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目的:探讨乳腺癌患者甲状腺功能与新辅助化疗期间关系。方法:观察102例原发性乳腺癌患者与213例良性乳腺癌患者,入院时抽血化验他们的甲状腺功能,分析90例乳腺恶性肿瘤患者在进行新辅助化疗前后的甲状腺功能的变化。结果:乳腺癌恶性肿瘤患者甲状腺功能低下的发生率较高,为20.6%,而乳腺良性疾病患者发生甲状腺功能低下的比较较低,仅为6.2%,首次入院时乳腺癌首诊患者游离三碘甲状腺原氨酸(free triiodothyronine,FT3)水平低于良性乳腺疾病患者(t=-2.036,P=0.042),新辅助化疗期间乳腺癌患者甲功较新辅助化疗前降低[三碘甲状腺原氨酸(triiodothyronine,T3):t=13.427,P<0.001;四碘甲状腺原氨酸(tetraiodothyronine,T4):t=3.732,P<0.001;FT3:Z=-10.264,P<0.001;促甲状腺激素(thyroid stimulating hormone,TSH):t=8.201,P<0.001],相邻两疗程新辅助化疗前甲功无显著性变化(T3:t=0.170,P=0.865;T4:t=1.458,P=0.147;FT3:t=0.180,P=0.858;FT4:t=-0.973,P=0.333;TSH:t=-0.877,P=0.383)。结论:乳腺癌患者首次确诊时多伴随低甲状腺功能状态,新辅助化疗期间甲功明显降低而在下一疗程新辅助化疗前甲功又明显恢复和改善。
Objective: To investigate the relationship between thyroid function and neoadjuvant chemotherapy in patients with breast cancer. Methods: A total of 102 patients with primary breast cancer and 213 patients with benign breast cancer were enrolled. Their thyroid function was assessed by blood sampling at admission. The thyroid function in 90 patients with breast cancer was analyzed before and after neoadjuvant chemotherapy. Results: The incidence of hypothyroidism was 20.6% in patients with breast cancer. The incidence of hypothyroidism in patients with benign breast diseases was relatively low, only 6.2%. The first trimester breast cancer patients with free triiodine The level of FT3 in patients with benign breast disease was lower than that in patients with benign breast disease (t = -2.036, P = 0.042). The level of thyroid function in patients with breast cancer during neoadjuvant chemotherapy was lower than that before neoadjuvant chemotherapy [triiodothyronine (T3): t = 13.427, P <0.001; tetraiodothyronine (T4): t = 3.732, P <0.001; FT3: Z = -10.264, P <0.001; thyroid stimulating hormone (T3: t = 0.170, P = 0.865; T4: t = 1.458, P = 0.147) in the two adjacent courses of neoadjuvant chemotherapy (t = 8.201, FT3: t = 0.180, P = 0.858; FT4: t = -0.973, P = 0.333; TSH: t = -0.877, P = 0.383). CONCLUSIONS: When breast cancer patients first diagnosed with low thyroid function status, neoadjuvant chemotherapy during the significantly reduced thyroid function in the next course of neoadjuvant chemotherapy before the recovery and improvement of thyroid function.