血清甲状腺激素水平与不同肿瘤转移的相关性分析

Relationship between serum thyroid hormone levels and different tumor metastasis

目的探讨不同肿瘤患者甲状腺激素水平的差异,分析甲状腺激素水平与不同肿瘤转移情况的相关性。方法收集713例实体肿瘤患者和309例健康人的病历资料,比较不同转移情况肿瘤患者和健康人的甲状腺激素水平,采用相关性分析法分析不同转移情况肿瘤患者甲状腺激素水平与脂代谢指标的相关性。结果肿瘤患者促甲状腺素(TSH)、三碘甲腺原氨酸(T_(3))、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))水平均明显低于健康人,差异均有统计学意义(P﹤0.01)。在713例肿瘤患者中,发生转移患者317例,转移发生率为44.46%。转移垂体瘤患者TSH、甲状腺素(T_(4))、T_(3)和FT_(3)均低于未转移患者,转移肺癌患者TSH和FT_(4)均低于未转移患者,转移食管癌患者T_(4)低于未转移患者,转移肝癌患者T_(4)和FT_(4)均低于未转移患者,差异均有统计学意义(P﹤0.05)。肿瘤患者总胆固醇(TC)和低密度脂蛋白(LDL)水平均明显高于健康人,差异均有统计学意义(P﹤0.01)。转移垂体瘤、肺癌、食管癌及肝癌患者的TC和LDL水平均明显高于未转移患者,差异均有统计学意义(P﹤0.01)。垂体瘤患者的FT_(3)、肺癌患者的FT_(4)、食管癌患者的T_(4)、肝癌患者的T_(4)与TC和LDL均呈负相关。结论T_(4)、FT_(3)和FT_(4)与肺癌、食管癌、垂体瘤、肝癌转移具有相关性。T_(4)、FT_(3)和FT_(4)降低可能通过提高TC和LDL影响脂代谢平衡,促进肿瘤转移,导致肺癌、食管癌、垂体瘤、肝癌的转移风险增加。

Objective To investigate the differences of thyroid hormone levels in patients with different tumors and analyze the correlation between thyroid hormone levels and tumor metastases.Method The medical records of 713 patients with solid tumor and 309 healthy subjects were collected,and the thyroid hormone levels in patients with different metastases and healthy subjects were compared.The correlation analysis method was used to analyze the correlation between thyroid hormone levels and lipid metabolism indexes in patients with metastases and without metastases.Result The levels of thyroid stimulating hormone(TSH),triiodothyronine(T_(3)),free triiodothyronine(FT_(3))and free thyroxine(FT_(4))in tumor patients were significantly lower than those in healthy subjects,the differences were statistically significant(P<0.01).Among 713 tumor patients,317(44.46%)had metastasis.TSH,thyroxine(T_(4)),T_(3) and FT_(3) in patients with metastatic pituitary tumor were lower than those without metastasis,TSH and FT_(4) in patients with metastatic lung cancer were lower than those without metastasis,T_(4) in patients with metastatic esophageal cancer was lower than that without metastasis,and T_(4) and FT_(4) in patients with metastatic liver cancer were lower than those without metastasis,the differences were statistically significant(P<0.05).The levels of total cholesterol(TC)and low density lipoprotein(LDL)in tumor patients were significantly higher than those in healthy subjects,the differences were statistically significant(P<0.01).The levels of TC and LDL in patients with metastatic pituitary tumor,lung cancer,esophageal cancer and liver cancer were significantly higher than those in non-metastatic patients,the differences were statistically significant(P<0.01).FT_(3) in pituitary tumor patients,FT_(4) in lung cancer patients,T_(4) in esophageal cancer patients and T_(4) in liver cancer patients were negatively correlated with TC and LDL.Conclusion T_(4),FT_(3) and FT_(4) are correlated with metastasis of lung cancer,esophageal cancer,pituitary tumor and liver cancer.The decrease of T_(4),FT_(3) and FT_(4) may affect the balance of lipid metabolism by increasing TC and LDL,promote tumor metastasis,and lead to increased risk of metastasis of lung cancer,esophageal cancer,pituitary tumor,and liver cancer.