横断面研究评估甲状腺自身抗体与甲状腺恶性肿瘤在孟加拉国三级护理医院的关系

Mitan Chakma, M. Barua, Kyaw Khin U, Mahmud Ullah Faruquee, Sayed Muhammad Alauddin Sharif, Shahin Ibn Rahman, Afjal Hossain, Aman Ullah
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摘要

甲状腺癌是最常见的内分泌恶性病变,其发病率持续上升。本研究的目的是评估甲状腺抗体和甲状腺恶性肿瘤之间的关系。本研究对2017年至2018年吉大港医学院附属附属医院耳鼻喉科收治的120名接受甲状腺切除术的甲状腺结节患者进行了横断面研究,这些患者术前甲状腺抗体(甲状腺球蛋白自身抗体(TgAb)和/或甲状腺过氧化物酶(TPOAb))水平均有记录。分析术前甲状腺抗体水平、细针穿刺细胞学(FNAC)结果、甲状腺手术类型和最终组织病理学之间的关系。研究人群的平均年龄为35.58岁(SD:±11.36)。根据120例患者的最终组织病理学诊断,80%为良性,20%为恶性。男性比女性更容易患甲状腺恶性肿瘤(33.3%比18.9%)。多结节多于孤立结节(55%比45%)。虽然单发组甲状腺恶性肿瘤的患病率高于多结节组(22.2%比18.2%),但差异无统计学意义。良性结节中以结节性甲状腺肿居多(88.5%),恶性结节中以甲状腺乳头状癌居多(80.3%)。FNA与组织病理学诊断有中度一致性(kappa为0.405)。与低TSH水平相比,高TSH水平患者与甲状腺恶性肿瘤有显著相关性。术前TgAb升高(≥40IU/mL)患者发生恶性病变的几率是TgAb正常患者的2.55倍。研究表明,TgAb水平升高可能是甲状腺恶性肿瘤的独立预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Cross Sectional Study to Assess the Association of Thyroid Autoantibodies with Thyroid Malignancies in a Tertiary Care Hospital in Bangladesh
Thyroid cancer is the most common endocrine malignant lesion and its incidence continues to rise. The aim of this study was to assess association between thyroid antibodies and thyroid malignancies. This was a cross sectional study of 120 patients with thyroid nodules undergoing thyroidectomy with recorded preoperative thyroid antibodies [autoantibodies to thyroglobulin (TgAb) and/or thyroid peroxidase (TPOAb)] levels from 2017 to 2018 admitted at the ENT Department of Chittagong Medical College Hospital, Chittagong. Analysis was done to assess the association between preoperative thyroid antibody levels, fine needle aspiration cytology (FNAC) results, type of thyroid surgery and final histopathology. Mean age of the study population was 35.58 years (SD:±11.36). According to the final histopathological diagnosis of the 120 patients 80% were benign and other 20% were malignant. Men are more likely to suffer from thyroid malignancy than women (33.3% versus 18.9%). Multinodules are predominant group than solitary nodule (55% versus 45%). Though the prevalence of thyroid malignancies is more in solitary group than multinodules group (22.2% versus 18.2%) the difference is not statistically significant. Among the benign nodules most of them (88.5%) were nodular goiter and among the malignancies most of them were (80.3%) were papillary thyroid carcinoma. There is moderate agreement between FNA and histopathological diagnosis (kappa is .405). The patients with high TSH level in comparison to low TSH level were significantly associated with thyroid malignancy. The patients with preoperative elevated TgAb (≥ 40IU/mL) has 2.55 times of more chance to have malignant lesion than the patients who has normal TgAb level. The study revealed that elevated level of TgAb may act as an independent prediction factor for thyroid malignancy.
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