术前血清TSH浓度与分化型甲状腺癌的相关性研究  

Relationship between preoperative serum TSH and differentiated thyroid carcinoma

作　　者：李建周[1] 刘欣[1] 张凌云[1] 金勇君[1] 

机构地区：[1]滨州医学院附属医院内分泌科,山东滨州256603

出　　处：《山东大学学报（医学版）》2011年第1期10-13,共4页Journal of Shandong University:Health Sciences

摘　　要：目的观察血清促甲状腺激素（TSH）浓度与分化型甲状腺癌（DTC）的相关性。方法回顾性分析371例甲状腺手术患者的TSH水平、肿瘤大小与DTC的关系及肿瘤分期与TSH水平间的关系。根据术后病理学报告判定良性和DTC,根据肿瘤直径及TSH值分成不同的小组。结果病理学诊断有120例患者患有DTC。随血清TSH浓度的升高DTC患病率升高,TSH〈0.28m IU/L组（58.33%）、1.462.28m IU/L组（26.92%）、2.294.19m IU/L组（37.14%）、≥4.2m IU/L组（46.67%）与0.281.45m IU/L组（23.81%）恶性率比较P值分别为0.018、0.605、0.036、0.005。肿瘤直径〈2cm组、23.9cm组和≥4cm组比较恶性率均较高,P值分别为〈0.001、0.027。TNM分期Ⅲ、Ⅳ期患者TSH水平高于Ⅰ、Ⅱ期患者,P=0.012。结论结节性甲状腺肿患者DTC发病率与血清TSH浓度和结节直径大小相关。Objective To investigate the association between serum TSH concentration and differentiated thyroid carcinoma（DTC）.Methods Retrospective analysis was made on 371 cases of thyroid tumor that underwent surgery.Relationships among TSH,goiter size and DTC,as well as the relationship between the stage and the TSH level were analyzed.Thyroid tumors were determined as benign or DTC according to pathological findings.The patients were divided into different groups based on goiter diameter and the level of TSH.Result 120 patients were confirmed as DTC.The risk of malignancy increased as serum TSH rose.The P values were 0.018,0.605,0.036,0.005 in the subjects with serum TSH〈0.28 mU/L（58.33%）,1.46-2.28 mIU/L（26.92%）,2.29-4.2 mIU/L（37.14%）,≥4.2 mIU/L（46.67%） or 0.28-1.45 mU/L（23.81%）,respectively.The group in which the diameter of the thyroid tumor was less than 2 cm showed higher risk of DTC than other groups（2.0-3.9 cm,P 〈0.001;≥4 cm,P =0.027）.Stage III and IV DTC were associated with a higher mean TSH than stage I and II（P =0.012）.Conclusions The incidence of DTC is related to the serum TSH concentration and thyroid tumor size.

关 键 词：分化型甲状腺癌 促甲状腺激素 

分 类 号：R581.9[医药卫生—内分泌]