全甲状腺切除术治疗原发性甲亢合并甲状腺癌对患者预后的影响
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摘要
目的探讨甲全切除治疗原发性甲亢合并甲状腺癌对患者预后的影响。方法 184例原发性甲亢合并甲状腺癌患者根据治疗方法的不同分为观察组与对照组各92例,对照组给予甲状腺次全切除术治疗,观察组给予全甲状腺切除术治疗,测定术前及术后14 d血清甲状腺素及相关标志物含量,随访1年记录两组疗效、心脏功能和肝功能变化情况。结果观察组与对照组术后的血清TT3与TT4值,心脏功能指标,LVEF、LVESV、LVEDV,治疗效果标志物STAT3、IL-27、VEGF-C、Galectin-3值低于术前1 d(P <0.05),术后14 d观察组的血清TT3、TT4,心脏功能指标,肝损伤率、STAT3、IL-27与对照组对比差异有统计学意义(P <0.05)。术后3个月观察组的并发症发生率为6.5%,对照组为4.3%,两组对比差异无统计学意义(P> 0.05)。结论相对于次全切除术,全甲状腺切除术治疗治疗原发性甲亢合并甲状腺癌具有很好的效果。
Objective To investigate the prognosis effects of total thyroidectomy in the treatment of primary hyperthyroidism combined with thyroid carcinoma. Methods 184 cases of patients with primary hyperthyroidism combined with thyroid cancer were randomly divided into observation group and control group. Eachgroup had92 cases. The control group were given subtotal thyroidectomy,and the observation group were given total thyroid resection.Serum thyroxine and related markers were measured before and 14 days after operation. Effects,changes in heart function and liver function in the two groups were recorded in the 1-year follow-up. Results The values of TT3 and TT4 in serum,LVEF,LVESV,LVEDV,therapeutic markers STAT3,IL-27,VEGF-C,and Galectin-3 in the observation group and the control group after operation were lower than 1 day before operation(P < 0.05).The values of TT3,TT4,cardiac function index,Liver injury rate,STAT3,and IL-27 in the observation group after operation were also significantly different from those in the control group(P < 0.05). The complication rate in the observation group 3 months after the operation were 6.5% while the control group 4.3%,and the difference has no statistical significantly(P > 0.05). Conclusion Compares with subtotal thyroidectomy,the total thyroidectomy in the treatment of primary hyperthyroidism combined with thyroid carcinoma has better effects.
Objective To investigate the prognosis effects of total thyroidectomy in the treatment of primary hyperthyroidism combined with thyroid carcinoma. Methods 184 cases of patients with primary hyperthyroidism combined with thyroid cancer were randomly divided into observation group and control group. Eachgroup had92 cases. The control group were given subtotal thyroidectomy,and the observation group were given total thyroid resection.Serum thyroxine and related markers were measured before and 14 days after operation. Effects,changes in heart function and liver function in the two groups were recorded in the 1-year follow-up. Results The values of TT3 and TT4 in serum,LVEF,LVESV,LVEDV,therapeutic markers STAT3,IL-27,VEGF-C,and Galectin-3 in the observation group and the control group after operation were lower than 1 day before operation(P < 0.05).The values of TT3,TT4,cardiac function index,Liver injury rate,STAT3,and IL-27 in the observation group after operation were also significantly different from those in the control group(P < 0.05). The complication rate in the observation group 3 months after the operation were 6.5% while the control group 4.3%,and the difference has no statistical significantly(P > 0.05). Conclusion Compares with subtotal thyroidectomy,the total thyroidectomy in the treatment of primary hyperthyroidism combined with thyroid carcinoma has better effects.
引文
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[19]张素芳,薛恩生,叶琴,等.TI-RADS联合细胞学Galectin-3、HBME-1检测对甲状腺良恶性结节的诊断价值[J].中国超声医学杂志,2018,v.34;No.331(5):17-20.
