血清促甲状腺激素浓度与甲状腺癌发病率之间的关联

[Association between the serum TSH concentration and thyroid cancer incidence].

作者信息

Li Jian-zhou, Jin Yong-jun, Liu Xin, Zhang Ling-yun

机构信息

Department of Endocrinology, Binzhou Medical College Hospital, Binzhou 256603, Binzhou, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2011 Dec;33(12):921-4.

PMID:22340102

Abstract

OBJECTIVE

To investigate the association between serum TSH concentration and thyroid cancer incidence.

METHODS

Three hundred and thirty patients with thyroid tumors who underwent surgical treatment were included in this study (99 cases of malignancy and 231 cases of benign tumors). The data of their serum TSH level, gender, age, tumor type, and number of tumors detected by ultrasonic inspection were retrospectively analyzed, and their association with thyroid cancer incidence was explored.

RESULTS

The proportion of thyroid cancer in the groups of younger than twenty years and older than seventy years were 63.0% and 58.3%, respectively, significantly higher than that in the group of age between 60 and 69 years (23.3%, P < 0.05). The incidence of thyroid cancer of the 81 male patients was 43.2%, significantly higher than that in the 249 female patients (25.7%, P = 0.003). The incidence of thyroid cancer in the 112 patients with single nodule was 42.0%, significantly higher than that in the 218 patients with multiple nodules (23.9%, P < 0.001). In the groups with TSH level lower than 0.28 mIU/L and higher than 4.20 mIU/L, the incidence of thyroid cancer were 54.6% and 50.0%, respectively, significantly higher than that in the group with TSH level between 0.28 and 1.44 mIU/L (16.1%, P < 0.05). The proportion of patients with thyroid cancer was also increased with the increasing serum TSH level in the normal range (P < 0.001). High serum TSH level (OR = 1.465, P = 0.014), male (OR = 1.964, P = 0.016) and a single thyroid nodule (OR = 2.090, P = 0.006) are independent risk factors of thyroid cancer.

CONCLUSION

The high serum TSH level, male, single thyroid nodule are factors leading to a high incidence of thyroid cancer.

摘要

目的

探讨血清促甲状腺激素（TSH）浓度与甲状腺癌发病率之间的关联。

方法

本研究纳入330例接受手术治疗的甲状腺肿瘤患者（99例恶性肿瘤和231例良性肿瘤）。回顾性分析其血清TSH水平、性别、年龄、肿瘤类型以及超声检查发现的肿瘤数量等数据，并探讨它们与甲状腺癌发病率的关联。

结果

20岁以下组和70岁以上组甲状腺癌的比例分别为63.0%和58.3%，显著高于60至69岁组（23.3%，P<0.05）。81例男性患者甲状腺癌的发病率为43.2%，显著高于249例女性患者（25.7%，P = 0.003）。112例单发结节患者甲状腺癌的发病率为42.0%，显著高于218例多发结节患者（23.9%，P<0.001）。TSH水平低于0.28 mIU/L组和高于4.20 mIU/L组甲状腺癌的发病率分别为54.6%和50.0%，显著高于TSH水平在0.28至1.44 mIU/L组（16.1%，P<0.05）。在正常范围内，甲状腺癌患者的比例也随血清TSH水平升高而增加（P<0.001）。血清TSH水平高（OR = 1.465，P = 0.014）、男性（OR = 1.964，P = 0.016）和单发甲状腺结节（OR = 2.090，P = 0.006）是甲状腺癌的独立危险因素。