TSH水平与甲状腺乳头状微小癌之间的关系探讨

目的探讨促甲状腺激素(TSH)与甲状腺乳头状微小癌之间的关系。方法回顾性分析2006年1月至2016年2月手术治疗的341例甲状腺结节患者,根据病理结果分为两组:甲状腺乳头状微小癌组104例,良性甲状腺结节组237例,收集并比较各组临床实验资料。数据分析采用SPSS 19.0统计软件,计量资料采用(x珋±s)表示,患者在年龄、结节直径、TSH浓度、淋巴结转移与TSH关系比较使用t检验;甲状腺乳头状微小癌发生率与TSH的关系采用χ2趋势检验,以P0.05表示差异具有统计学意义。结果甲状腺乳头状微小癌组患者结节直径平均为(1.92±1.13)cm,低于良性甲状腺结节组患者的(2.82±1.44)cm(t=-5.654,P0.05);甲状腺乳头状微小癌组患者TSH平均为(3.01±1.51)μIU/ml,高于良性甲状腺结节组患者的(1.90±1.32)μIU/ml(t=6.836,P0.05),差异均有统计学意义;按照TSH水平分为0.34μIU/ml、0.34~1.00μIU/ml、1.01~2.00μIU/ml、2.01~5.60μIU/ml和5.60μIU/ml,甲状腺乳头状微小癌组发生比例分别为11.76%、14.29%、23.94%、39.06%和53.33%,检验结果显示TSH水平越高其甲状腺乳头状微小癌的发生率越高(χ2=28.783,P0.05);甲状腺乳头状微小癌伴淋巴结转移患者TSH为(5.07±1.31)μIU/ml、明显高于无淋巴结转移患者的(2.83±1.55)μIU/ml,差异比较有统计学意义(t=5.844,P0.05)。结论 TSH可作为预测甲状腺乳头状微小癌风险的指标之一,可为临床诊断提供参考依据。

The relationship between TSH level and papillary thyroid microcarcinoma

Objective To investigate the relationship between thyroid stimulating hormone ( TSH) level and papillary thyroid microcarcinoma . Methods From January 2006 to February 2016, retrospective analysis was performed in 341 patients with thyroid nodules who underwent thyroid surgery .According to the pathological results , 341 patients was divided into two groups:104 cases of papillary thyroid microcarcinoma group and 237 cases of benign thyroid nodules group .Clinical data of each group were analyzed by using SPSS19.0 software, measurement data.Measurement data were expressed as (x±s) and examined by using t test, including age, nodule diameter, TSH concentration, lymph node metastasis and TSH level. Relationship of Papillary thyroid microcarcinoma occurrence rate and TSH level was examined by using χ2 trend test.A P value of <0.05 was considered as significant difference . Results In papillary thyroid microcarcinoma group, nodules diameter was (1.92 ±1.13) cm and less than (2.82 ±1.44) cm in benign thyroid nodule group, with significant difference (P<0.05).In papillary thyroid microcarcinoma group, TSH level was (3.01 ±1.51) μIU/ml and was significantly higher than (1.90 ±1.32) μIU/ml in benign thyroid nodules group, with significant difference (P <0.05).When TSH <0.34 μIU/ml, 0.34 ~1.00 μIU/ml, 1.01 ~2.00 μIU/ml, 2.01 ~5.60 μIU/ml and >5.60 μIU/ml, incidence of thyroid papillary microcarcinoma group were 11.76%, 14.29%, 23.94%, 39.06% and 53.33% respectively, which showed that higher TSH level was correlated with higher incidence of papillary thyroid microcarcinoma (P <0.05).In patients with papillary thyroid microcarcinoma and lymph node metastasis , TSH was (5.07 ±1.31) μIU/ml, which was significantly higher than (2.83 ±1.55) μIU/ml of patients without lymph node metastasis,with significant difference (P<0.05). Conclusion TSH level could be used as one of predicting indicators of papillary thyroid microcarcinoma for a reference of clinical diagnosis .