142例女性乳腺癌患者临床特征与甲状腺激素水平的关联分析

doi:10.6040/j.issn.1671-7554.0.2020.112

摘要/Abstract

摘要： 目的探讨女性乳腺癌临床特征与甲状腺激素水平的关系。方法收集142例女性乳腺癌患者的临床资料,包括基本特征、肿瘤特征、甲状腺功能等,将患者按照年龄、月经状态、肿瘤大小、转移程度、TNM分期、病理分级、雌激素受体、糖尿病患病情况、手术和化疗情况、肿瘤标志物水平分组,对患者甲状腺激素水平在不同临床特征分组间的差异进行统计学分析。结果 (1)游离三碘甲状腺原氨酸(FT3)水平在无转移组、局部淋巴结转移组及远处转移组间差异有统计学意义(F=11.565,P<0.001),其中远处转移组高于无转移组［(5.10±0.51)vs(4.67±0.45)pmol/L, P<0.001］和局部淋巴结转移组［(5.10±0.51)vs(4.58±0.49)pmol/L,P<0.001］;游离甲状腺素(FT4)水平在无转移组、局部淋巴结转移组及远处转移组间差异有统计学意义(F=5.730,P<0.05),其中无转移组高于局部淋巴结转移组［(16.77±2.59)vs (15.26±2.15)pmol/L, P=0.001］和远处转移组［(16.77±2.59)vs(15.75±2.08)pmol/L, P=0.053］。以年龄、月经状态、雌激素受体、糖尿病患病、手术与化疗情况等作为协变量,分析142例女性乳腺癌患者转移程度与甲状腺激素水平的关系,发现FT3水平在无转移组、局部淋巴结转移组及远处转移组间差异有统计学意义(F=6.810,P<0.05),其中远处转移组FT3水平高于局部淋巴结转移组［(5.10±0.12)vs(4.58±0.07)pmol/L, P<0.001］和无转移组［(5.10±0.12)vs(4.67±0.06)pmol/L, P<0.001］,局部淋巴结转移组FT3水平低于无转移组［(4.58±0.07) vs(4.67±0.06)pmol/L, P<0.001］;FT4水平在无转移组、局部淋巴结转移组及远处转移组差异有统计学意义(F=3.855, P<0.05),其中局部淋巴结转移组FT4水平低于无转移组［(15.25±0.37)vs(16.52±0.32)pmol/L, P<0.001］和远处转移组［(15.25±0.37) vs(16.34±0.60)pmol/L,P<0.001］;(2)已手术治疗患者FT3水平高于未手术患者［(4.86±0.59)vs(4.66±0.44)pmol/L, t=2.354,P<0.05］;(3)已化疗患者FT3水平高于未化疗患者［(4.95±0.50)vs(4.62±0.48)pmol/L, t=3.862,P<0.001］;已接受化疗患者其FT4水平低于未化疗患者［(15.38±2.02)vs(16.49±2.57)pmol/L, t=-2.593, P<0.05］。结论甲状腺激素与乳腺癌的转移有关,手术与化疗均可能影响甲状腺激素水平。

关键词: 甲状腺激素, 乳腺癌, 转移, 三碘甲腺原氨酸, 化疗

Abstract: Objective To explore the relationship between clinical characteristics of female breast cancer and thyroid hormonal levels. Methods The clinical data of 142 female breast cancer patients were collected, including basic characteristics, tumor characteristics, thyroid function, and so on. The patients were classified into different groups according to age, menstrual status, tumor size, degree of metastasis, TNM stage, pathological grade, estrogen receptor, diabetes, surgery, chemotherapy and tumor markers. The differences in thyroid hormonal levels were statistically analyzed among the groups. Results (1) There was statistically significant difference in free triiodothyronine(FT3)level among the non-metastasis group, local lymph node metastasis group and distant metastasis group(F=11.565, P<0.001). The distant metastasis group had higher FT3 level than non-metastasis group ［(5.10±0.51)vs(4.67±0.45)pmol/L, P<0.001］ and local lymph node metastasis group ［(5.10±0.51)vs(4.58±0.49)pmol/L, P<0.001］. There was statistically significant difference in free thyroxine(FT4)level among the three groups(F=5.730, P<0.05). The non-metastasis group had higher FT4 level than local lymph node metastasis group ［(16.77±2.59)vs(15.26±2.15)pmol/L, P=0.001］ and distant metastasis group ［(16.77±2.59)vs(15.75±2.08)pmol/L, P=0.053］. When age, menstrual status, estrogen receptor, diabetes, surgery and chemotherapy were taken as covariates, there was significant difference in FT3 level among the three groups(F=6.810, P<0.05). The distant metastasis group had higher FT3 level than local lymph node metastasis group ［(5.10±0.12)vs(4.58±0.07)pmol/L, P<0.001］ and non-metastasis group ［(5.10±0.12)vs(4.67±0.06)pmol/L, P<0.001］, and local lymph node metastasis group had lower FT3 level than non-metastasis group ［(4.58±0.07)vs(4.67±0.06)pmol/L, P<0.001］. The was significant difference in FT4 level among the three groups(F=3.855, P<0.05). The local lymph node metastasis group had lower FT4 level than non-metastasis group ［(15.25±0.37)vs(16.52±0.32)pmol/L, P<0.001］ and distant metastasis group ［(15.25±0.37)vs )16.34±0.60)pmol/L, P<0.001］. (2) The surgical group had higher FT3 level than non-surgical group ［(4.86±0.59)vs(4.66±0.44)pmol/L, t=2.354, P<0.05］. (3) The chemotherapy group had higher FT3 level than non-chemotherapy group ［(4.95±0.50)vs(4.62±0.48)pmol/L, t=3.862, P<0.001］, but lower FT4 level ［(15.38±2.02)vs(16.49±2.57)pmol/L, t=-2.593, P<0.05］. Conclusion Thyroid hormones are associated with the metastasis of breast cancer. Both surgery and chemotherapy may affect the levels of thyroid hormones.

Key words: Thyroid hormones, Breast cancer, Metastasis, Triiodothyronine, Chemotherapy

中图分类号:

R574

郭田,付依林,高聆,宋勇峰,付国斌,耿冲,王潍博. 142例女性乳腺癌患者临床特征与甲状腺激素水平的关联分析[J]. 山东大学学报 (医学版), 2020, 58(6): 53-59.

GUO Tian, FU Yilin, GAO Ling, SONG Yongfeng, FU Guobin, GENG Chong, WANG Weibo. Correlation between thyroid hormonal levels and clinical characteristics of 142 women with breast cancer[J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 53-59.

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