男性分化型甲状腺癌患者泌乳素水平与促甲状腺激素的相关性分析

Correlation Analysis of Prolactin Level with Thyroid Stimulating Hormone in the Males with Differentiated Thyroid Carcinoma

目的了解甲状腺功能减退状态下男性分化型甲状腺癌(DTC)患者血清泌乳素(PRL)水平以及与血清促甲状腺激素(TSH)相关性,为DTC诊治提供参考。方法选择2015年4月—2018年3月住院拟行1311清除残留甲状腺组织的分化型甲状腺癌男性患者96例作为观察组,还纳入同期123例甲状腺功能正常男性作为对照组。所有患者均停用甲状腺激素治疗3～4周以使血清TSH升高大于30 mIU/mL。采用化学发光法分别检测2组男性的血清泌乳素(PRL)水平和促卵泡刺激素(FSH)水平,采用时间分辨荧光免疫评估血清TSH水平。对2组检测值进行比较和分析。结果观察组的PRL水平明显高于对照组[(215.1±58.0)μIU/mL vs(188.4±76.3)μIU/mL,P=0.04);观察组的FSH水平与对照组的差异无统计学意义[(6.0±2.2)mIU/mLvs(6.1±4.5)mIU/mL,P>0.05)];观察组的TSH水平显著高于对照组[(95.4±41.8)mIU/mL vs(1.75±0.72)mIU/mL,P=0.00]。结论甲减状态下DTC患者的血清PRL较健康者升高,提示TSH升高通过甲状腺轴反馈刺激垂体增生可能是血泌乳素异常升高的原因。

Objective To investigate the level of serum prolactin（PRL） and its correlation with serum thyroid stimulating hormone（TSH） in the male with differentiated thyroid carcinoma（DTC） and hypothyroid so as to provide reference for the diagnosis and treatment of DTC. Methods 96 males with DTC hospitalized for residual thyroid tissue ablation using iodine-131 during the period from April, 2015 to March, 2018 were selected as observation group while 123 male adult norm were selected as control group; thyroid hormone were withdrawn from the males in observation group for 3～4 weeks to let serum TSH increase over 30 mlU/mL; chemiluminescence was applied in detecting the levels of serum PRL and follicle stimulating hormone（FSH）while time-resolved fluoroimmunoassay（TRFIR） was applied in detecting the level of serum TSH of all the males in both groups;the results of the 2 groups were compared and analyzed. Results The level of PRL in observation group was significantly higher than that in control group [（215.1±58） IU/mL vs（188.4 ±76.3） IU/mL,P=0.04]; there existed no statistical difference in FSH between observation group and control group [（6.0± 2.2） mIU/mL vs（6.1 ± 4.5） mIU/mL, P0.05]; the TSH level in observation group was significantly higher than that in control group [（95.4 ± 41.8） mIU/mL] vs（1.75 ±0.72） mIU/mL,P=0.00]. Conclusions Males with DTC and hypothyroid have a higher level of PRL than norm, which indicates that the abnormal increase of PRL level may be due to the pituitary hyperplasia caused by the feedback stimulation of high TSH through thyroid axis..