直肠癌患者血清甲状腺素变化的分析

Serum thyroid hormone changes in patients with rectal cancer

目的分析直肠癌患者血清甲状腺激素水平变化的意义。方法选取40例直肠癌患者，采用放射性免疫法检测促甲状腺激素（TSH）、三碘甲腺原氨酸（T3）、四碘甲腺原氨酸（L）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）及癌胚抗原（CEA）水平。分析不同类型的直肠癌甲状腺激素水平的差异及癌胚抗原与甲状腺激素之间的关系。结果在腺癌、黏液癌及未分化癌3种组织类型中，甲状腺激素相比较，黏液腺癌的FT3及T1水平最低，且差异有统计学意义（P〈0．05）；FT3／T3及T4随Dukes分期的进展而逐步减少，在不同的Dukes分期中，FT3／L及T4水平差异有统计学意义（P〈0．05）；线性相关分析显示，CEA水平与甲状腺激素FT3及T3性线正相关（P〈0．05）。结论甲状腺素水平降低可能与直肠癌的不良预后密切相关，在临床上密切监测直肠癌患者的甲状腺素水平很有必要。

Objective To assess the changes of serum thyroid hormone in patients with rectal cancer. Methods A total of 40 patients with rectal cancer were included. The levels of thyroid-stimula- ting hormone （ TSH ）, triiodothyronine （ T3 ）, thyroxine （ T4 ）, free triiodothyronine （ FF3 ）, free thyroxine （FT4 ）and carcino-embryonic antigen（CEA） were determined by radio-immunity methods. The changes of thyroid hormone in various types of rectal cancers and the relationship between CEA and thyroid hormones were analyzed. Results Among the different types of rectal cancers, patients with mucinous adenocarci- noma had the lowest FT3 and T3 levels（P 〈0.05）. The levels of FF3/T3 and T4 decreased with the pro- gression of Duke＇s stages. Among different Duke＇s stages,the differences of FT3 ,T3 and T4 were significant （P 〈 0.05 ）. Linear correlation model demonstrated that CEA levels positively correlated with FT3 and T3 （P 〈 0.05 ）. Conclusion The decrease of thyroid hormone may be closely related to the prognosis of rectal cancer. Therefore, it is reasonable to monitor the levels of thyroid hormone in patients with rectal