乳腺癌患者甲状腺功能的相关研究

目的：探讨乳腺癌患者的甲状腺功能情况及与发病间的关系，乳腺癌患者自身免疫与非自身免疫甲状腺疾病的发病情况。方法：收集2008年1月至2013年1月我院诊治的乳腺癌病例100例、乳腺良性疾病患者100例，正常对照病例100例。以放射免疫检测法测血清 FT3、FT4、TSH、TG －Ab、TPO －Ab 水平；通过临床检查、B 型超声、甲状腺素及抗体水平检查、细针穿刺活组织检查等对比甲状腺疾病的发病情况，并分析与乳腺癌的关系。结果：乳腺癌组患者血清 FT4水平（16．56±0．45）pmol／L 和 TPO －Ab 水平（51．44±22．59） U ／ml 虽均在正常范围，但其 FT4水平显著低于乳腺良性疾病组和正常对照组（P ＝0．023，P ＝0．017），其 TPO－Ab 水平高于乳腺良性疾病组和正常对照组（P ＝0．013，P ＝0．002）。乳腺癌组非自身免疫与自身免疫甲状腺疾病的发病率高于对照组36％（36／100）vs 12％（12／100），P ＝0．004；22％（22／100）vs 14％（14／100）， P ＝0．001]，乳腺良性疾病组与对照组相近。乳腺癌 FT4降低与乳腺癌的肿块大小、肿瘤分期、淋巴结转移有关联（P ＜0．05）。与年龄、病理类型、ER、PR 表达无关联（P ＞0．05）；乳腺癌 TPO －Ab 高表达与乳腺癌的肿块大小、肿瘤分期、淋巴结转移、ER、PR 表达有关联（P ＜0．05），与年龄、病理类型无关联（P ＞0．05）。追踪条件匹配的40例乳腺癌放化疗及内分泌治疗，发现与放射肿瘤及内分泌治疗有关联（P ＜0．05）。结论：甲状腺功能变化和乳腺癌的发生发展有一定联系。甲状腺激素和自身抗体水平有助于临床监测和预后判断，乳腺癌患者的非自身免疫与自身免疫甲状腺疾病的发病率高于非乳腺癌者。乳腺癌患者 FT4水平降低及 TPO －Ab 高表达可反映乳腺癌的严重程度。

Clinical studies of thyroid function in breast cancer patients

Objective:To investigate the relation of thyroid function in patients with breast cancer.Methods:We selected 100 breast cancer cases,100 cases of benign breast disease,and normal control patients 100 cases.RIA was used to measure serum FT3,FT4,TSH,TG -Ab,TPO -Ab levels;B -mode ultrasound,thyroid hormone and antibody levels were tested,fine -needle aspiration biopsy of thyroid disease was performed.Results:Serum FT4 levels in pa-tients with breast cancer group(16.56 ±0.45)pmol/L and TPO -Ab levels(51.44 ±22.59)U /ml,although in the normal range,but its FT4 levels were significantly lower than that of benign breast disease and normal control group(P=0.023,P =0.017),higher than its TPO -Ab benign breast disease group and the control group (P =0.013,P=0.002).Breast cancer patients with non -autoimmune pathogenesis of autoimmune thyroid disease was higher than the control group36%(36 /100)vs 12%(12 /100),P =0.004;22%(22 /100)vs 14%(14 /100),P =0.001].Re-duced FT4 was related with breast cancer tumor size,tumor stage,lymph node metastasis associated(P <0.05),not associated with age,histological type,ER,PR expression(P >0.05).Breast TPO -Ab high expression were related and breast cancer tumor size,tumor stage,lymph node metastasis,ER,PR expression(P <0.05),no association with age,pathological type(P >0.05).Conclusion:Thyroid function is related with the development of breast cancer.Re-ducing FT4 and TPO -Ab high levels expression may reflect the severity of breast cancer.