女性甲状腺结节患者性激素水平及其受体表达的研究  

Expression of sex hormones and their receptors in female patients with different types of thyroid nodules

作　　者：董愫[1] 宋雪松[1] 庞磊[1] 刘嘉[2] 

机构地区：[1]吉林大学第一医院麻醉科,长春130021 [2]吉林大学第一医院甲状腺外科,长春130021

出　　处：《中华内分泌外科杂志》2017年第1期29-33,共5页Chinese Journal of Endocrine Surgery

基　　金：吉林大学白求恩培育基金[2015307]

摘　　要：目的探讨女性甲状腺结节患者血清雌激素、孕激素、卵泡刺激素、黄体生成素水平及甲状腺组织性激素受体的表达。方法收集2009年12月至2014年12月在吉林大学第一医院甲状腺外科行择期甲状腺结节手术治疗患者435例，其中甲状腺腺瘤97例，结节性甲状腺肿103例，PTC 208例，甲状腺低分化癌17例，甲状腺未分化癌10例。采用化学发光法测定血清样本中雌激素、孕激素、卵泡刺激素和黄体生成素的水平；采用免疫组化染色法测定甲状腺组织性激素受体的阳性表达率。结果甲状腺结节组血清雌激素水平及甲状腺雌激素受体α的阳性率较正常对照组明显增高，雌激素受体β的阳性率较正常对照组下降，尤其是甲状腺低分化癌和未分化癌组。甲状腺腺瘤、结节性甲状腺、PTC组血性孕激素水平下降和孕激素受体的阳性率较正常对照组明显。甲状腺腺瘤组血清卵泡刺激素和黄体生成素水平及其受体阳性表达率较其他组均明显增加。结论甲状腺结节的发生与性激素具有相关性，可供临床疾病的激素治疗参考，帮助甲状腺疾病的诊断治疗和预后评估。ObjectiveTo investigate the levels of estrogen, progesterone, follicle-stimulating hormone （FSH） , and luteinizing hormone （LH） in serum and the expression of ER, PR, FSH receptor （FSHR） , and LH receptor （LHR） in thyroid tissues of patients with different types of thyroid nodules.MethodsSerum levels of estrogen, progesterone, FSH, and LH were measured by chemiluminescence and expression of ER, PR, FSHR, and LHR in thyroid tissue was detected by immunohistochemistry in female patients with thyroid adenoma （n=97） , nodular goiter （n=103） , thyroid papillary cancer （n=208） , poorly differentiated thyroid carcinoma （n=17） , or undifferentiated thyroid carcinoma （n=10） and in normal controls （n=60） from Dec. 2009 to Dec. 2014 in Department of Thyroid Surgery of the First Hospital of Jilin University.ResultsThe positive rates of serum estrogen level and ER expression were significantly greater in patients with various types of thyroid nodules than in normal controls. The positive rates of ER expression were significantly lower in various types of thyroid nodules than in normal thyroid tissues, especially in poorly differentiated carcinoma and undifferentiated carcinoma. The negative rates of serum progesterone level and positive rates of PR expression in thyroid tissue were significantly greater in patients with thyroid adenoma, nodular goiter, or thyroid papillary cancer than in normal controls. The positive rates of serum FSH and LH levels and FSHR and LHR expression were significantly greater in the thyroid adenoma group than in other groups.ConclusionsThe occurance of thyroid nodules might be related to sex hormone. The combined detection of serum levels of sex hormones and expression of their receptors allows for a differential diagnosis and evaluation of the degree of differentiation among various types of thyroid nodules.

关 键 词：甲状腺结节 雌激素 孕激素 卵泡刺激素 黄体生成素 

分 类 号：R653[医药卫生—外科学]