嘉兴地区甲状腺结节手术患者尿碘浓度及其与甲状腺乳头状癌的关系

Urinary iodine concentration and its relationship with papillary thyroid carcinoma in patients undergoing thyroid nodule surgery in Jiaxing

目的探讨嘉兴地区甲状腺结节手术患者尿碘浓度及其与甲状腺乳头状癌(PTC)的关系。方法选取2014年4月至2016年8月在嘉兴市第二医院行甲状腺结节手术的298例患者为研究对象,所有患者在嘉兴地区生活10年以上;术前均行尿碘浓度检测,术后行病理学诊断。分析甲状腺结节良恶性与患者临床特征的关系以及PTC患者尿碘浓度与临床特征的关系,绘制ROC曲线分析尿碘浓度对PTC的诊断效能。结果298例甲状腺结节手术患者,碘缺乏10例(3.4%),碘足量48例(16.1%),碘过量28例(9.4%),碘超过量212例(71.1%)。155例甲状腺良性结节患者中位尿碘浓度为390.18μg/L,143例PTC患者中位尿碘浓度为1001.76μg/L。甲状腺结节良恶性与患者年龄、甲状腺球蛋白抗体(TGAB)、抗甲状腺过氧化物酶抗体(TPOAB)、尿碘浓度等有关,差异均有统计学意义(均P<0.05);与性别、促甲状腺激素(TSH)无关(均P>0.05)。尿碘浓度≥1058.27μg/L可作为PTC的预测指标,其灵敏度为0.469,特异度为0.800。PTC患者尿碘浓度≥1058.27μg/L组肿瘤个数多于<1058.27μg/L组,差异有统计学意义(P<0.05);但与年龄、性别、TSH、TGAB、TPOAB、肿瘤直径、腺体外浸润、淋巴结转移、pTNM分期等均无关(均P>0.05)。结论对于嘉兴地区甲状腺结节手术患者,尿碘浓度≥1058.27μg/L可作为PTC的预测指标,且PTC患者的尿碘浓度与肿瘤个数有关。

Objective To explore the urinary iodine concentration(UIC)and its relationship with papillary thyroid carcinoma(PTC)of patients undergoing thyroid nodule surgery in Jiaxing area.Methods A total of 298 patients who underwent thyroid nodule surgery in Jiaxing Second Hospital from April 2014 to August 2016 were selected as the research objects.All the patients had lived in Jiaxing area for more than 10 years,the urinary iodine concentration was detected before operation and the pathological diagnosis was performed after operation.The relationship between benign and malignant thyroid nodules and the clinical characteristics of patients and the relationship between the urine iodine concentration and clinical characteristics of patients with PTC were analyzed,and the ROC curve was drawn to analyze the diagnostic efficacy of urine iodine concentration on PTC.Results Among the 298 patients undergoing thyroid nodule surgery,10 patients were iodine deficiency(3.4%),48 patients were iodine adequate(16.1%),28 patients were iodine excess(9.4%),and 212 patients were severe iodine excess(71.1%).The median urinary iodine concentration of 155 patients with benign thyroid nodules was 390.18μg/L,and the median urinary iodine concentration of 143 patients with PTC was 1001.76μg/L.The benign and malignant thyroid nodules were related to the patient's age,thyroglobulin antibody(TGAB),anti-thyroid peroxidase antibody(TPOAB),urinary iodine concentration,etc.The differences were statistically significant(all P<0.05).The benign and malignant thyroid nodules were not related to the patient's gender and thyroid stimulating hormone(TSH)(all P>0.05).Urinary iodine concentration≥1058.27μg/L can be used as a predictor of PTC,with a sensitivity of 0.469 and a specificity of 0.800.The number of tumors in the PTC patients with urinary iodine concentration≥1058.27μg/L group was more than that in the group<1058.27μg/L,the difference was statistically significant(P<0.05).But it was not related to age,gender,TSH,TGAB,TPOAB,tumor diameter,extraglandular infiltration,lymph node metastasis,pTNM staging,etc(all P>0.05).Conclusion For patients undergoing thyroid nodule surgery in Jiaxing,urinary iodine concentration≥1058.27μg/L can be used as a predictor of PTC,and the urinary iodine concentration of PTC patients is related to the number of tumors.