结节性甲状腺肿合并甲状腺癌的临床特征分析

The clinical features of nodular goiter with thyroid cancer

目的分析结节性甲状腺肿合并甲状腺癌的临床特征,为临床治疗提供科学依据。方法回顾性分析112例结节性甲状腺肿合并甲状腺癌患者（病例组）和215例结节性甲状腺肿患者（对照组）的临床资料。结果病例组和对照组间甲状腺素（T4）、促甲状腺激素（TSH）、甲状腺球蛋白抗体（Tg Ab）的差异有统计学意义（P〈0.05）。在年龄20-岁和≥70岁组的患者中,结节性甲状腺肿合并甲状腺癌所占的比例（分别为43.8%、45.8%）高于50-岁组（25.0%）,但差异无统计学意义（χ2值分别为3.572、6.982,P〉0.05）。在T4〈51.00 ng/ml组中,结节性甲状腺肿合并甲状腺癌所占的比例（54.5%）高于T4≥141.00 ng/ml组（20.0%）,差异有统计学意义（χ2=10.000,P〈0.01）。在TSH≥4.20μIU/ml组中,结节性甲状腺肿合并甲状腺癌所占的比例（51.2%）高于TSH〈0.27μIU/ml组（29.4%）和0.27-4.20μIU/ml组（32.0%）,差异均有统计学意义（χ2值分别为6.040、4.323,P〈0.05）。在Tg Ab≥115.00 IU/ml组中,结节性甲状腺肿合并甲状腺癌所占的比例（68.6%）高于0-115.00IU/ml组（30.1%）,差异有统计学意义（χ2=22.236,P〈0.01）。结论血清低T4和高TSH（亚临床甲状腺功能减低）及高Tg Ab增加结节性甲状腺肿合并甲状腺癌的风险。

Objective To analyze the clinical features of nodular goiter associated with thyroid cancer and to provide the base for clinic treatment. Methods The subjects were divided into the case group（112 patients with nodular goiter plus thyroid cancer）and control group（215 patients with nodular goiter）. The clinic data were retrospectively analyzed. Results There were significant differences of thyroxine（T4）, thyroid stimulating hormone（TSH） and thyroglobulin antibody（Tg Ab） between case group and control group（P0.05）. In 20-29 years old subgroup and 70 years old subgroup, the proportions of nodular goiter with thyroid cancer（43.8%, 45.8%, respectively） were higher than that（25.0%） in 50-59 years old subgroup, but there were no significant differences（P0.05）. The proportion（54.5%） of nodular goiter with thyroid cancer in subgroup with T451.00 ng/ml was significantly higher than that（20.0%） in subgroup with T4≥141.00 ng/ml（P0.01）. The proportion（51.2%） of nodular goiter with thyroid cancer in subgroup with TSH≥4.20 μIU/ml was significantly higher than that（29.4%） in subgroup with TSH0.27 μIU/ml and that（32.0%）in subgroup with TSH 0.27-4.20 μIU/ml（P0.05）. The proportion（68.6%） of nodular goiter with thyroid cancer in subgroup with Tg Ab≥115.00 IU/ml was significantly higher than that（30.1%） in subgroup with Tg Ab 0-115.00 IU/ml（P0.01）. Conclusion The risk of nodular goiter with thyroid cancer in patients with low level of T4 and high levels of TSH or Tg Ab increased.