甲状腺结节中预测甲状腺乳头状癌的多因素分析:甲状腺球蛋白抗体的意义

发布时间：2018-05-23 19:25

  本文选题：甲状腺乳头状癌 + 甲状腺自身抗体　； 参考：《中国微创外科杂志》2017年02期

【摘要】：目的探讨甲状腺结节患者甲状腺自身抗体与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)发生风险之间的相关性。方法回顾性分析2012年1月~2014年12月我院2128例因甲状腺结节行手术治疗的临床和病理资料,其中PTC 807例(37.9%),良性结节1321例(62.1%)。采用logistic回归分析,评价年龄、性别、病理诊断的慢性淋巴细胞性甲状腺炎(chronic lymphocytic thyroiditis,CLT)、甲状腺球蛋白抗体(thyroglobulin antibody,TGAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、促甲状腺激素(thyroid stimulating hormone,TSH)等因素与PTC发生风险的相关性。结果与良性结节组相比,PTC组年龄更小[中位数43(四分位数33,53)岁vs.51(39,59)岁,P=0.000],合并CLT的比率更高[27.1%(219/807)vs.12.7(168/1321),P=0.000],TGAb阳性比率更高[26.6%(215/807)vs.13.7%(181/1321),P=0.000],TPOAb阳性比率更高[26.0%(210/807)vs.18.8%(249/1321),P=0.000],血清TSH水平更高[1.67(1.11,2.37)m IU/L vs.1.42(0.91,2.12)m IU/L,P=0.000]。多因素logistic回归分析显示,合并CLT(OR=1.843,95%CI:1.375~2.471,P=0.000)及TGAb阳性(60~99 U/ml组OR=2.005,95%CI:1.237~3.249,P=0.005;≥500 U/ml组OR=2.146,95%CI:1.281~3.594,P=0.004)与PTC发生风险独立相关,而TPOAb阳性与PTC发生风险未见独立相关;此外,PTC的发生风险随TSH水平的升高而增加。结论甲状腺结节合并CLT、TGAb阳性及TSH水平升高与PTC发生风险增加相关。
[Abstract]:Objective to investigate the relationship between thyroid autoantibodies and the risk of papillary thyroid carcinoma in thyroid nodules. Methods from January 2012 to December 2014, the clinical and pathological data of 2128 cases of thyroid nodule treated by operation in our hospital were retrospectively analyzed. Among them, there were 807 cases with PTC and 37.9 cases with benign nodule and 1321 cases with benign nodule. Logistic regression analysis was used to evaluate age and sex. The relationship between chronic lymphocytic thyroiditis, thyroid globulin antibody, thyroid peroxidase antibody, thyrotropin stimulating hormonet, and so on were correlated with the risk of PTC in the pathologically diagnosed chronic lymphocytic thyroiditis. 缁撴灉涓庤壇鎬х粨鑺傜粍鐩告瘮,PTC缁勫勾榫勬洿灏廩涓�浣嶆暎�

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