甲状腺癌与糖尿病相关性的临床病理分析

Clinical pathological analysis of the correlation between diabetes and thyroid carcinoma

目的探讨甲状腺癌与糖尿病发病机率以及病理类型、临床特征的相关性。方法采集2010年6月～2016年12月在我院住院手术切除病理确诊为甲状腺癌的临床资料163例进行回顾性分析,随机选取该年龄段志愿者258例并进行健康体检证实身体健康者作为对照组,比较两组人群在碘的摄取量、放射线接触史、促甲状腺激素的刺激作用、性激素的作用、一些甲状腺良性疾病、糖尿病史及家族遗传史等资料上的差异;应用非条件Logistic多因素回归分析,来评估甲状腺癌与糖尿病发病风险的相关性。结果甲状腺癌组和对照组中糖尿病的发病率分别为31.9%和22.9%,两组差异有统计学意义(P<0.05);甲状腺癌患者中糖尿病组和非糖尿病组在肿瘤的病理分型、大小、个数上比较,差异均无统计学意义(P>0.05);多因素Logistic回归分析显示,甲状腺癌与糖尿病发病率之间呈正相关(OR=0.584,95%CI:0.354～0.966);甲状腺癌合并糖尿病的患者中淋巴结转移(38.5%)和远处转移(11.5%)与甲状腺癌非糖尿病组比较,差异有统计学意义(P<0.05)。结论糖尿病患者罹患甲状腺癌的风险性增加,并且影响患者的转移与播散,是甲状腺癌发病的危险因素,糖尿病患者应定期做甲状腺检查,做到早发现早治疗,并且通过合理饮食和运动相配合的方式把血糖控制在一个合理的范围内,以较少甲状腺癌的发生。

Objective To explore the correlation between the invasion probability of diabetes,pathological type and clinical features. Methods 163 case of thyroid cancer were collected retrospectively from June 2010 to December 2016 in our hospital with surgical resection and diagnosed by pathology.258 participants were given a healthy physical examination to control group at random.The iodine intake, radiation exposure,the stimulating effect of the thyroid stimulating hormone,role of sex hormones,some benign thyroid disease,diabetes history and the differences of family factors etc of two group were compared.Non-conditional Logistic regression was applied to analyze the association between diabetes and thyroid carcinoma. Results The invasion probability of diabetes in thyroid cancer and control group was 31.9% and 22.9% respectively,the difference was statistically significant（P 〈 0.05）.The pathological classification,size and number of infiltration of thyroid cancer patients were compared with those of the non- diabetic group,there was no statistically significant difference between the two groups（P 〉 0.05）.Multifaetor Logistic regression analysis showed a postitive correlation between diabetes and thyroid cancer incidence （ OR=0.584,95%CI： 0.354-0.966 ） .Among patients with thyroid cancer combined with diabetes 38.5% of lymph node metastisis and 11.5% of distant metastasis were compared with non-diabetic thyroid cancer,the difference was statistically significant （P 〈 0.05）. Conclusion Diabetes increases the risk of thyroid cancer,and influence the transfer and dissemination,is a risk factor for thyroid cancers,diabetes patients should regularly for a thyroid test,early found early treatment,through the reasonable diet and exercise to keep blood sugar under control,in order to reduce the occurrence of thyroid carcinoma.