甲状腺乳头状癌与微量元素相关性研究
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摘要
目的探讨甲状腺乳头状癌的发生、发展与微量元素的相关性。方法收集新疆医科大学第一附属医院2016年10月-2017年10月在甲状腺外科经病理诊断为甲状腺乳头状癌和结节性甲状腺肿的患者各200例,检测2组术前甲状腺功能、甲状腺自身抗体、尿碘、血硒、血铜和血锌水平并进行统计学分析。结果 2组血清TSH、TPOAb检测水平差异有统计学意义(P <0.001),TT3、TT4和TgAb检测水平差异无统计学意义(P>0.05)。甲状腺乳头状癌组术前尿碘、血铜水平高于结节性甲状腺肿组,血硒、血锌水平低于结节性甲状腺肿组,差异均有统计学意义(P均<0.05)。结论碘、硒、铜、锌微量元素水平可能与甲状腺乳头状癌的发生、发展相关,适宜的微量元素摄取可能对甲状腺癌的预防有一定作用。
Objective To study the relationship between the thyroid papillary carcinoma and trace elements.Methods Two hundred cases of thyroid papillary carcinoma and nodular goiter diagnosed by pathology in the First Affiliated Hospital of Xinjiang Medical University from October 2016 to October 2017 were collected respectively.The thyroid function and thyroid autoantibodies were detected in the two groups before operation.Urine iodine,serum selenium,serum copper and zinc levels were analyzed statistically.Results There were significant differences in serum TSH,TPOAb levels between the two groups(P <0.001),but no significant differences in TT3,TT4 and TgAb levels(P >0.05).The levels of urinary iodine and serum copper in the papillary thyroid carcinoma group were higher than those in the nodular goiter group,and the levels of serum selenium and zinc were lower than those in the nodular goiter group(P <0.05).Conclusion The thyroid papillary carcinoma is positively correlated with urinary iodine and serum copper,and negatively correlated with serum selenium and serum zinc.The proper uptake of trace elements may play a role in the prevention of thyroid cancer.
Objective To study the relationship between the thyroid papillary carcinoma and trace elements.Methods Two hundred cases of thyroid papillary carcinoma and nodular goiter diagnosed by pathology in the First Affiliated Hospital of Xinjiang Medical University from October 2016 to October 2017 were collected respectively.The thyroid function and thyroid autoantibodies were detected in the two groups before operation.Urine iodine,serum selenium,serum copper and zinc levels were analyzed statistically.Results There were significant differences in serum TSH,TPOAb levels between the two groups(P <0.001),but no significant differences in TT3,TT4 and TgAb levels(P >0.05).The levels of urinary iodine and serum copper in the papillary thyroid carcinoma group were higher than those in the nodular goiter group,and the levels of serum selenium and zinc were lower than those in the nodular goiter group(P <0.05).Conclusion The thyroid papillary carcinoma is positively correlated with urinary iodine and serum copper,and negatively correlated with serum selenium and serum zinc.The proper uptake of trace elements may play a role in the prevention of thyroid cancer.
引文
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[2]LI F,CHEN G,SHENG C,et al.BRAFV600E mutation in papillary thyroid microcarcinoma:a meta-analysis[J].Endoer Relat Cancer,2015,22(2):159-168.
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[6]刘树利.微量元素测定在肿瘤患者诊断及防治中的意义[J].检验医学与临床,2013,10(6):673-674.
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[11]刘诗川,谷云有.碘与硒对甲状腺功能影响的研究进展[J].中国地方病防治杂志,2012,27(6):431-432.
[12]赵义刚,勾正兴.碘摄入量与甲状腺疾病关系的研究[J].现代医药卫生,2010,26(21):3282-3284.
[13]陈先玲,王雯易,任青.碘摄入与甲状腺疾病的研究进展[J].医学理论与实践,2012,25(4):405-407.
[14]World Health Organization.Assessment of iodine deficiency disorders and monitoring their elimination:aguide for programme managers[R].Geneva:WHO,2007:32-34.
