Jiao Jie, Zhou Yingsheng
Department of Endocrinology & Metabolism, Affiliated Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Department of Endocrinology & Metabolism, Affiliated Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China; Email:
Zhonghua Yi Xue Za Zhi. 2015 Mar 31;95(12):908-11.
To explore the relationship between serum level of thyroxin-stimulating hormone (TSH) and development and progression of papillary thyroid microcarcinoma (PTMC) in nodular thyroid disease.
A total of 365 eligible patients with thyroid nodules undergoing initial thyroidectomy were enrolled, including 113 patients with PTMC diagnosed by postoperative pathology (PTMC group) and 252 patients with benign thyroid nodules (BTN group). Their clinical data were retrospectively reviewed. The serum levels of TSH in two groups and the proportion of PTMC in different serum TSH level groups in all patients were compared respectively. The relationship of preoperative serum TSH levels with tumor size and lymphatic metastasis in patients with PTMC were analyzed.
No significant difference existed in serum TSH levels between PTMC and BTN groups (P > 0.05). The median age was younger in PTMC group than that in BTN group (Z = -2.877, P = 0.004). And the TGAb levels were higher in PTMC group than those in BTN group (Z = -2.887, P = 0.004). They were divided into 6 groups according to the serum TSH levels, and there weren't significant difference in the proportion of PTMC among those group (P > 0.05). Binary logistic regression analysis showed age was the only risk factor of PTMC (OR = 0.971, 95%CI: 0.953-0.990, P = 0.003). The serum TSH levels were positively correlated with tumor size in patients with PTMC (r = 0.218, P = 0.025). However, the proportions of lymphatic metastasis were comparable among different TSH levels groups in patients with PTMC (P > 0.05).
Serum TSH is probably associated with the de novo oncogenesis of PTMC. However, serum TSH may be involved in the growth of preexisting PTMC.
探讨结节性甲状腺疾病中血清促甲状腺激素（TSH）水平与甲状腺微小乳头状癌（PTMC）发生发展的关系。
共纳入365例首次接受甲状腺切除术的符合条件的甲状腺结节患者，其中113例术后病理诊断为PTMC（PTMC组），252例为良性甲状腺结节（BTN组）。回顾性分析其临床资料。分别比较两组患者的血清TSH水平以及所有患者中不同血清TSH水平组PTMC的比例。分析PTMC患者术前血清TSH水平与肿瘤大小及淋巴结转移的关系。
PTMC组与BTN组血清TSH水平差异无统计学意义（P>0.05）。PTMC组患者的年龄中位数低于BTN组（Z=-2.877，P=0.004）。PTMC组甲状腺球蛋白抗体（TGAb）水平高于BTN组（Z=-2.887，P=0.004）。根据血清TSH水平将患者分为6组，各组PTMC比例差异无统计学意义（P>0.05）。二元logistic回归分析显示年龄是PTMC的唯一危险因素（OR=0.971，95%CI：0.953-0.990，P=0.003）。PTMC患者血清TSH水平与肿瘤大小呈正相关（r=0.218，P=0.025）。然而，PTMC患者不同TSH水平组淋巴结转移比例相当（P>0.05）。
血清TSH可能与PTMC的起始肿瘤发生有关。然而，血清TSH可能参与了已存在的PTMC的生长。
