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采用印迹细胞学检查法观察无甲状腺相关眼病的桥本甲状腺炎患者结膜形态学变化

Changes in Conjunctiva Morphology Using Impression Cytology in Patients with Hashimoto’s Thyroiditis without Thyroid-Associated Ophthalmopathy.

作者信息

Altay Mustafa, Şahin Tuğba, Yıldız Zennure, Şimşek Gülçin, Çıtırık Mehmet, Ateş İhsan, Dağdeviren Murat, Bitiren Muharrem

机构信息

Department of Endocrinology and Metabolism, University of Health Sciences, Keçiören Health Administration and Research Center, ANKARA, TURKEY

出版信息

Turk Patoloji Derg. 2019;35(3):213-220. doi: 10.5146/tjpath.2019.01461.

Abstract

OBJECTIVE

To compare the conjunctival morphological changes in patients with Hashimoto’s thyroiditis (HT) without thyroid-associated ophthalmopathy (TAO) and controls using impression cytology technique.

MATERIAL AND METHOD

We included 25 HT patients and 33 healthy controls who did not have TAO findings or dry eye. For both groups, thyroid stimulating hormone (TSH), free T4(FT4), and anti-thyroid peroxidase (anti-TPO) were measured. Thyroid ultrasonography was performed, together with all routine eye check-ups and the Schirmer’s test. Also, conjunctival impression cytology (CIC) test was performed to analyze the conjunctival morphology.

RESULTS

When the CIC of HT patients was observed; 12% had grade 0, 40% had grade 1, 28% had grade 2 and 20% had grade 3. While patients with squamous metaplasia made up 48% of the HT group, this was observed at 6.1% in the control group (p < 0,001). In the regression model formulated, it was observed that obesity (OR=7.500; p=0.017) and anti TPO levels (OR=1.370, p=0,007) were independent stipulations for the squamous metaplasia.

CONCLUSION

Conjunctival squamous metaplasia was more frequently seen in HT than controls and serum Anti-TPO level and obesity were detected as independent predictors of the worsening at the conjunctival impression cytology.

摘要

目的

运用印迹细胞学技术比较无甲状腺相关眼病(TAO)的桥本甲状腺炎(HT)患者与对照组的结膜形态学变化。

材料与方法

我们纳入了25例HT患者和33例无TAO表现或干眼的健康对照者。对两组均检测促甲状腺激素(TSH)、游离甲状腺素(FT4)和抗甲状腺过氧化物酶(抗-TPO)。进行甲状腺超声检查,同时进行所有常规眼部检查和泪液分泌试验。此外,进行结膜印迹细胞学(CIC)检测以分析结膜形态。

结果

观察HT患者的CIC时;12%为0级,40%为1级,28%为2级,20%为3级。鳞状化生患者在HT组中占48%,而在对照组中为6.1%(p<0.001)。在构建的回归模型中,观察到肥胖(OR=7.500;p=0.017)和抗-TPO水平(OR=1.370,p=0.007)是鳞状化生的独立决定因素。

结论

HT患者结膜鳞状化生的发生率高于对照组,血清抗-TPO水平和肥胖被检测为结膜印迹细胞学恶化的独立预测因素。

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