The Clinical Valve Of Preoperative Thyyoid Stimulating Hormone And Thyroid Autoantibodies In Papillary Thyroi Carcinoma

Objective:To investigate the difference of serum thyroid stimulating hormone(TSH)and thyroid autoantibodies in patients with nodular goiter and papillary thyroid carcinoma(PTC)who met the inclusion criteria,and to analyze the significance and clinical value of serum TSH and thyroid autoantibodies in PTC before operation.Methods: A total of 710 patients with thyroid nodules who were admitted to the Department of head and neck Breast thyroid surgery in the North Hospital of Yongzhou Central Hospital from January 1,2015 to December 31,2019 were collected.Their postoperative pathological results were nodular goiter and PTC,and met the inclusion criteria.The preoperative TSH,thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)levels of these patients were compared and analyzed by SPSS20.0 statistical software.Results:(1)The average age of patients with nodular goiter wassignificantly higher than that of PTC group,and the difference was statistically significant(T = 4.364,P< 0.001).(2)The average diameter of nodules in nodular goiter group was significantly larger than that in PTC group,and the difference was statistically significant(T = 10.89,P <0.001).(3)There was significant difference in the number of nodules between nodular goiter group and PTC group(χ2= 63.22,P < 0.001).(4)The serum TSH level in the PTC group was significantly higher than that in the nodular goiter group,the difference was statistically significant(Z=-4.642,P <0.001),The preoperative serum TSH level was divided into7 groups according to the interval of 1uIU/mL.It was found that the higher the serum TSH level was,the higher the correlation of PTC was,and there were significant differences among the PTC with different serum TSH levels(χ2=32.24,P< 0.001).(5)Serum TgAb level in PTC group was higher than that in nodular goiter group,the difference was statistically significant(Z =-4.762,P <0.001).There was no significant difference in serum TPOAb level between PTC group and nodular goiter group(Z=-1.564,P>0.05).(6)The TSH level in the group with lymph node metastasis was significantly higher than that in the group without lymph node metastasis,the difference was statistically significant(Z =-2.397,P = 0.017);there was no significant difference in the levels of TgAb and TPOAb between the group with lymph node metastasis and the group without lymph node metastasis.(7)The difference in cervicallymphnode metastasis rate between PTC with diameter> 10 mm and PTC with diameter ≤ 10 mm was statistically significant(χ2 = 4.83,P=0.028)Conclusion:(1)The increase of preoperative serum TSH and TgAb levels may be an important relevant factor for PTC.(2)The cervicallymph node metastasis of PTC may be related to the increase of TSH level and the diameter of nodules.