目的:虽然自身免疫性甲状腺炎和甲状腺乳头状癌(PTC)之间的潜在关联已被确认,PTC的临床病理特征是否会受到甲状腺自身抗体的影响尚不清楚.
方法:我们进行了一项病例对照研究,调查了来自中国中部省份3个医疗中心的15,305例患者(包括11,465名女性和3,840名男性)的甲状腺自身抗体与PTC临床病理特征的关系。采用Logistic回归和限制性三次样条模型分析甲状腺自身抗体与PTC临床病理特征的关系。
结果:总计,在这项研究的15305名患者中,10087(65.9%)甲状腺自身抗体阴性,5,218(34.1%)检测出甲状腺自身抗体阳性。在这些人中,1,530(10.0%)仅显示TPOAb阳性,仅TGAb的1,247(8.2%)和另外2,441(15.9%)对TPOAb和TGAb的组合均表现出双重阳性。甲状腺自身抗体水平与PTC的某些侵袭性特征显着相关。具体来说,TGAb水平显示与多焦点可能性增加直接相关,双侧肿瘤,甲状腺外延伸,淋巴结转移,以及超过五个受影响的淋巴结。然而,TPOAb水平与甲状腺外延伸相关的风险呈负相关,淋巴结转移,和超过五个受影响的淋巴结。
结论:TGAb水平升高与PTC中侵袭性特征的风险呈正相关,而高水平的TPOAb与甲状腺外扩展和淋巴结转移的风险呈负相关。
OBJECTIVE: Although the potential association between autoimmune thyroiditis and papillary thyroid cancer (PTC) has been acknowledged, whether the clinicopathological features of PTC will be affected by thyroid autoantibodies remains unknown.
METHODS: We conducted a case-control study to investigate the association of thyroid autoantibodies with clinicopathological characteristics of PTC in 15,305 patients (including 11,465 females and 3,840 males) from 3 medical centers in the central province of China. Logistic regression and restricted cubic spline models were performed to analyze the association of thyroid autoantibodies with clinicopathological features of PTC.
RESULTS: In total, out of the 15,305 patients enrolled in this study, 10,087 (65.9%) had negative thyroid autoantibodies, while 5,218(34.1%) tested positive thyroid autoantibodies. Among these individuals, 1,530(10.0%) showed positivity for TPOAb only, 1,247(8.2%) for TGAb only and a further 2,441(15.9%) exhibited dual positivity for both TPOAb and TGAb combined. Thyroid autoantibodies level demonstrated significant correlations with certain
aggressive features in PTC. Specifically, TGAb level displayed a direct correlation to an increased likelihood of multifocality, bilateral tumor, extrathyroidal extension, lymph node metastasis, as well as more than five affected lymph nodes. However, TPOAb level exhibited an inverse association with the risk associated with extrathyroidal extension, lymph node metastasis, and more than five affected lymph nodes.
CONCLUSIONS: Elevated level of TGAb were positively correlated with the risk of
aggressive features in PTC, while high level of TPOAb were inversely associated with the risk of extrathyroidal extension and lymph node metastasis.