甲状腺乳头状癌与结节性甲状腺肿患者甲状腺功能相关因素对比分析

Analysis of thyroid function in patients with papillary thyroid carcinoma and nodular goiter

目的 对比分析甲状腺乳头状癌（PTC）与结节性甲状腺肿（NG）患者甲状腺功能相关因素。 方法 回顾性分析2011年8月至2013年7月首都医科大学附属北京安贞医 院收治的216例甲状腺结节患者的临床资料。术后经病理检查证实为PTC患者115例（PTC组）；术中组织观察或术后经病理检查证实为NG患者101例（NG组）。比较2组患者性别、年龄 、促甲状腺激素（TSH）、总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、甲状腺球蛋白抗体（TGAb）和甲状腺微粒体 抗体（TMAb）水平，分析PTC的危险因素。 结果 PTC组年龄明显小于NG组［（44±13）岁比（50±13）岁］，TGAb水平明显高于NG组［（32±27）mIU/L比（14±11）mIU/L］ ，差异均有统计学意义（均P＜0.05）。2组性别、TSH、TT3、TT4、FT3、FT4和TMAb水平比较，差异均无统计学意义（均P＞0.05）。TGAb水平和年龄与PTC的发病相关（均P＜0.05） 。其中TGAb水平是PTC发病的独立危险因素，年龄是PTC发病的保护因子。 结论 PTC和NG的TSH和甲状腺激素水平无明显差异，NG和PTC皆好发于女性。TGAb和年龄可作为PTC和 NG鉴别的参考指标。

Objective To analyze the thyroid function in patients with papillary thyroid carcinoma（PTC） and nodular goiter（NG）. Methods A total of 216 patients with thyroid nodules from August 2011 to July 2013 at Beijing Anzhen Hospital, Capital Medical University were enrolled; 115 cases were diagnosed of PTC by postoperative pathology（PTC group）; 101 cases were diagnosed of nodular goiter（NG group）. Gender, age, thyroid stimulating hormone （TSH）, total triiodothyronine （TT3）, total thyroxine （TT4）, free triiodothyronine（FT3）, free thyroxine（FT4）, thyroglobulin antibody（TGAb） and thyroid microsomal antibody（TMAb） were analyzed. Results The average age of PTC group was significantly lower than that of NG group[（44±13）years vs （50±13）years]; the level of TGAb in PTC group was significantly higher than that in NG group[（32±27）mIU/L vs （14±11）mIU/L]（P〈0.05）. Gender, TSH, TT3, TT4, FT3, FT4 and TMAb levels had no significant differences between groups（P〉0.05）. TGAb level was an independent risk factor of PTC; age was a protective factor of PTC（P〈0.05）. Conclusion Levels of TSH and thyroid hormone have no difference between patients with PTC and NG; both PTC and NG are common in female; age and TGAb level can be differentiating indicators for PTC and NG.