砷和雌激素水平与甲状腺乳头状癌的关联研究  

Associations of arsenic and estrogen levels with the risk of papillary thyroid carcinoma

作　　者：买哈巴·木合塔尔 古丽达娜·塔布斯别克 马晓薇[1] 李宏昀 江志红 黎飞海 吴军[1] Maihaba Muhetaer;Gulidana Tabusibieke;MA Xiaowei;LI Hongyun;JIANG Zhihong;LI Feihai;WU Jun(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830011,China;Altay Customs,Altay,Xinjiang 836500,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]阿勒泰海关,新疆阿勒泰836500

出　　处：《预防医学》2022年第6期577-580,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：新疆维吾尔自治区自然科学基金项目(2018D01C147);新疆维吾尔自治区十四五特色学科-公共卫生与预防医学。

摘　　要：目的分析砷和雌激素水平与甲状腺乳头状癌的关联,为预防甲状腺乳头状癌提供依据。方法选择2018年在新疆维吾尔自治区乌鲁木齐市2家三甲医院治疗的57例甲状腺乳头状癌患者纳入病例组,同期57名甲状腺功能正常的健康体检者为对照;通过问卷调查收集研究对象的性别、年龄、民族、职业和甲状腺疾病史等资料。采用高效液相-氢化物发生原子分光光度法检测血清二甲基砷酸(DMA)和一甲基砷酸(MMA);采用放射免疫法检测血清甲状腺激素(TSH);采用酶联免疫吸附试验检测雌二醇(E_(2));采用蛋白质印迹法检测雌激素受体(ER)α和ERβ。采用多因素lo⁃gistic回归模型分析砷和雌激素与甲状腺乳头状癌的关联。结果病例组男性16例,占28.07%;女性41例,占71.93%;年龄为(42.63±11.01)岁。对照组男性21人,占36.84%;女性36人,占63.16%;年龄为(40.89±11.30)岁。病例组与对照组的年龄(χ^(2)=0.373,P=0.542)、性别(χ^(2)=1.000,P=0.317)和民族(χ^(2)=0.291,P=0.590)构成差异均无统计学意义。病例组血清TSH、E_(2)、ERα、ERβ、DMA和MMA分别为2.85(1.61)μmol/L、74.93(120.44)pmol/L、1.49(1.13)、1.59(0.55)、116.02(100.48)μg/L和56.92(47.90)μg/L,均高于对照组的2.45(1.79)μmol/L、61.60(37.35)pmol/L、0.70(0.31)、0.72(0.36)、32.33(56.06)μg/L和27.90(24.99)μg/L,差异有统计学意义(Z=-2.414、-2.292、-4.923、-5.167、-5.448、-4.019,均P<0.05)。多因素logistic回归分析结果显示,DMA(OR=1.013,95%CI:1.003~1.024)和E_(2)(OR=1.020,95%CI:1.004~1.036)水平与甲状腺乳头状癌患病存在统计学关联。结论砷负荷增加、E2水平升高可能与甲状腺乳头状癌的发生发展有关。Objective To examine the associations of arsenic and estrogen levels with the risk of papillary thyroid carci⁃noma,so as to provide insights into prevention of papillary thyroid carcinoma.Methods Totally 57 patients with papil⁃lary thyroid carcinoma admitted to two tertiary hospitals in Urumqi,Xinjiang Uygur Autonomous Region in 2018 were selected as the case group,while 57 subjects with normal thyroid functions during the same period were selected as the control group.Subjects'gender,age,ethnicity,occupation and medical history of thyroid disease were collected using question⁃naire surveys.Serum dimethyl arsenic acid(DMA)and monomethyl arsenic acid(MMA)were determined using high-per⁃formance liquid chromatography(HPLC)coupled to hydride generation-atomic fluorescence spectrometry(HG-AFS),se⁃rum thyroid hormone(TSH)by radioimmunoassay,estradiol(E_(2))by enzyme-linked immunosorbent assay and estrogen re⁃ceptor ERαand ERβby western blotting.The associations of arsenic and estrogen levels with the risk of papillary thy⁃roid carcinoma were evaluated using a multivariable logistic regression model.Results There were 16 males(28.07%)and 41 females(71.93%)in the case group,with a mean age of(42.63±11.01)years,and there were 21 males(36.84%)and 36 females(63.16%)in the control group,with a mean age of(40.89±11.30)years.There were no significant dif⁃ferences between the case and control groups in terms of age(χ^(2)=0.373,P=0.542),gender(χ^(2)=1.000,P=0.317)or eth⁃nic composition(χ^(2)=0.291,P=0.590).The serum levels of TSH[2.85(1.61)vs.2.45(1.79)μmol/L],E_(2)[74.93(120.44)vs.61.60(37.35)pmol/L],ERα[1.49(1.13)vs.0.70(0.31)],ERβ[1.59(0.55)vs.0.72(0.36)],DMA[116.02(100.48)vs.32.33(56.06)μg/L]and MMA[56.92(47.90)vs.27.90(24.99)μg/L]were all significantly higher in the case group than in the control group(Z=-2.414,-2.292,-4.923,-5.167,-5.448 and-4.019,all P<0.05).Multivariable logistic re⁃gression analysis showed DMA(OR=1.013,95%CI:1.003-1.024)and E_(2) levels(OR=1.020,95%CI:1.004-1.036)were ass

关 键 词：甲状腺乳头状癌 砷 雌激素 促甲状腺激素 

分 类 号：R114[医药卫生—卫生毒理学]