非小细胞肺癌患者化疗前后血清甲状腺激素水平变化及临床意义

Clinical Significance of Serum Thyroid Hormone Level in Patients with Non-small Cell Lung Cancer before and after Chemotherapy

目的探讨非小细胞肺癌(NSCLC)患者血清甲状腺激素水平在化疗前后的变化及其临床意义。方法采用放射免疫分析法测定78例NSCLC患者化疗前后血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TF4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)水平,并与35例正常人血清甲状腺激素水平比较。结果 NSCLC患者血清TT3[(1.27±0.36)nmol/L比(2.62±0.46)nmol/L]、FT3[(2.65±0.76)pmol/L比(3.79±0.63)pmol/L]水平低于正常对照组(P<0.05),TT4、FT4及TSH水平与正常对照组接近(P>0.05)。血清TT3和FT3水平与临床分期有关(P<0.05),与分化程度和病理类型无关(P均>0.05);化疗后有效者(完全缓解和部分缓解)血清TT3、FT3水平明显高于化疗前(P<0.05)。结论血清甲状腺激素水平检测对肺癌的病情判断及疗效监测有一定的临床意义。

Objective To investigate the changes of thyroid hormone level in patients with non- small cell lung cancer （NSCLC） before and after chemotherapy and its clinical significance. Methods 78 cases of NSCLC admitted between January 2009 and December 2011 were recruited in the study. The level of total triiodothyronine （ TT3 ）, total thyroxine （ TF4 ）, free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ）, and thyroid stimulating hormone （TSH） were measured by radioimmunoassay before and after chemotherapy. 35 normal subjects were recruited as control. Results The levels of TT3 [ （ 1.27 ± 0. 36） nmol/L vs. （2. 62±0.46） nmol/L] and FT3 [ （2. 65±0. 76） pmol/L vs. （3.79 ±0. 63） pmol/L] in the NSCLC patients were significantly lower than those in the controls （P 〈 0. 05 ） , while the levels of TT4, FT4 and TSH were similar to the controls. The level of TT3 and FT3 were correlated with clinical stage （ P 〈 0. 05 ）, and not with histological grade and pathological type （P 〉 0. 05 ）. The levels of TT3 and FT3 were remarkably increased in complete remission or partial remission patients after chemotherapy （ P 〈 0. 05 ）. Conclusion Thyroid hormone measurement may be useful in the patients condition judgment and therapeutic effect monitoring.