乳腺癌放疗对甲状腺功能和钙磷离子水平的影响  

The effects of thyroid function and calcium and phosphorus on radiotherapy of breast cancer

作　　者：张明[1] 魏世鸿[1] 刘锐峰[1] 欧阳水根[1] 管玲[1] 江秀娟[1] 高力英[1] Zhang Ming;Wei Shihong;Liu Ruifeng;Ouyang Shuigen;Guan Ling;Jiang Xiujuan;Gao Liying(Department of Radiation Oncology,Gansu Provincial Cancer Hospital,Gansu Lanzhou 730050,China)

机构地区：[1]甘肃省肿瘤医院放疗科,甘肃兰州730050

出　　处：《现代肿瘤医学》2018年第14期2199-2202,共4页Journal of Modern Oncology

基　　金：甘肃省卫生行业科研计划项目(编号:GSWSKY-2015-27)

摘　　要：目的:通过对比乳腺癌术后锁骨上区放疗前后甲状腺、甲状旁腺功能,甲状腺超声和钙磷离子的变化,探讨放疗对甲状腺损伤的影响因素。方法:选取甘肃省肿瘤医院放疗科2015年1月至2017年1月收治的120例分期为Ⅱ、Ⅲ期,且具有术后放疗适应证的女性乳腺癌患者,分别在放疗前、放疗结束、放疗结束后1个月、6个月、12个月、24个月检查甲状腺、甲状旁腺功能,甲状腺超声和钙磷离子水平。结果:放疗结束、放疗结束后1和6个月三碘甲状腺原氨酸(T3)[(2.01±0.33)nmol/L、(2.05±0.39)nmol/L、(2.05±0.27)nmol/L]与放疗前相比明显减低,差异有统计学意义(P<0.05);放疗结束后1个月血清游离甲状腺激素(FT4)[(13.63±1.67)pmol/L]与放疗前比较明显降低,差异有统计学意义(P<0.05);放疗结束12个月后甲状腺过氧化物酶抗体(A-TPO)[(5.38±0.73)IU/L]与放疗前比较明显降低,差异有统计学意义(P<0.05);放疗结束12个月后患者钙离子检测有下降趋势,磷离子和甲状旁腺激素无明显变化;甲状腺结节与结节附近丰富血流比例在放疗结束6个月后减少较明显。结论:乳腺癌术后锁骨上区放疗对甲状腺、甲状旁腺功能有影响,但影响有限,随时间延长,甲减风险增高;对甲状旁腺和磷离子无明显影响;钙离子放疗结束12个月后有降低趋势;放疗结束6个月后甲状腺结节和血流减少明显。Objective： To investigate the influencing factors of thyroid and parathyroid function,thyroid ultrasonography and calcium and phosphorusions before and after radiotherapy in breast cancer,and to explore the influencing factors of thyroid and so on. Methods： From 2015-1 to 2017-1 120 cases of stage Ⅱ,Ⅲ,with postoperative radiotherapy indications of female breast cancer patients were collected. Before radiotherapy,at the end of radiotherapy,after radiotherapy about 1 month,6 months,12 months,24 months,all indexes were detected. Results： After the end of radiotherapy T3 and T3 of 1 month and 6 months after the end of radiotherapy were[（ 2. 01 ± 0. 33） nmol/L,（ 2. 05 ±0. 39） nmol/L,（ 2. 05 ± 0. 27） nmol/L]respectively,with statistical significance（ P〈0. 05）. FT4 in the 1 month after the end of radiotherapy was lower than that before radiotheray,and the difference was statistically significant[（ 13. 63 ± 1. 67） pmol/L]（ P〈0. 05）. The level of A-TPO in the 12 months after the end of radiotherapy was significantly lower than that before radiotherapy[（ 5. 38 ± 0. 73） IU/L],with statistical significance（ P〈0. 05）. After radiotherapy,the detection of calcium decreased after 12 months phosphorus and parathyroid hormone had no significant change. The proportion of thyroid nodules and nodules near the rich blood flow after the end of radiotherapy 6 months to reduce was more obvious. Conclusion： The postoperative supraclavicular radiotherapy for breast cancer has an effect on thyroid and thyroid function,but it has a limited impact. With the extension of time,the risk of hypothyroidism is increased. There is no significant effect on parathyroid and phosphorus ions. Calcium ion radiotherapy has a trend of decreasing after 12 months. Thyroid nodules and blood flow decreased significantly 6 months after radiotherapy.

关 键 词：乳腺癌 甲状腺 甲状旁腺 钙磷离子 

分 类 号：R737.9[医药卫生—肿瘤]