[15]张颖,李俞莹,姚旋,等.碘与甲状腺疾病[J].生命科学,2012,24(8):901-908.
[16]崔俊生,倪劲松,孔庆杨,等.食盐加碘前后甲状腺恶性肿瘤检出率及组织学类型分析[J].吉林大学学报(医学版),2008,34(6):1075-1078.
[17]HYE J K,HYEONG K P,DONG W B,et al.Iodine intake as a risk factor for BRAF mutations in papillary thyroid cancer patients from an iodine-replete area[J].Eur J Nutr,2016,24(5):76-83.
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[19]JONKLAAS J,DANIELSEN M,WANG H.A pilot study of serum selenium,vitamin D,and thyrotropin concentrations in patients with thyroid cancer[J].Thyroid,2013,23(9):1079-1086.
[20]KUCHARZEWSKI M,BRAZIEWICZ J,MAJEWSKA U,et al.Concentration of Selenium in the whole blood and the thyroid tissue of patients with various thyroid diseases[J].Biol Trace Elem Res,2002,88(1):25-30.
[21]LACKA K,SZELIGA A.Significance of selenium in thyroid physiology and pathology[J].Pol Merkur Lekarski,2015,38(288):348-353.
[22]DUNTAS L H.Selenium and the thyroid:a close-knit connection[J].J Clin Endocrinol Metab,2010,95(12):5180-5188.
[23]WU Q,RAYMAN M P,LV H,et al.Low population selenium status is associated with increased prevalence of thyroid disease[J].J Clin Endocrinol Metab,2015,100(11):4037-4047.
[24]KUCHARZEWSKI M,BRAZIEWICZ J,MAJEWSKA U,et al.Copper,zinc and selenium in whole blood and thyroid tissue of people with various thyroid diseases[J].Biol Trace Elem Res,2003,93(1-3):9-18.
[25]MCKINNIS J D,NGUYEN H.African american prostate cancer incidence rates inside and outside of zinc zones[J].Cancer Res,2014,74(5):263.
[26]HASHIMOTO A,KAMBE T.Mg,Zn and Cu transport proteins:a brief overview from physiological and molecular perspectives[J].J Nutr Sci Vitaminol,2015,61(Supplement):116-118.
[27]AO T,PIERCE J L,POWER R,et al.Effects of feeding different forms of zinc and copper on the performance and tissue mineral content of chicks[J].Poult Sci,2009,88(10):2171-2215.
[28]BALAY K S,HAWTHORNE K M,HICKS P D,et al.Low zinc status and absorption exist in infants with jejunostomies or ileostomies which persists after intestinal repair[J].Nutrients,2012,4(9):1273-1281.
[29]卢琦,连小兰.铜与甲状腺疾病的关系[J].医学综述,2015,21(6):986-988.
[2]LI F,CHEN G,SHENG C,et al.BRAFV600E mutation in papillary thyroid microcarcinoma:a meta-analysis[J].Endoer Relat Cancer,2015,22(2):159-168.
[3]AHN H S,KIM H J,WELCH H G.Korea’s thyroid-cancer epidemic-screening and over diagnosis[J].N Engl J Med,2014,371(19):1765-1767.
[4]HEGEDUS L.Clinical practice:the thyroid nodule[J].N Engl J Med,2004,351(17):1764-1771.
[5]李才淑,楼蔓藤,李增禧,等.血清微量元素含量与疾病相关性数据[J].广东微量元素科学,2012,19(11):25-56.
[6]刘树利.微量元素测定在肿瘤患者诊断及防治中的意义[J].检验医学与临床,2013,10(6):673-674.
[7]FIORE E,RAGO T,PROVENZALE M A,et al.L-thyroxinetreated patients with nodular goiter have lower serum TSH and lower frequency of papillary thyroid cancer:results of a crosssectional study on 27914patients[J].Endocr Relat Cancer,2010,17(1):231-239.
[8]ROGER P P,VAN STAVEREN W C,COULONVAL K,et al.Signal transduction in the human thyrocyte and its perversion in thyroid tumors[J].Mol Cell Endocrinol,2010,321(1):3-19.
