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甲状腺细针穿刺活检对甲状腺相关生化参数的长期影响。

Long-term effects of thyroid fine-needle biopsy on the thyroid-related biochemical parameters.

机构信息

Department of Endocrinology, 424 Military Hospital, Thessaloniki, Greece.

出版信息

Int J Clin Pract. 2012 Jun;66(6):602-9. doi: 10.1111/j.1742-1241.2012.02919.x.

Abstract

AIMS

Thyroid fine-needle biopsy (FNB) is a simple, reliable, inexpensive and generally safe diagnostic procedure in the management of thyroid nodules. FNB may trigger biochemical alterations through destruction of thyroid follicles. We aimed to investigate long-term post-FNB alterations in serum thyroid-related parameters.

METHODS

One hundred and ten consecutive patients with thyroid nodular disease were subjected to FNB. Thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3), thyroglobulin (Tg), thyroglobulin autoantibodies (anti-Tg), thyroid-peroxidase autoantibodies (anti-TPO) were measured in all subjects at baseline, 10 days, 2 and 6 months. Subsequently, patients were divided into subgroups according to the technique of FNB, the presence of disease characteristics as thyroid autoimmunity (Hashimoto's thyroiditis), goitre, singularity-maximum diameter-blood pattern of the nodule(-s), the number of passes and the administration of L-thyroxine (LT4).

RESULTS

A significant increase in Tg, anti-Tg and FT3 levels was observed. These alterations were more prominent within patients with dominant nodule's maximum diameter ≥ 2 cm or without Hashimoto's thyroiditis. Tg and anti-Tg levels were significantly increased only in patients not being on LT4. On the other hand, FNB technique did not affect any of the measured parameters.

CONCLUSION

Our data suggest that FNB results in statistically significant but clinically insignificant increases in Tg, anti-Tg and FT3 levels, implying a thyroid trauma of some level, more likely to happen in patients with larger nodules. The FNB technique used has no effect on the thyroid-related biochemical parameters.

摘要

目的

甲状腺细针穿刺活检(FNB)是一种简单、可靠、经济且通常安全的诊断甲状腺结节的方法。FNB 可能通过破坏甲状腺滤泡引起生化改变。我们旨在研究 FNB 后血清甲状腺相关参数的长期变化。

方法

110 例甲状腺结节患者连续接受 FNB。所有患者均在基线时、第 10 天、第 2 个月和第 6 个月检测甲状腺刺激激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、甲状腺球蛋白(Tg)、甲状腺球蛋白自身抗体(抗-Tg)和甲状腺过氧化物酶自身抗体(抗-TPO)。随后,根据 FNB 技术、疾病特征(桥本甲状腺炎)、甲状腺肿、结节最大直径-血流模式、穿刺次数和左旋甲状腺素(LT4)的应用情况,将患者分为亚组。

结果

观察到 Tg、抗-Tg 和 FT3 水平显著升高。在最大直径≥2cm 的优势结节或无桥本甲状腺炎的患者中,这些改变更为明显。仅在未服用 LT4 的患者中,Tg 和抗-Tg 水平显著升高。另一方面,FNB 技术并未影响任何测量参数。

结论

我们的数据表明,FNB 导致 Tg、抗-Tg 和 FT3 水平出现统计学上显著但临床上无意义的升高,提示存在一定程度的甲状腺创伤,更可能发生在结节较大的患者中。使用的 FNB 技术对甲状腺相关生化参数无影响。

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