甲状腺癌与桥本甲状腺炎及其他相关危险因素的研究  

Relationship between thyroid carcinoma, Hashimoto＇s thyroiditis and other related risk factors

作　　者：于亚静[1] 杨彩哲[2] 关小宏[2] 王良宸[2] 吴石白[2] 刘明[3] 肖黎[2] 张妲[2] 刘朝阳[1] 

机构地区：[1]河北北方学院,张家口075000 [2]北京空军总医院内分泌科,100142 [3]北京空军总医院病理科,100142

出　　处：《国际内分泌代谢杂志》2015年第1期27-30,共4页International Journal of Endocrinology and Metabolism

摘　　要：目的 探讨甲状腺癌与桥本甲状腺炎及其他相关危险因素的关系.方法 采用回顾性研究方法分析2001年1月-2013年9月于空军总医院经手术治疗的1 141例甲状腺结节患者的临床资料,其中,病理诊断为甲状腺癌270例,甲状腺良性结节871例（甲状腺腺瘤194例,结节性甲状腺肿341例,腺瘤性结节性甲状腺肿336例）.比较甲状腺癌患者及甲状腺良性结节患者在桥本甲状腺炎、性别、年龄、病程、结节大小、甲状腺功能等方面的差异,并采用Logistic回归法分析甲状腺癌的危险因素.结果 与甲状腺良性结节患者相比,甲状腺癌患者合并桥本甲状腺炎比例较高（t=20.534,P＜0.01）、患者较年轻（t=0.855,P＜0.01）、结节直径较小（t=-5.927,P＜0.01）,促甲状腺激素（TSH）水平（t=2.380,P＜0.05）、甲状腺球蛋白抗体异常率（χ2=16.088,P＜0.01）及甲状腺过氧化物酶抗体异常率（χ2=7.023,P＜0.01）均较高.Logistic回归分析显示桥本甲状腺炎[优势比（OR）=1.829,95％CI：1.163～2.877,P＜O.01]、年龄≤45岁（OR=1.716,95％CI：1.166～2.528,P＜0.01）、结节直径≤1 cm（OR=4.261,95％ CI：2.467～7.360,P＜0.01）是甲状腺癌的危险因素.结论 桥本甲状腺炎可能是甲状腺癌的危险因素,对于促甲状腺激素、甲状腺球蛋白抗体、甲状腺过氧化物酶抗体水平较高的甲状腺结节患者应高度关注,加强随访.Objective To explore the relationship between thyroid carcinoma,Hashimoto＇s thyroiditis and other related risk factors.Methods A retrospective analysis was used to analyze 1 141 postoperative patients with thyroid nodules in Air Force General hospital during 2001.1-2013.9.According to the pathological results,there were 270 cases of thyroid carcinomas,871 cases of thyroid benign nodules including 194 cases of thyroid adenoma,341 cases of nodular goiter,336 cases of adenomatous nodular goiter.Difference between patients with thyroid carcinoma and benign thyroid nodules was compared,including the prevalence of Hashimoto＇s thyroiditis and other factors such as gender,age,course of disease,size of nodules,thyroid function,etc.Logistic regression analysis was used to explore the risk factors of thyroid carcinoma.Results Compared with patients with benign thyroid nodules,the prevalence of Hashimoto＇s thyroiditis was higher（t =20.534,P 〈 0.01）,the age was younger（t =0.855,P 〈 0.01）,the diameter of the nodules was smaller（t =-5.927,P 〈0.01） in patients wih thyroid carcinoma.And the level of thyroid stimulating hormone（TSH,t =2.380,P 〈0.05）,the percentage of abnormal thyroid globulin antibody （χ2 =16.088,P 〈 0.01）,the percentage of abnormal thyroid peroxidase antibody （χ2 =7.023,P 〈 0.01）were all higher in patients with thyroid carcinoma.Logistic regression analysis indicated that Hashimoto＇s thyroiditis [odd ratio （OR） =1.829,95% CI：1.163-2.877,P 〈 0.01],age（≤45 years） （OR =1.716,95% CI：1.166-2.528,P 〈 0.01）,the diameter of the nodules ≤ 1 cm （OR =4.261,95 % CI：2.467-7.360,P 〈 0.01） were risk factors of thyroid carcinoma.Conclusion Hashimoto＇s thyroiditis may be a risk factor of thyroid carcinoma.Besides,more concern and intensive follow-up should be recommended for patients with increased TSH,thyroid globulin body,thyroid peroxidase antibody levels.

关 键 词：甲状腺癌 桥本甲状腺炎 甲状腺良性结节 

分 类 号：R581.4[医药卫生—内分泌]