[9]RABER W,KASERER K,NIEDERLE B,et al.Risk factors for malignancy of thyroid nodules initially identified as follicular neoplasia by fine-needle aspiration:results of a prospective study of one hundred twenty patients[J].Thyroid,2000,10(8):709-712.
[10]刘翔,高明.促甲状腺素抗氧化传导通路与甲状腺乳头状癌侵袭力的关系[J].中华耳鼻咽喉头颈外科杂志,2009,44(4):287-291.
[11]刘诗川,谷云有.碘与硒对甲状腺功能影响的研究进展[J].中国地方病防治杂志,2012,27(6):431-432.
[12]赵义刚,勾正兴.碘摄入量与甲状腺疾病关系的研究[J].现代医药卫生,2010,26(21):3282-3284.
[13]陈先玲,王雯易,任青.碘摄入与甲状腺疾病的研究进展[J].医学理论与实践,2012,25(4):405-407.
[14]World Health Organization.Assessment of iodine deficiency disorders and monitoring their elimination:aguide for programme managers[R].Geneva:WHO,2007:32-34.
[15]张颖,李俞莹,姚旋,等.碘与甲状腺疾病[J].生命科学,2012,24(8):901-908.
[16]崔俊生,倪劲松,孔庆杨,等.食盐加碘前后甲状腺恶性肿瘤检出率及组织学类型分析[J].吉林大学学报(医学版),2008,34(6):1075-1078.
[17]HYE J K,HYEONG K P,DONG W B,et al.Iodine intake as a risk factor for BRAF mutations in papillary thyroid cancer patients from an iodine-replete area[J].Eur J Nutr,2016,24(5):76-83.
[18]RAYMAN M P.Selenium in cancer prevention:a review of the evidence and mechanism of action[J].Proc Nutr Soc,2005,64(4):527-542.
[19]JONKLAAS J,DANIELSEN M,WANG H.A pilot study of serum selenium,vitamin D,and thyrotropin concentrations in patients with thyroid cancer[J].Thyroid,2013,23(9):1079-1086.
[20]KUCHARZEWSKI M,BRAZIEWICZ J,MAJEWSKA U,et al.Concentration of Selenium in the whole blood and the thyroid tissue of patients with various thyroid diseases[J].Biol Trace Elem Res,2002,88(1):25-30.
[21]LACKA K,SZELIGA A.Significance of selenium in thyroid physiology and pathology[J].Pol Merkur Lekarski,2015,38(288):348-353.
[22]DUNTAS L H.Selenium and the thyroid:a close-knit connection[J].J Clin Endocrinol Metab,2010,95(12):5180-5188.
[23]WU Q,RAYMAN M P,LV H,et al.Low population selenium status is associated with increased prevalence of thyroid disease[J].J Clin Endocrinol Metab,2015,100(11):4037-4047.
[24]KUCHARZEWSKI M,BRAZIEWICZ J,MAJEWSKA U,et al.Copper,zinc and selenium in whole blood and thyroid tissue of people with various thyroid diseases[J].Biol Trace Elem Res,2003,93(1-3):9-18.
[25]MCKINNIS J D,NGUYEN H.African american prostate cancer incidence rates inside and outside of zinc zones[J].Cancer Res,2014,74(5):263.
[26]HASHIMOTO A,KAMBE T.Mg,Zn and Cu transport proteins:a brief overview from physiological and molecular perspectives[J].J Nutr Sci Vitaminol,2015,61(Supplement):116-118.
[27]AO T,PIERCE J L,POWER R,et al.Effects of feeding different forms of zinc and copper on the performance and tissue mineral content of chicks[J].Poult Sci,2009,88(10):2171-2215.
[28]BALAY K S,HAWTHORNE K M,HICKS P D,et al.Low zinc status and absorption exist in infants with jejunostomies or ileostomies which persists after intestinal repair[J].Nutrients,2012,4(9):1273-1281.
[29]卢琦,连小兰.铜与甲状腺疾病的关系[J].医学综述,2015,21(6):986-988.