血清甲状腺抗体与甲状腺癌风险的相关性分析

Association of serum antithyroid antibodies with risk of thyroid cancer

目的探讨甲状腺结节（TN）患者血清抗甲状腺自身抗体与甲状腺癌（Tc）风险的关系。方法甲状腺癌的确诊是依据术后甲状腺组织的病理活检。测定898例甲状腺结节患者血清抗甲状腺过氧化物酶抗体（TPO—Ab）、抗甲状腺球蛋白抗体（TgAb）及促甲状腺激素（TSH）水平。使用回顾性队列分析法，采用多元Logistic回归分析法分析各独立变量与Tc的关系，并以相对危险度（OR）和95％可信区间（95％CI）来进行描述。结果纳入分析的898例TN患者中，术后病理组织活检发现良性甲状腺结节患者662例（76．4％），甲状腺癌236例（23．6％）。甲状腺癌的发生风险与血清TPOAb及TgAb水平均呈正相关（r值分别为1．028和0．940，OR值分别为3．038和2．698，95％C1分别为2．121～4．351及1．899～3．834），且男性和年龄〈35岁等因素也与Tc的发生风险有较强的相关趋势。结论在甲状腺结节患者中，血清TPOAb及TgAb水平均与甲状腺癌的风险呈正相关，两者在预测甲状腺结节良恶性方面具有一定意义。

Objective To study the association of serum thyroid antibodies with the risk of thyroid cancer（ TC ） in patients with thyroid nodule（TN）. Methods TC was confirmed by the postoperative histopathology examination of thyroidectomy tissue. The serum levels of thyroperoxidase antibody （TPOAb）, thyroglobulin antibody（TgAb） and thyroid stimulating hormone（TSH） were tested in 898 patients. A retrospective cohort analysis was performed. The correlations of the independent variables with TC were determined by multivariable logistic regression analysis and reported as the adjusted odds ratio （OR） ,95% confidence interval（CI）. Results Among the 898 patients, there were 662（76.4% ） patients with benign TN and 236（23.6% ） with malignant TN. TC was associated with elevated TPOAb and TgAb（ r = 1. 028 and 0.94,odds ratio OR = 3. 038 and 2. 698,95% confidence interval CI ： 2. 121 -4. 351 and 1. 899 -3. 834 ,respectively） ,and demonstrated a strong trend for association with male gender and age 〈 35 years. Conclusion The positive TPOAb and TgAb were significantly correlated with TC in TN patients and could add a certain prediction in determining the risk of thyroid malignancy.