乳腺癌放射治疗前后甲状腺功能的变化及临床意义  

Changes and Clinical Significance of Thyroid Function in Patients with Breast Cancer before and after Radiotherapy and Clinical Significance

作　　者：艾秀清[1] 努尔古丽.阿布都热西提 董晓霞[1] 葛玉红[1] 木妮热.木沙江 

机构地区：[1]新疆医科大学附属肿瘤医院乳腺放疗科,乌鲁木齐市830011

出　　处：《中国病案》2017年第6期107-110,共4页Chinese Medical Record

基　　金：新疆医科大学科研创新基金(XYDCX201459)

摘　　要：目的探讨乳腺癌患者行锁骨上下淋巴引流区放射治疗前后甲状腺功能的变化及其临床意义。方法随机选择2010年6月-2016年6月期间160例行术后放射治疗的乳腺癌患者,其中,80例放射治疗靶区不包括锁骨上下淋巴引流区(保乳术后组),80例放射治疗靶区包括锁骨上下淋巴引流区(改良根治术后组),分别在放射治疗前、放射治疗后6个月、1、3、5年检测T4、T3、FT3,FT4和TSH水平,观察其激素水平变化及临床症状。另选80例乳腺良性病患者作为对照组。结果改良根治术后组与乳腺良性病组对比,放射治疗前乳腺癌患者的T3、T4、FT3、FT4及TSH水平差异无统计学意义;与保乳术后组相比,放射治疗后3年10例出现TSH水平升高,其中5例出现精神不振、乏力、食欲减退、头昏失眠等甲状腺功能减退症状,各项激素水平变化差异无统计学意义;放射治疗后5年其TSH水平升高(t=23.19,P<0.05),FT3、FT4水平下降(t=18.51,2.34,P<0.05),差异有统计学意义。结论乳腺癌与乳腺良性疾病患者的甲状腺功能无明显差异。锁骨上下引流区的放射治疗对乳腺癌者的甲状腺功能有损伤,可能诱发甲状腺功能减退,需定期检测并及时治疗。Objective To investigate the changes of thyroid function and its clinical significance in patients with breast cancer before and after radiation therapy of the upper and lower lymphatic drainage area. Methods The random selection of 160 cases of postoperative radiotherapy for breast cancer patients were included, of which, 80 cases of radiotherapy target area includes the supraclavicular upper and lower area （Modified radical operation group） s and 80 cases does not include （Breast conserving surgery group）. T3, T4, FT3, FT4 and TSH were respectively detected in radiation therapy before, after radiotherapy 6 months, 1, 3, 5 years, and observe the changes in hormone levels and clinical symptoms. Another 80 cases of breast benign disease patients as the control group, measure the T3, T4, FT3, FT4 and TSH levels. Results Compared with benign breast disease group, the difference of T3, T4, FF3, FT4, and TSH in breast cancer patients before radiotherapy was not statistically significant. Compared with the breast conserving surgery group, before radiotherapy, after radiotherapy 6 months and 1 years, the changes of hormone levels in modified radical operation group were not statistically significant. 3 vears after radiotherapy in 10 patients with elevated TSH levels, including 5 cases of dizziness, fatigue, anorexia, dizziness, insomnia and other symptoms of hypothyroidism, there were no significant differences in the hormone levels. The level of TSH rises （t=-23.19, P〈0.05）, FF3 and FT4 decreased （t=-18.51, 2. 34, P〈0. 05） after radiotherapy for 5 years. Conclusion There was no significant difference in thyroid function in patients with breast cancer and benign breast disease. The radiotherapy of the upper and lower drainage area of the breast cancer patients with thyroid function damage, may induce hypothyroidism, and it needs to regularly detect and timely treatment.

关 键 词：乳腺癌 放射治疗 甲状腺功能 

分 类 号：R730.55[医药卫生—肿瘤] R737.9[医药卫生—临床医学]