甲状腺激素与甲状腺结节良恶性的关系

【摘要】目的 观察甲状腺结节（TN）患者血清甲状腺激素的水平并探讨其与TN良恶性的关系。方法随机抽取TN患者245例，根据甲状腺相关抗体水平及术后病理结果分为结节性甲状腺肿组（NG组）、甲状腺腺瘤组（TA 组）和甲状腺癌组（TC组），TC组进一步分为甲状腺相关抗体升高组（TC-Ab +组）和甲状腺相关抗体正常组(TC-Ab - 组)。检测患者术前血清游离T3（FT3）、游离T4（FT4）和促甲状腺激素（TSH）。分析各组患者甲状腺激素水平的差异。结果以NG组、TA组和TC组3组比较时，TC组血清TSH水平高于其他2组（P＜0.05）。TC-Ab +组血清FT3水平低于NG组和TC-Ab -组，FT4水平低于NG组，TSH水平明显高于其他各组（P＜0.05）。结论部分TC患者出现血清TSH水平升高，其原因可能是由于伴有自身免疫性甲状腺炎并继发了甲状腺功能减退。血清TSH水平升高未必是TC的固有特征。

Relationship between Thyroid Hormones and the Nature of Thyroid Nodules

[Abstract] Objective To detect serum levels of thyroid hormones in patients with thyroid nodules (TN), and investi? gate their relationship with the nature of TN.Methods A total of245patients with TN were recruited in the study. Accord? ing to levels of thyroid antibodies and postoperative pathological results, all patients were divided into nodular goiter (NG) group, thyroid adenoma (TA) group and thyroid cancer (TC) group. TC group was further classified as the TC with increased level of thyroid antibodies (TC-AB + group) and the TC with normal level of thyroid antibodies (TC-AB group). The serum levels of free T3(FT3), free T4(FT4) and thyroid stimulating hormone (TSH) were detected for all patients before operation, and differences of thyroid hormones were analyzed between different groups.Results The serum level of TSH was signifi? cantly higher in TC group than that of NG group and TA group (P＜0.05). The serum level of FT3was significantly lower in TC-AB + group than that of NG group and TC-AB group. The serum level of FT4was significantly lower in TC-AB + group than that of NG group, and the serum TSH level was significantly higher than that of other groups (P＜0.05). Conclusion The increased serum levels of TSH were found in some patients with TC, which may partly attribute to their coexistence with autoimmune thyroiditis and subsequent hypothyroidism. The increased serum TSH level may not be the inherent characteris? tics of TC.