Antonelli A, Ferri C, Fallahi P, Nesti C, Zignego A L, Maccheroni M
Department of Internal Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy.
Clin Exp Rheumatol. 2002 Sep-Oct;20(5):693-6.
The prevalence of thyroid cancer in a series of unselected HCV-related mixed cryoglobulinemic patients was investigated in comparison with a control group.
Among 107 consecutive patients with mixed cryoglobulinemia (MC), 94 were eligible for the study. A control group was obtained from a sample of the general population (2,401 subjects), age > 50 years, who had undergone thyroid ultrasonography (582 subjects); 5 sex-matched controls were randomly assigned to each MC patients (470 individuals). The mean age was similar in the MC patients and controls (64.2 +/- 10.0 vs. 63.4 +/- 7.0).
The prevalence of thyroid nodules was higher, although not significantly so, in control subjects than in MC patients (65.3 vs. 54.8%). Two patients with papillary thyroid cancer were found in the MC series, while no case was observed among controls (p = 0.001, chi-square P value; p = 0.02, Fisher's exact test). In both MC patients with papillary thyroid cancer lymphocytic infiltration was observed in the thyroid tissue.
The possible association between HCV-related MC and thyroid cancer indicates that a careful monitoring of the thyroid would be opportune during the clinical follow-up of HCV-associated MC patients, especially in those with signs of thyroid autoimmune disorders.
与对照组相比,研究一系列未经选择的丙型肝炎病毒(HCV)相关混合性冷球蛋白血症患者中甲状腺癌的患病率。
在107例连续性混合性冷球蛋白血症(MC)患者中,94例符合研究条件。对照组来自年龄>50岁的普通人群样本(2401名受试者),这些人接受过甲状腺超声检查(582名受试者);为每名MC患者随机分配5名性别匹配的对照(共470人)。MC患者和对照组的平均年龄相似(分别为64.2±10.0岁和63.4±7.0岁)。
对照组甲状腺结节的患病率高于MC患者,尽管差异不显著(分别为65.3%和54.8%)。在MC组中发现2例甲状腺乳头状癌患者,而对照组未观察到病例(卡方检验P值=0.001;Fisher精确检验P值=0.02)。在这2例甲状腺乳头状癌的MC患者中,甲状腺组织均观察到淋巴细胞浸润。
HCV相关的MC与甲状腺癌之间可能存在关联,这表明在HCV相关MC患者的临床随访期间,尤其是那些有甲状腺自身免疫紊乱迹象的患者,对甲状腺进行仔细监测是合适的。