Serum Calcium and Risk of Nonmedullary Thyroid Cancer in Patients with Primary Hyperparathyroidism.
Serum Calcium and Risk of Nonmedullary Thyroid Cancer in Patients with Primary Hyperparathyroidism.
复制标题
原发性甲状旁腺功能亢进症患者的血清钙和非髓样甲状腺癌的风险
DOI：
10.12659/msm.898138
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发表时间：
2016-11-21
期刊：
影响因子：
--
通讯作者：
Zhang KQ
中科院分区：
文献类型：
--
作者：
Xue Y;Ye ZQ;Zhou HW;Shi BM;Yi XH;Zhang KQ
背景 甲状腺非髓样癌（NMTC）合并原发性甲状旁腺功能亢进症（PHPT）的临床病例偶尔有报道。然而，PHPT 患者并发 NMTC 的临床特征和危险因素仍不清楚。本研究旨在评估PHPT与NMTC之间的关联，并评估中国PHPT患者NMTC的临床特征和危险因素。材料/方法这是一项回顾性队列分析。我们回顾了2009年至2014年间在中国两个大型医疗中心接受手术的155例PHPT患者的病历，分析了PHPT患者的临床表现、生化异常和组织学特征。结果 155 例 PHPT 患者中，58 例（37.4%）有甲状腺结节，12 例（7.7%）合并 NMTC。与良性甲状腺结节的 PHPT 患者相比，患有 NMTC 的 PHPT 患者术前血清钙水平显着降低（p<0.05）。在 PHPT 患者中发现术前血清钙水平与 NMTC 存在显着负相关（p<0.05）。此外，ROC分析显示，白蛋白校正血清钙水平<2.67 mmol/L能够很好地区分患有NMTC的PHPT患者与良性甲状腺结节患者。结论 与一般人群甲状腺癌患病率低得多的报道相比，我们的研究结果表明 PHPT 可能是甲状腺结节恶性的危险因素；血清钙水平较低可能预示着患有甲状腺结节的 PHPT 患者存在 NMTC。
Background Clinical cases of nonmedullary thyroid carcinoma (NMTC) in combination with primary hyperparathyroidism (PHPT) have been reported occasionally. However, the clinical characteristics and risk factors of concomitant NMTC in PHPT patients remain unclear. This study aimed to assess the association between PHPT and NMTC, and evaluate the clinical characteristics and risk factors of NMTC in Chinese patients with PHPT. Material/Methods This was a retrospective cohort analysis. We reviewed the medical records of 155 patients who underwent surgery for PHPT in two large medical centers in China between 2009 and 2014. The clinical manifestations, biochemical abnormalities, and histological characteristics of PHPT patients were analyzed. Results Of the 155 patients with PHPT, 58 patients (37.4%) had thyroid nodules and 12 patients (7.7%) were ill with concomitant NMTC. PHPT patients with NMTC demonstrated significantly lower preoperative serum calcium levels compared to PHPT patients with benign thyroid nodules (p<0.05). A significantly negative association between preoperative serum calcium levels and the presence of NMTC was found in PHPT patients (p<0.05). Furthermore, ROC analysis revealed that albumin-corrected serum calcium levels <2.67 mmol/L had good capacity to differentiate the PHPT patients with NMTC from those with benign thyroid nodules. Conclusions Compared with the reported much lower prevalence of thyroid carcinoma in the general population, our results suggest that PHPT might be a risk factor for the malignancy of thyroid nodules; a lower level of serum calcium may predict the existence of NMTC in PHPT patients with thyroid nodules.
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