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中文摘要：
目的 探讨血清促甲状腺激素（TSH）水平与甲状腺结节中乳头状甲状腺微小癌（PTMC）发生发展的关系.方法 收集首次行甲状腺结节手术并符合条件者365例,术后病理确诊PTMC者113例（PTMC组）,良性结节252例（良性组）,回顾性调查两组病史资料,比较两组术前TSH水平及所有入组患者不同TSH水平组间PTMC患病比例;在PTMC患者中,分析术前TSH水平与癌灶大小及淋巴结转移的关系.结果 PTMC组和良性组间术前TSH水平差异无统计学意义（P＞0.05）,PTMC组的中位年龄低于良性组（Z=-2.877,P=0.004）,而抗甲状腺球蛋白抗体（TGAb）水平高于良性组（Z=-2.887,P=0.004）;不同TSH水平组间PTMC患病比例差异无统计学意义（P＞0.05）,logistic回归分析显示仅年龄是PTMC的危险因素（OR=0.971,95％CI：0.953～0.990,P=0.003）;PTMC患者中,TSH水平与癌灶大小呈正相关（r=0.218,P=0.025）,但不同TSH水平组间淋巴结转移比例差异无统计学意义（P＞0.05）.结论 血清TSH水平可能与PTMC的新发无关,但可能参与了已存在的PTMC的增长.
英文摘要：
Objective To explore the relationship between serum level of thyroxin-stimulating hormone （TSH） and development and progression of papillary thyroid microcarcinoma （PTMC） in nodular thyroid disease.Methods A total of 365 eligible patients with thyroid nodules undergoing initial thyroidectomy were enrolled,including 113 patients with PTMC diagnosed by postoperative pathology （PTMC group） and 252 patients with benign thyroid nodules （BTN group）.Their clinical data were retrospectively reviewed.The serum levels of TSH in two groups and the proportion of PTMC in different serum TSH level groups in all patients were compared respectively.The relationship of preoperative serum TSH levels with tumor size and lymphatic metastasis in patients with PTMC were analyzed.Results No significant difference existed in serum TSH levels between PTMC and BTN groups （P 〉 0.05）.The median age was younger in PTMC group than that in BTN group （Z =-2.877,P =0.004）.And the TGAb levels were higher in PTMC group than those in BTN group （Z =-2.887,P =0.004）.They were divided into 6 groups according to the serum TSH levels,and there weren＆#39;t significant difference in the proportion of PTMC among those group （P 〉 0.05）.Binary logistic regression analysis showed age was the only risk factor of PTMC （OR =0.971,95% CI：0.953-0.990,P =0.003）.The serum TSH levels were positively correlated with tumor size in patients with PTMC （r =0.218,P =0.025）.However,the proportions of lymphatic metastasis were comparable among different TSH levels groups in patients with PTMC （P 〉 0.05）.Conclusion Serum TSH is probably associated with the de novo oncogenesis of PTMC.However,serum TSH may be involved in the growth of preexisting PTMC.
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