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[3]CHARAZKA B,SULIGOWSKA A,KOMOROWSKI J,et al.Quality of life in patients with orbitopathy-single center experience[J].Pol Merkur Lekarski,2018,44(264):272-275.
[4]SEIDEL D U,SCHULLER L,KOSTEV K,et al.Diagnoses of thyroid disorders in ENT and general practices in Germany between 2008 and 2016[J].Hno,2018,66(12):922-928.
[5]朱国献,王祖辉,朱小兵,等.结节性甲状腺肿并存甲状腺癌118例的诊断与治疗[J].中华普通外科学文献(电子版),2015,(3):227-229.
[6]EBERST G,LAKHZOUM W,TOMASINI P,et al.Autoimmune-related bleeding occurring during combined immunotherapy for lung cancer-Case report[J].Rev Mal Respir,2018,35(9):974-977.
[7]李红光,赵利红,张振华,等.黏蛋白1基因调控酪氨酸蛋白激酶/信号转导与转录激活因子3信号通路抑制甲状腺癌细胞增殖及促进细胞凋亡机制[J].中华实验外科杂志,2017,34(11):1889.
[8]GRAMATICA L,CECENARRO R R,ANTUENO F J,et al.Primary hyperthyroidism minimally invasive video-assisted parathyroidectomy][J].Rev Fac Cien Med Univ Nac Cordoba,2017,74(4):361-364.
[9]丁斌.全腔镜甲状腺次全切除术对早期分化型甲状腺癌患者术中切口长度及术后血清Tg、VEGF水平变化的影响[J].实用医学杂志,2017,33(21):3581-3584.
[10]INOUE K,LEUNG A M,SUGIYAMA T,et al.Urinary iodine concentration and mortality among U.S.adults[J].Thyroid,2018,28(7):913-920.
[11]JAESCHKE H,UNDEUTSCH H,PATYRE K,et al.Hyperthyroidism and papillary thyroid carcinoma in thyrotropin receptor D633h mutant mice[J].Thyroid,2018,28(10):1372-1386.
[12]不同手术术式对甲状腺切除术患者血清甲状腺激素水平的影响[J].海南医学院学报,2016,22(18):2209-2212.
[13]KIM K J,HA S,LEE Y H,et al.The status and distinct characteristics of endocrine diseases in north korean articles published between 2006 and 2015[J].Endocrinol Metab(Seoul),2018,33(2):268-272.
[14]KIMBARA S,FUJIWARA Y,IWAMA S,et al.Association of antithyroglobulin antibodies with the development of thyroid dysfunction induced by nivolumab[J].Cancer Sci,2018,109(11):3583-3590.
[15]王茹.3项指标检测在甲状腺疾病诊断中的临床价值[J].检验医学与临床,2018,15(9):1268-1270.
[16]卢亚敏,霍丽静,张明明,等.血清抵抗素、白细胞介素-6在甲状腺功能亢进症及甲亢性肝损害患者治疗前后的变化及其意义[J].临床内科杂志,2016,33(11):776-777.
[17]尚培中,张进权,柳勇,等.VEGF和Gal-3表达与甲状腺乳头状癌浸润转移的关系[J].中国现代普通外科进展,2017,20(6):488-489.
[18]武现生,唐云,陈志达,等.VEGF和p53蛋白在甲状腺肿瘤中的表达及在诊断甲状腺良、恶性肿瘤中的应用价值研究[J].癌症进展,2017,15(04):91-94.
[19]张素芳,薛恩生,叶琴,等.TI-RADS联合细胞学Galectin-3、HBME-1检测对甲状腺良恶性结节的诊断价值[J].中国超声医学杂志,2018,v.34;No.331(5):17-20.
[20]SHAHBAZ A,FRANSAW Y ALKOMOS M,MAHENDHAR R,et al.Follicular variant of papillary thyroid carcinoma presented as autonomous functioning thyroid nodule:A case report and review of literature[J].Cureus,2018,10(7):e3014.