目的 探讨血清硒水平和尿碘水平对甲状腺癌患病的影响.方法 选取2014年3-12月新疆医科大学第二附属医院血管甲状腺外科收治的甲状腺癌患者153例、甲状腺良性结节患者154例,并于同期在本院选取甲状腺形态正常的健康体检者327例.比较3组的性别、年龄、血清甲状腺功能及自身抗体指标水平、血清硒水平及尿碘水平,并采用多元逐步Logistic回归分析探讨性别、年龄、血清硒水平及尿碘水平对甲状腺癌患病的影响.结果 3组性别、年龄及血清总三碘甲状腺原氨酸(TT 3)、总甲状腺素(TT 4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)水平比较,差异有统计学意义(P<0.05).3组血清硒水平和尿碘水平比较,差异有统计学意义(P<0.05).其中,甲状腺形态正常组血清硒水平优于甲状腺良性结节组,甲状腺良性结节组血清硒水平优于甲状腺癌组,差异有统计学意义(P<0.05);甲状腺形态正常组、甲状腺良性结节组尿碘水平优于甲状腺癌组,差异有统计学意义(P<0.05);而甲状腺形态正常组与甲状腺良性结节组尿碘水平比较,差异无统计学意义(P>0.05).多元逐步Logistic回归分析结果显示,性别、血清硒水平、尿碘水平是甲状腺癌患病的影响因素.结论 女性、低血清硒水平、高尿碘水平是甲状腺癌患病的危险因素.%Objective To investigate the correlation of serum selenium and urinary iodine levels with thyroid cancer. Methods The enrolled participants were all from the Second Affiliated Hospital of Xinjiang Medical University, including 153 cases of thyroid cancer and 154 cases of benign thyroid nodules who received treatment in Department of Vascular and Thyroid Surgery and 327 healthy controls with normal thyroid who underwent physical examination between March and December 2014. Comparisons were made between the groups in terms of sex distribution,age,levels of total thyroid function markers 〔total triiodothyronine (TT 3 ),total thyroxine (TT 4 ),thyroid stimulating hormone(TSH)〕,thyroglobulin antibody (TGAb),thyroid peroxidase antibody (TPOAb),serum selenium (Se),and urinary iodine (UI). The correlation of sex, age,serum Se and UI levels with the prevalence of thyroid cancer was investigated by stepwise multiple regression models. Results Significant differences were observed in sex distribution,age,levels of serum TT 3 ,TT 4 ,TSH,TGAb,TPOAb and Se as well as UI between the thyroid cancer,benign thyroid nodule and control groups (P < 0. 05). The average serum Se levels in healthy controls were higher than those of the benign thyroid nodule group (P < 0. 05). The benign thyroid nodule group had higher average serum Se levels than the thyroid cancer group (P < 0. 05). Significantly lower average UI levels were noted in the thyroid cancer group rather than the other two groups (P < 0. 05). However,there was no significant difference in the average UI levels between the control and benign thyroid nodule groups (P < 0. 05). Stepwise multiple Logistic regression analysis revealed that sex,Se and UI levels were associated factors for thyroid cancer. Conclusion Female,decreased serum Se and increased UI levels might be the associated risk factors for thyroid cancer.
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