Association of Hashimoto's thyroiditis with thyroid cancer.
Association of Hashimoto's thyroiditis with thyroid cancer.
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DOI：
10.1530/erc-14-0258
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发表时间：
2014
影响因子：
3.9
通讯作者：
Malchoff CD
中科院分区：
文献类型：
--
作者：
Azizi G;Keller JM;Lewis M;Piper K;Puett D;Rivenbark KM;Malchoff CD
本前瞻性研究旨在探讨桥本甲状腺炎(HT)与甲状腺结节(TNS)患者甲状腺癌(TC)的关系。我们前瞻性地检查了2010年1月5日至2013年8月15日期间的2100名患者的2753个TNS。共有2023例患者2669个TNS符合TN≥5 mm和年龄≥18岁的纳入标准。每例患者在细针吸取活检(FNAB)前抽血进行以下检测：TSH、游离甲状腺素、游离三碘甲腺原氨酸、甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TgAb)。甲状腺癌的诊断依据是甲状腺切除组织的病理分析。通过单因素和多因素Logistic回归分析确定TC与独立变量的相关性，并报告为调整后的优势比(OR)，其可信区间为95%。233例患者共发现恶性结节248个。TC与血清TgAb浓度升高和年龄及45岁有关。良性结节组血清TgAb值为10.2%(182/1790)，恶性结节组为20.6%(48/233，P≤0.0001)。在控制年龄和性别的多因素分析中，TgAb(OR=2.2 4：CI=1.5 7、3.19)和促甲状腺激素≥1 μIU/ml(OR(95%CI))、OR：1.49(1.0 9、2.0 3)是TC的显著预测因素。血清总胆固醇与血清TPOAb浓度无相关性。在TN患者中，血清TgAb和促甲状腺激素≥1 μIU/ml升高是TC的独立预测因素。HT和TC之间的联系是抗体特异性的。
This prospective study investigates the relationship between Hashimoto's thyroiditis (HT) and thyroid cancer (TC) in patients with thyroid nodules (TNs). We prospectively examined 2100 patients with 2753 TNs between January 5, 2010 and August 15, 2013. A total of 2023 patients with 2669 TNs met the inclusion criteria of TN ≥5 mm and age ≥18 years. Each patient had blood drawn before fine-needle aspiration biopsy (FNAB) for the following measurements: TSH, free thyroxine, free tri-iodothyronine, thyroid peroxidase antibody (TPOAb), and antithyroglobulin antibody (TgAb). Diagnosis of TC was based on pathology analysis of thyroidectomy tissue. The associations of TC with the independent variables were determined by univariate and multivariate logistic regression analysis and reported as adjusted odds ratio (OR) with 95% CI. A total of 248 malignant nodules were found in 233 patients. There was an association of TC with both increased serum TgAb concentration and age<45 years. An elevated serum TgAb concentration was found in 10.2% of patients (182 of 1790) with benign nodules as compared with 20.6% of patients (48 of 233) with malignant nodules (P≤0.0001). TgAb (OR=2.24: CI=1.57, 3.19) and TSH ≥1 μIU/ml (OR (95% CI)) OR: 1.49 (1.09, 2.03) were significant predictors of TC in multivariate analysis controlling for age and gender. TC was not associated with serum concentrations of TPOAb. In patients with TN, elevated serum concentration of TgAb and TSH ≥1 μIU/ml are independent predictors for TC. The association between HT and TC is antibody specific.