detection of serum level of thyroid hormones combining with measure of serum proteins may contribute significantly to the prognosis of patients with advanced tumors.