Lo Galbo Annalisa M, de Bree Remco, Kuik Dirk J, Lips Paul Th A M, Mary B, Von Blomberg E, Langendijk Johannes A, Leemans C Rene
Department of Otorinolaryngology/Head and Neck Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Acta Otolaryngol. 2007 Mar;127(3):312-7. doi: 10.1080/00016480600818096.
The incidence rate of hypothyroidism after treatment for laryngeal and hypopharyngeal cancer is high, especially after combination treatment. An association between hypothyroidism and autoantibodies was found.
The incidences of hypothyroidism and autoantibodies were assessed retrospectively in 156 patients with laryngeal and hypopharyngeal carcinoma who were treated with surgery and/or radiotherapy between 1977 and 2002.
Patients treated for T2-T4 carcinoma or a recurrence after T1 who visited the outpatient clinic for their regular follow-up visit were included. All patients were evaluated for the development of hypothyroidism, defined as increased thyroid-stimulating hormone level (>4.5 mU/L) and the presence of autoantibodies. A questionnaire regarding symptoms was administered.
The prevalence of undiagnosed hypothyroidism following treatment of laryngeal carcinoma was 28.2%: 18.6% subclinical hypothyroidism and 9.6% clinical hypothyroidism. The prevalence of circulating antithyroid antibodies (anti-thyreoperoxidase and/or anti-thyreoglobulin) was 10.5%. Univariate analysis showed that patients with laryngectomy, hemithyroidectomy, ipsilateral neck dissection and autoantibodies had a higher risk of hypothyroidism. The combination of surgery and radiotherapy increased the risk. Symptoms such as weight gain and cold intolerance were significantly associated with hypothyroidism. Multivariate analysis showed hemithyroidectomy, autoantibodies, weight gain and cold intolerance to be prognostic factors for the development of hypothyroidism.
喉癌和下咽癌治疗后甲状腺功能减退的发生率很高，尤其是联合治疗后。发现甲状腺功能减退与自身抗体之间存在关联。
回顾性评估1977年至2002年间接受手术和/或放疗的156例喉癌和下咽癌患者的甲状腺功能减退和自身抗体的发生率。
纳入接受T2 - T4期癌或T1期癌复发治疗后到门诊进行定期随访的患者。所有患者均评估甲状腺功能减退的发生情况，定义为促甲状腺激素水平升高（>4.5 mU/L）和自身抗体的存在。发放了一份关于症状的问卷。
喉癌治疗后未诊断出的甲状腺功能减退患病率为28.2%：亚临床甲状腺功能减退为18.6%，临床甲状腺功能减退为9.6%。循环抗甲状腺抗体（抗甲状腺过氧化物酶和/或抗甲状腺球蛋白）的患病率为10.5%。单因素分析显示，接受喉切除术、半甲状腺切除术、同侧颈部清扫术和自身抗体阳性的患者发生甲状腺功能减退的风险更高。手术和放疗联合增加了风险。体重增加和不耐寒等症状与甲状腺功能减退显著相关。多因素分析显示，半甲状腺切除术、自身抗体、体重增加和不耐寒是甲状腺功能减退发生的预后因素。
