摘要
目的调查乌鲁木齐甲状腺癌的相关危险因素。方法选取2014年3—12月于新疆医科大学第一附属医院血管甲状腺外科进行手术并经病理确诊的甲状腺癌患者156例(甲癌组)和良性甲状腺结节患者158例(良性组)。选择同期在新疆医科大学第二附属医院体检并经B超判断甲状腺形态正常的健康成年人301例(正常组)。采用统一自行编制的调查问卷对调查对象进行问卷调查,包括:一般情况、生活方式及环境、射线暴露史、疾病及家族史、心理因素、甲状腺功能及甲状腺自身抗体检测、女性月经史、女性用药史、妇科手术史。甲状腺癌影响因素分析采用多因素Logistic回归分析。结果 3组性别构成、年龄、化妆品使用率、染发剂使用率、X线检查率、颅脑颈部CT平扫率及血清促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)水平比较,差异均有统计学意义(P<0.05)。甲癌组血清TSH、TGAb水平高于良性组与正常组(P<0.05);甲癌组血清TPOAb水平高于正常组(P<0.05);良性组血清TGAb水平低于正常组,TPOAb水平高于正常组(P<0.05)。3组女性初潮年龄、避孕药服用率、子宫切除术发生率比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,女性、颅脑颈部CT平扫、血清TGAb水平升高为甲状腺癌的危险因素(P<0.05);子宫切除术为女性甲状腺癌的危险因素〔χ2=9.241,P<0.05,OR(95%CI)=7.139(2.010,25.350)〕。结论女性、颅脑颈部CT平扫、血清TGAb水平升高为乌鲁木齐甲状腺癌的危险因素,且子宫切除术为乌鲁木齐女性甲状腺癌的危险因素,为今后进一步研究提供了参考依据。
Objective To investigate the related risk factors of thyroid cancer in Urumqi. Methods The study enrolled 156 thyroid cancer patients（thyroid cancer group）and 158 patients with benign thyroid nodules（benign group）who underwent surgery and were definitely diagnosed as thyroid cancer by pathology in the First Affiliated Hospital of Xinjiang Medical University from March to December 2014. Meanwhile,the study also enrolled 301 healthy adults（normal group）who received physical examination and were determined with normal thyroid gland by B ultrasound in the Second Affiliated Hospital of Xinjiang Medical University. A self - designed questionnaire survey was conducted on the subjects,concerning general information,mode of life and environment,history of ray exposure,history of diseases and family history of diseases,psychological factor,thyroid function,detection of thyroid autoantibodies, history of menstruation of female subjects, history of medication of female subjects,and history of gynecological operation. Multivariate Logistic regression analysis was used to investigate the influencing factors for thyroid cancer. Results The three groups were significantly different in gender composition,age,the usage rate of cosmetics,the usage rate of hair dye,the rate of X - ray examination,the rate of head and neck CT scan,and the serum levels of TSH,TGAb and TPOAb（P 〈 0. 05）. Thyroid cancer group was higher than benign group and normal group in the serum levels of TSH and TGAb（P 〈 0. 05）;thyroid cancer group was higher than normal group in the serum level of TPOAb（ P 〈0. 05）;benign group was lower in the serum level of TGAb and was higher in the serum level of TPOAb than normal group（P 〈0. 05）. The three groups were significantly different in the age of menophania,the using rate of contraceptive,and the incidence rate of hysterectomy（P 〈 0. 05）. Multivariate Logistic regression analysis showed that females,head and neck CT scan,and increase in the serum level of TGAb were risk factors for thyroid cancer（ P 〈 0. 05）,and hysterectomy was a risk factor for thyroid cancer in females〔 χ^2 = 9. 241,P 〈 0. 05,OR（ 95% CI） = 7. 139（ 2. 010,25. 350 ）〕 . Conclusion Being females,head and neck CT scan and increase in the serum level of TGAb are risk factors for thyroid cancer in Urumqi,and hysterectomy is a risk factor for thyroid cancer in females in Urumqi,which provide references for further study.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第12期1446-1450,共5页
Chinese General Practice
基金
新疆维吾尔自治区自然科学基金资助项目(2013211A057)
