分化型甲状腺癌与TSH、TgAb和TPOAb的相关性

The Correlation of Differentiated Thyroid Carcinoma with TSH,TgAb and TPOAb

目的探讨促甲状腺素(thyrotropin,TSH),甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)和甲状腺过氧化酶抗体(thyroid peroxidase antibody,TPOAb)与乳头状甲状腺癌(papillary thyroid carcinoma,PTC)发生发展的关系。方法选取2014年1月至2018年12月在我院首次手术的甲状腺结节患者500例,其中病理明确诊断为分化型甲状腺癌(differentiated thyroid cancer,DTC)患者250例,术后明确诊断为甲状腺良性结节的患者250例。采用化学发光法检测血清中的TSH、TgAb和TPOAb。结果DTC组与甲状腺良性结节组相比,血清TgAb水平与TSH水平明显升高(P<0.01)。DTC组与甲状腺良性结节组血清POAb水平差异无统计学意义(P=0.25)。甲状腺结节组TgAb阳性率明显高于甲状腺良性结节组(P<0.01)。DTC组单因素分析显示,TgAb和TSH与DTC的发生呈正相关。多因素分析表明,TgAb和TSH升高与DTC呈显著正相关。有颈淋巴结转移组与无颈淋巴结转移组相比,TSH水平明显升高(P<0.01)。结论血清TSH、TgAb与DTC的发生发展有关,可能是独立的危险因素。并与与颈部淋巴结转移有关。

Objective To investigate the relationship between thyroid stimulating hormone(TSH),thyroid globulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)and the development of papillary thyroid carcinoma(PTC).Methods 500 patients with thyroid nodules who underwent surgery for the first time in our hospital from January,2014 to December,2016 were selected for the study,including 250 patients diagnosed pathologically with DTC and 250 patients diagnosed with benign thyroid nodules after operation.TSH,TgAb and TPOAb in serum were detected by chemiluminescence.Results Serum TgAb and TSH level in DTC group were significantly increased,compared with that in the benign thyroid nodules group(P<0.01).There was no difference for TPOAb between DTC group and benign thyroid nodules group(P=0.25).The positive rate of TgAb in the thyroid nodules group is significantly higher than that of the benign thyroid nodules group(P<0.01).Univariate analysis showed that TgAb and TSH were positively correlated with the occurrence of DTC.Multivariate analysis showed that the increase of TgAb and TSH were significantly positively correlated with DTC.TSH level was significantly increased in the group with cervical lymph node metastasis compared with the group without cervical lymph node metastasis(P<0.01).Conclusion Serum TSH and TgAb are related to the occurrence and development of DTC and could be independent risk factors.It is associated with lymph node metastasis in the neck.