■甲状腺激素是几种生理过程的关键调节剂,包括差异化,胚胎发育,扩散,和新陈代谢。一些前瞻性研究表明,甲状腺功能亢进与癌症发病率之间存在关系;然而,由于甲状腺激素水平和肺癌之间的关联仍然存在争议,本研究旨在确定两者的相关性。
■我们回顾性分析了289例患者,他们于2016年1月至2021年1月在湖州市中心医院被诊断出患有肺癌,以及238名健康受试者。收集两组患者的基线临床资料。甲状腺激素的浓度,肿瘤CEA,CYF,SCC,分析了肺癌患者和健康志愿者组的NSE。使用学生t检验或曼-惠特尼检验来比较连续变量。采用卡方检验评估血清甲状腺激素水平与肺癌临床特征的关系。ROC曲线分析用于确定甲状腺激素的特征以识别肺癌。
■结果显示血清促甲状腺激素(TSH),总甲状腺素,总三碘甲状腺原氨酸,游离三碘甲状腺原氨酸(FT3)水平显著降低,而肺癌患者的游离甲状腺素(FT4)水平升高。此外,FT3被鉴定为I-IV期肺癌的潜在诊断性生物标志物,曲线下面积值为0.807。更重要的是,FT3和FT4与CEA组合使用,并被鉴定为0期肺癌(Tis)的潜在诊断性生物标志物,曲线下面积值为0.774。
■我们的研究强调了使用甲状腺激素作为肺癌创新诊断标志物的可能性。
血清TSH,肺癌患者的TT4、TT3和FT3水平显著降低。低TT3浓度与年龄呈正相关(p<0.05),性别(p<0.05),肿瘤大小(p<0.05)和淋巴结转移(p<0.05)。此外,FT3的浓度取决于年龄(p<0.05)和肿瘤大小(p<0.05)。IV期患者的血清FT4浓度明显高于I-III期患者(p<0.05)。当FT3与CEA和CYF联合使用时,I-IV期肺癌筛查的敏感性和特异性分别提高到85.9%和97.5%,分别。当我们在诊断中包括FT3,FT4和CEA时,AUC为0.774。0期肺癌筛查的敏感性和特异性分别提高到70.2%和75.2%,分别。
Thyroid hormones are key regulators of several physiological processes, including differentiation, embryonic development, proliferation, and metabolism. Several prospective studies have shown a relationship between hyperthyroidism and cancer incidence; however, since the association between thyroid hormone levels and lung cancer remains controversial, this
study aimed to determine the correlation between the same.
We retrospectively analyzed 289 patients, who were diagnosed with lung cancer at the Huzhou Central Hospital between January 2016 and January 2021, and 238 healthy subjects. The baseline clinical data of two groups were collected. The concentrations of thyroid hormones, tumor CEA, CYF, SCC, and NSE in both the lung cancer patient and healthy volunteer groups were analyzed. Student\'s t-test or Mann-Whitney test was used to compare continuous variables. A chi-square test was adopted to estimate the relationship between serum thyroid hormones level and clinical characteristics of lung cancer cases. ROC curve analyses were used to determine the characteristics of thyroid hormones for recognizing lung cancer.
The results showed that serum thyroid stimulating hormone (TSH), total thyroxine, total triiodothyronine, and free triiodothyronine (FT3) levels were significantly decreased, while free thyroxine (FT4) levels were increased in patients with lung cancer. In addition, FT3 was identified as a potential diagnostic biomarker of stage I-IV lung cancer with the area under the curve values of 0.807. What\'s more, FT3 and FT4 were used in combination with CEA and were identified as potential diagnostic biomarkers of stage 0 lung cancer (Tis) with the area under the curve values of 0.774.
Our
study highlights the possibility of using thyroid hormones as innovative diagnostic markers for lung cancer.
Serum TSH, TT4, TT3, and FT3 levels were significantly decreased in patients with lung cancer.low TT3 concentration was positively associated with age (p < 0.05), sex (p < 0.05), tumor size (p < 0.05) and lymph node metastasis (p < 0.05). Moreover, the concentration of FT3 was dependent on age (p < 0.05) and tumor size (p < 0.05). The serum FT4 concentration was discernible with obviously higher concentration in stage IV patients compared with stage I–III patients (p < 0.05).When FT3 was used in combination with CEA and CYF, the sensitivity and specificity in the screening for stage I–IV lung cancer were markedly increased to 85.9% and 97.5%, respectively. When we included FT3, FT4, and CEA in the diagnosis, the AUC was 0.774. The sensitivity and specificity of screening for stage 0 lung cancer were increased to 70.2% and 75.2%, respectively.