Research Institute of Clinical Medicine, Jeonbuk National University and Biomedical Research Institute, Korea.
Ann R Coll Surg Engl. 2021 May;103(5):367-373. doi: 10.1308/rcsann.2020.7064. Epub 2021 Mar 8.
It has been established that thyroid-stimulating hormone (TSH) stimulates the growth and development of thyroid malignancy, and a higher serum TSH level is associated with the incidence of thyroid cancer and an advanced tumour stage. This study aimed to evaluate the association of preoperative subclinical hypothyroidism with the prognosis of papillary thyroid cancer (PTC).
A total of 466 patients who underwent surgery for PTC between December 2006 and June 2009 were enrolled. Among them, 44 patients had subclinical hypothyroidism, while 422 did not have subclinical hypothyroidism, as diagnosed using the preoperative thyroid function test. We compared the recurrence rate and association with clinicopathological features in the two groups.
The median patient age was 46.9 years (17-74 years). There were 420 female and 46 male patients. The median follow-up duration was 81.4 months. There were no statistical differences between the two groups with respect to age, sex, tumour size, extrathyroidal extension, multifocality, lymph node metastasis, TNM stages, recurrence and disease-free survival, despite a significant difference in the average TSH concentrations of the two groups.
Our results suggest that preoperative subclinical hypothyroidism was not associated with tumour aggressiveness and recurrence in PTC.
已证实促甲状腺激素（TSH）可刺激甲状腺恶性肿瘤的生长和发展，较高的血清 TSH 水平与甲状腺癌的发病率和肿瘤晚期有关。本研究旨在评估术前亚临床甲状腺功能减退症与甲状腺癌（PTC）患者预后的关系。
本研究共纳入了 2006 年 12 月至 2009 年 6 月期间因 PTC 接受手术治疗的 466 例患者。其中，44 例患者患有亚临床甲状腺功能减退症，422 例患者无亚临床甲状腺功能减退症，这是通过术前甲状腺功能检查诊断出来的。我们比较了两组患者的复发率及与临床病理特征的相关性。
患者的中位年龄为 46.9 岁（17-74 岁）。其中女性 420 例，男性 46 例。中位随访时间为 81.4 个月。两组患者在年龄、性别、肿瘤大小、甲状腺外侵犯、多灶性、淋巴结转移、TNM 分期、复发和无病生存方面均无统计学差异，尽管两组的平均 TSH 浓度存在显著差异。
我们的结果表明，术前亚临床甲状腺功能减退症与 PTC 的肿瘤侵袭性和复发无关。
