小切口甲状腺叶切除术对甲状腺乳头状癌患者免疫功能及血清甲状腺球蛋白、紧密连接蛋白-1的影响

Effects of small incision thyroidectomy on immune function,serum thyroglobulin and Claudin-1 in patients with papillary thyroid carcinoma

目的 探讨小切口甲状腺叶切除术对甲状腺乳头状癌患者免疫功能及血清甲状腺球蛋白(TG)、紧密连接蛋白-1(Claudin-1)的影响。方法 选取2015年1月至2021年6月于河南科技大学第一附属医院确诊为甲状腺乳头状癌的患者共80例作为研究对象,根据随机数字表法均分为对照组和观察组,每组40例,观察组采用小切口甲状腺叶切除术,对照组采用传统甲状腺切除术。比较2组患者手术前后免疫功能,血清TG、Claudin-1水平,治疗效果,并发症发生情况。结果 与同组术前比较,观察组和对照组患者术后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)数值均升高(观察组:t=16.830,P<0.001;t=22.680,P<0.001;t=29.480,P<0.001;对照组:t=10.350,P<0.001;t=19.480,P<0.001;t=13.630,P<0.001),且观察组术后均高于对照组(t=7.646,P<0.001;t=3.276,P=0.002;t=21.389,P<0.001);术后CD8^(+)数值均降低(观察组:t=10.970,P<0.001;对照组:t=5.248,P<0.001),且观察组术后低于对照组(t=4.462,P<0.001)。与同组术前比较,2组患者术后血清TG、Claudin-1水平均降低(观察组:t=53.070,P<0.001;t=43.170,P<0.001;对照组:t=44.900,P<0.001;t=30.420,P<0.001),且观察组术后均低于对照组(t=14.251,P<0.001;t=14.147,P<0.001)。观察组治疗总缓解率高于对照组(χ^(2)=4.588,P=0.032)。观察组并发症总发生率低于对照组(χ^(2)=5.000,P=0.025)。结论 小切口甲状腺叶切除术对甲状腺乳头状癌患者免疫功能影响较小,可降低血清TG、Claudin-1水平,治疗效果较好,并发症少,值得临床推广。

Objective To investigate the effects of small incision thyroidectomy on immune function,serum thyroglobulin(TG)and Claudin-1 in patients with papillary thyroid carcinoma.Methods A total of 80 patients diagnosed with thyroid papillary carcinoma in the First Affiliated Hospital of Henan University of Science and Technology from January 2015 to June 2021 were selected as the research objects,and were divided into the control group and the observation group according to the random number table method,40 patients in each group,the observation group was treated with small incision thyroidectomy,and the control group was treated with traditional thyroidectomy.The immune function,serum TG levels,serum Claudin-1 levels,therapeutic effects,complications were compared between the two groups before and after operation.Results Compared with before operation,the values of CD3+,CD4+and CD4+/CD8+in the observation group and the control group were increased after operation(the observation group:t=16.830,P<0.001;t=22.680,P<0.001;t=29.480,P<0.001;the control group:t=10.350,P<0.001;t=19.480,P<0.001;t=13.630,P<0.001),and the values of CD3+,CD4+and CD4+/CD8+after operation in the observation group were higher than those in the control group(t=7.646,P<0.001;t=3.276,P=0.002;t=21.389,P<0.001).The value of CD8+was decreased(the observation group:t=10.970,P<0.001;the control group:t=5.248,P<0.001)after operation,and the value of CD8+after operation in the observation group was lower than that in the control group(t=4.462,P<0.001).Compared with before operation,serum TG and Claudin-1 levels in the two groups were decreased after operation(the observation group:t=53.070,P<0.001;t=43.170,P<0.001;the control group:t=44.900,P<0.001;t=30.420,P<0.001),and the serum TG and Claudin-1 levels in the observation group were lower than those in the control group(t=14.251,P<0.001;t=14.147,P<0.001).The total remission rate of the observation group was higher than that of the control group(χ^(2)=4.588,P=0.032).The total complication rate of the observation group was lower than that of the control group(χ^(2)=5.000,P=0.025).Conclusion Small incision thyroidectomy has little effect on immune function of patients with papillary thyroid carcinoma,and can reduce serum TG and Claudin-1 levels,with good therapeutic effect and fewer complications.