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目的探讨非小细胞肺癌(NSCLC)患者化疗前后血清甲状腺激素水平的变化及其临床意义。方法选取2012年1月至2013年12月化疗的55例NSCLC患者,用放射免疫分析法测定患者化疗前后血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平,并选取40例体检正常健康者的血清甲状腺激素水平作对照,比较NSCLC患者化疗前后血清甲状腺激素水平变化。结果 NSCLC患者血清TT3和FT3水平明显低于正常对照组水平(P均<0.05),TT4、FT4、TSH与正常对照组水平比较无统计学差异(P均>0.05)。NSCLC患者甲状腺激素水平和临床分期有关(P均<0.01),和病理分型、分化程度无关(P均>0.05)。Ⅲb~Ⅳ期与Ⅱb~Ⅲa期患者比较,血清TT3和FT3水平明显降低(P均<0.01),但TT4、FT4、TSH均无统计学差异(P均>0.05)。化疗前后TT3和FT3有明显改变,化疗有效组TT3和FT3均明显高于化疗前,化疗无效组TT3和FT3均明显低于化疗前,差异均有统计学意义(P均<0.05);无论有效与否,TT4、FT4、TSH化疗前后差异均无统计学意义(P均>0.05)。结论 NSCLC患者体内甲状腺激素水平会随病情改变、治疗等发生变化,可辅助用于病情观察及预后判断。
Objective To investigate the changes of serum thyroid hormones before and after chemotherapy in patients with non-small cell lung cancer (NSCLC) and its clinical significance. Methods Fifty-five patients with NSCLC who underwent chemotherapy from January 2012 to December 2013 were enrolled in this study. Serum total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured. Serum thyroid hormone levels were measured in 40 healthy controls. Serum levels of thyroid hormones were measured before and after chemotherapy. Results Serum levels of TT3 and FT3 in patients with NSCLC were significantly lower than those in normal controls (all P <0.05). There were no significant differences in the levels of TT4, FT4 and TSH between the two groups (P> 0.05). The level of thyroid hormone in NSCLC patients was correlated with clinical stage (all P <0.01), but not with pathological type and differentiation (all P> 0.05). The levels of TT3 and FT3 in serum of patients in stage Ⅲb-Ⅳ were significantly lower than those of patients in stage Ⅱb-Ⅲa (all P <0.01), but there were no significant differences in TT4, FT4 and TSH (all P> 0.05). The levels of TT3 and FT3 in chemotherapy-treated group were significantly higher than those in chemotherapy-treated group before and after chemotherapy. The levels of TT3 and FT3 in chemotherapy-ineffective group were significantly lower than those before chemotherapy (all P <0.05) Whether or not, TT4, FT4, TSH chemotherapy before and after the difference was not statistically significant (P all> 0.05). Conclusion The level of thyroid hormones in patients with NSCLC may change with the change of the disease and treatment, which can be used for the observation of the disease and prognosis.