血清甲状腺过氧化物酶抗体对合并桥本甲状腺炎甲状腺微小癌淋巴结转移影响

目的:探讨合并桥本甲状腺炎的甲状腺微小乳头状癌淋巴结转移的特点,分析血清甲状腺过氧化物酶抗体(Thyroid peroxidase-antibody,TPO-Ab)滴度对该组病例淋巴结转移的影响。方法:回顾性分析武汉同济医院甲状腺乳腺外科2012年1月至2014年5月收治的甲状腺微小癌伴桥本甲状腺炎的病例,运用卡方检验、阈值效应分析、多因素logistic回归方法分析该组病例血清TPO-Ab滴度对淋巴结转移的影响。结果:共收集75例合并桥本甲状腺炎的微小乳头状癌病例,血清TPO-Ab滴度与淋巴结转移相关:抗体滴度对淋巴结转移的影响存在分段特征,有阈值效应,该组病例以212 IU/m L为阈值;多因素logistic回归显示,随着血清TPO-Ab水平升高,淋巴结转移率下降(OR=0.993,95%CL=0.987,0.999,P=0.018)。结论:合并桥本甲状腺炎的甲状腺微小乳头状癌病例,血清TPO-Ab滴度对淋巴结转移的影响可能存在阈值效应,值得深入分析;且高血清TPO-Ab滴度可能是淋巴结转移的保护因素,但两者的相互关系尚需进一步探讨。

Effect of SerumTPO-Ab on Lymph Node Metastasis in Papillary ThyroidMicrocarcinoma Combined with Hashimoto's Thyroiditis Patients

Objective:To investigate the effect of serumThyroid peroxidase-antibody (TPO-Ab) on cervical lymph node metastasis(CLNM) in papillary thyroid microcarcinoma (PTMC) combined with Hashimoto''s Thyroiditis (HT).Methods:A retrospective analysiswas performed with patients who were diagnosed as papillary thyroid microcarcinoma combined with Hashimoto''s thyroiditis from January2012 to May 2014 in Wuhan Tongji Hospital. Chi-square test, threshold effect, multivariate Logistic Regression analysis was performedwith serum TPO-Ab titer and CLNM. Results:75 cases were collected in our analysis. The preoperative serum TPO-Ab titer wasassociated with CLNM. Logistic Regression analysis revealed that high TPO-Ab titer corelated with low CLNM rate in these cases(OR=0.993, 95%CL=0.987,0.999, P=0.018).Conclusion:The corelation between serum TPO-Ab and CLNMin PTMC combined withHT may have threshold effect, and high titer may lead to low CLNMrate. But the detail study need to undertake in the future.