血清TSH浓度与结节性甲状腺肿合并甲状腺癌关系的研究

Relationship Between Preoperative Serum TSH Concentration and Thyroid Carcinoma in Patients with Nodular Goiter

目的探讨术前血清促甲状腺素(TSH)浓度与结节性甲状腺肿合并甲状腺癌的相关性。方法回顾性分析632例结节性甲状腺肿患者的TSH浓度与合并甲状腺癌间的关系。根据TSH值不同,将患者分成5组进行统计分析。结果结节性甲状腺肿合并甲状腺癌患者血清TSH浓度为(2.10±1.38)mU/L,较未合并者的(1.51±0.98)mU/L高(P<0.000 1);随着血清TSH浓度的升高,合并甲状腺癌比率升高(P=0.023 5),TSH0.3～0.9 mU/L组为9.91%、0.9～1.7 mU/L组为12.37%、1.7～4.8 mU/L组为20.09%、>4.8 mU/L组为27.27%。肿瘤直径<2 cm组、2～4 cm组和>4 cm组比较,直径较大的TSH浓度更高(P=0.018 6)。TNM分期T3～T4期患者TSH浓度高于T1～T2期患者(P=0.030 6)。结论术前血清TSH浓度可能是预测结节性甲状腺肿合并甲状腺癌风险的一个指标。

Objective To investigate the association between preoperative serum TSH concentration and thyroid carcinoma in patients with nodular goiter.Methods Data of 632 patients with nodular goiter from January 2004 to December 2010 were analyzed retrospectively.Results Preoperative serum TSH in nodular goiter with thyroid carcinoma was higher than that without thyroid carcinoma,which was（2.10±1.38）mU/L and（1.51±0.98）mU/L, respectively（P0.000 1）.The risk of malignancy increased as serum level of TSH rose in nodular goiter patients（P=0.023 5）,the ratios were 9.91%（0.3-0.9mU/L）,12.37%（0.9-1.7mU/L）,20.09%（1.7-4.8mU/L）,and 27.27%（4.8mU/L）.The TSH level of stageⅢ-Ⅳ patients higher than that stageⅠ-Ⅱ patients（P=0.030 6）.The diameter of tumor 4 cm had highest mean TSH level,and which ≤ 2cm had lowest mean TSH level（P=0.018 6）.Conclusion Preoperative serum TSH level perhaps is a risk predictor for nodular goiter with thyroid carcinoma.