乳腺癌患者甲状腺激素和自身抗体的水平及临床意义

The levels and clinical significance of thyroid hormone and autoantibody in breast cancer patients

目的探讨乳腺癌患者的血清三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPOAb)和促甲状腺激素受体抗体(TRAb)水平及临床意义。方法分别选取95例乳腺癌患者和95例同期健康体检者作为观察组和对照组,比较两组受试者的血清T3、T4、FT3、FT4、TSH、TPOAb和TRAb水平,观察乳腺癌患者的上述甲状腺激素水平与临床特征的关系。结果两组受试者的T3、FT3水平及TPOAb和TRAb阳性率比较,差异均无统计学意义(P﹥0.05);观察组的T4、FT4水平均明显低于对照组,TSH水平明显高于对照组,差异均有统计学意义(P﹤0.01)。不同病理类型、肿瘤直径和TNM分期乳腺癌患者的T3、FT3、T4、FT4水平比较,差异均无统计学意义(P﹥0.05)。不同病理类型、肿瘤直径乳腺癌患者的血清TSH水平比较,差异均无统计学意义(P﹥0.05);TNM分期为Ⅲ~Ⅳ期乳腺癌患者的血清TSH水平明显高于TNM分期为Ⅰ~Ⅱ期的乳腺癌患者,差异有统计学意义(P﹤0.01)。结论乳腺癌患者的血清T4、FT4水平较低,TSH水平较高,且TSH水平与乳腺癌的TNM分期可能存在一定的关系,与病理类型和肿瘤直径可能无关。

Objective To investigate the levels of serum triiodothyronine(T3), tetraiodothyronine(T4), free triiodothyronine(FT3), free thyroxine(FT4), thyroid stimulating hormone(TSH), thyroid peroxidase antibody(TPOAb), thyroid stimulating hormone receptor antibody(TRAb) in breast cancer patients, and discuss the clinical significance. Method Ninety-five breast cancer patients were included as study group, meanwhile, another 95 healthy subjects were selected as control group, the levels of serum T3, T4, FT3, FT4, TSH, TPOAb and TRAb were compared in the two groups, and the relationship between thyroid hormone and clinical characteristics in breast cancer patients were observed. Result There were no significant differences regarding the serum T3, FT3 levels and the positive rates of TPOAb and TRAb between the two groups(P>0.05);while the levels of serum T4 and FT4 in study group were lower compared to control group, and the level of serum TSH was higher in study group compared to control group(P<0.01). No significant differences were observed in regard to the levels of serum T3, FT3, T4 and FT4 among breast cancer patients with different pathological types,tumor diameter and clinical stages(P>0.05). The level of serum TSH of breast cancer patients with different pathological types and tumor diameters showed no statistically significant differences(P>0.05), but the level of serum TSH was significantly higher in patients with TNM stage Ⅲ~Ⅳ compared with those with TNM stage Ⅰ~Ⅱ(P<0.01). Conclusion Among breast cancer patients, the levels of serum T4 and FT4 are relative low, while TSH is increased, which is likely related to the clinical stage but independent of pathological type and tumor diameter in breast cancer patients.