血清促甲状腺素水平与甲状腺癌发病的相关性

目的 观察血清促甲状腺素(TSH)水平与甲状腺癌发病的关系.方法 回顾性分析330例(恶性99例,良性231例)行甲状腺手术的甲状腺疾病患者的血清TSH水平、性别、年龄、肿瘤类型、结节个数,并探讨其与甲状腺癌发生之间的关系.结果 在年龄＜20岁和≥70岁的患者中,甲状腺癌所占的比例分别为63.0％和58.3％,明显高于60 ～ 69岁组(23.3％,均P＜0.05).在81例男性患者中,甲状腺癌所占的比例为43.2％,明显高于女性患者(25.7％,P=0.003).在112例单结节患者中,甲状腺癌所占的比例为42.0％,明显高于多结节患者(23.9％,P＜0.001).在TSH＜ 0.28mIU/L组和≥4.20 mIU/L组患者中,甲状腺癌所占的比例分别为54.6％和50.0％,均明显高于0.28～1.44 mIU/L组(16.1％,均P＜0.05);在正常TSH范围内,甲状腺癌所占与的比例随TSH水平的升高而升高(P ＜0.001).血清TSH水平高(OR=1.465,P=0.014)、男性(OR=1.964,P=0.016)以及单个甲状腺结节( OR=2.090,P=0.006)均为发生甲状腺癌的独立危险因素.结论 血清TSH水平高、男性、单个甲状腺结节者患甲状腺癌的风险高.

Association between the serum TSH concentration and thyroid cancer incidence

Objective To investigate the association between serum TSH concentration and thyroid cancer incidence.Methods Three hundred and thirty patients with thyroid tumors who underwent surgical treatment were included in this study (99 cases of malignancy and 231 cases of benign tumors ).The data of their serum TSH level,gender,age,tumor type,and number of tumors detected by ultrasonic inspection were retrospectively analyzed,and their association with thyroid cancer incidence was explored.Results The proportion of thyroid cancer in the groups of younger than twenty years and older than seventy years were 63.0％ and 58.3％,respectively,significantly higher than that in the group of age between 60 and 69 years (23.3％,P＜0.05).The incidence of thyroid cancer of the 81 male patients was 43.2％,significantly higher than that in the 249 female patients ( 25.7％,P =0.003 ).The incidence of thyroid cancer in the 112 patients with single nodule was 42.0％,significantly higher than that in the 218 patients with multiple nodules (23.9％,P ＜0.001 ).In the groups with TSH level lower than 0.28 mIU/L and higher than 4.20mIU/L,the incidence of thyroid cancer were 54.6％ and 50.0％,respectively,significantly higher than that in the group with TSH level between 0.28 and 1.44 mIU/L ( 16.1％,P ＜ 0.05 ).The proportion of patients with thyroid cancer was also increased with the increasing serum TSH level in the normal range (P ＜0.001 ).High serum TSH level ( OR =1.465,P =0.014),male ( OR =1.964,P =0.016) and a single thyroid nodule ( OR =2.090,P =0.006) are independent risk factors of thyroid cancer.Conclusion The high serum TSH level,male,single thyroid nodule are factors leading to a high incidence of thyroid cancer.