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韩国甲状腺乳头状癌与尿碘及膳食碘状况的病例对照研究。

Case-Control Study of Papillary Thyroid Carcinoma on Urinary and Dietary Iodine Status in South Korea.

作者信息

Lee Joon-Hyop, Song Ra-Yeong, Yi Jin Wook, Yu Hyeong Won, Kwon Hyungju, Kim Su-Jin, Chai Young Jun, Choi June Young, Moon Jae Hoon, Lee Kyu Eun, Park Young Joo, Park Sue K

机构信息

Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.

Thyroid and Endocrine Surgery Section, Department of Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.

出版信息

World J Surg. 2018 May;42(5):1424-1431. doi: 10.1007/s00268-017-4287-x.

Abstract

BACKGROUND

The association between iodine levels and the risk of papillary thyroid cancer (PTC) has been suggested, but not definitively established. This study is to compare the iodine status of a group of patients with PTC (with and without BRAF ) with that of a healthy population cohort.

METHODS

A cohort of patients scheduled for thyroidectomy was enrolled, along with a community-based health-screening cohort with no known history of thyroid disease. Median urinary iodine (UI) levels, creatinine-adjusted median UI levels, and food frequency questionnaire (FFQ) scores (mean ± SD) were compared. In a subgroup analysis, these values were compared between BRAF -positive and BRAF -negative patients in the PTC group.

RESULTS

The PTC group consisted of 210 patients, and the control group consisted of 90 healthy individuals. Among the 191 PTC patients whose BRAF mutational status was reported, 169 (88.5%) were revealed positive for the mutation. The median UI levels were significantly higher in the PTC group (786.0 μg/l) than the control group (112.0 μg/l; p < 0.001), as was the case with creatinine-adjusted median UI levels (884.6 μg/g creatinine versus 182.0 μg/g creatinine; p < 0.001) and FFQ scores (66.2 ± 17.5, range 13-114 versus 54.6 ± 21.5, range 16-134; p < 0.001). No significant differences were seen in the subgroup analysis between BRAF -positive and BRAF -negative patients.

CONCLUSIONS

Our results indicate that iodine status differs significantly between patients with PTC and healthy controls, suggesting that iodine may be involved in the occurrence of PTC, although the association between iodine levels and BRAF mutational status did not reach statistical significance.

摘要

背景

碘水平与甲状腺乳头状癌(PTC)风险之间的关联已被提出,但尚未明确确立。本研究旨在比较一组PTC患者(有或无BRAF )与健康人群队列的碘状态。

方法

纳入一组计划进行甲状腺切除术的患者队列,以及一个无甲状腺疾病已知病史的社区健康筛查队列。比较尿碘中位数(UI)水平、肌酐校正后的尿碘中位数水平和食物频率问卷(FFQ)得分(均值±标准差)。在亚组分析中,比较PTC组中BRAF阳性和BRAF阴性患者的这些值。

结果

PTC组包括210例患者,对照组包括90名健康个体。在报告了BRAF突变状态的191例PTC患者中,169例(88.5%)显示突变阳性。PTC组的尿碘中位数水平(786.0μg/l)显著高于对照组(112.0μg/l;p<0.001),肌酐校正后的尿碘中位数水平(884.6μg/g肌酐对182.0μg/g肌酐;p<0.001)和FFQ得分(66.2±17.5,范围13 - 114对54.6±21.5,范围16 - 134;p<0.001)也是如此。BRAF阳性和BRAF阴性患者的亚组分析中未观察到显著差异。

结论

我们的结果表明,PTC患者与健康对照者的碘状态存在显著差异,提示碘可能参与PTC的发生,尽管碘水平与BRAF突变状态之间的关联未达到统计学意义。

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