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目的：探讨合并桥本甲状腺炎的甲状腺微小乳头状癌淋巴结转移的特点，分析血清甲状腺过氧化物酶抗体(Thyroid peroxidase- antibody, TPO-Ab)滴度对该组病例淋巴结转移的影响。方法：回顾性分析武汉同济医院甲状腺乳腺外科2012 年1 月至2014 年5 月收治的甲状腺微小癌伴桥本甲状腺炎的病例，运用卡方检验、阈值效应分析、多因素logistic 回归方法分析该组病例血清 TPO-Ab 滴度对淋巴结转移的影响。结果：共收集75 例合并桥本甲状腺炎的微小乳头状癌病例，血清TPO-Ab 滴度与淋巴结转移相关：抗体滴度对淋巴结转移的影响存在分段特征，有阈值效应，该组病例以212 IU/mL 为阈值；多因素logistic 回归显示，随着血清TPO-Ab 水平升高，淋巴结转移率下降（OR=0.993，95%CL=0.987,0.999，P=0.018）。结论：合并桥本甲状腺炎的甲状腺微小乳头状癌病例，血清TPO-Ab 滴度对淋巴结转移的影响可能存在阈值效应，值得深入分析；且高血清TPO-Ab 滴度可能是淋巴结转移的保护因素，但两者的相互关系尚需进一步探讨。

英文摘要:

Objective:To investigate the effect of serumThyroid peroxidase-antibody (TPO-Ab) on cervical lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC) combined with Hashimoto's Thyroiditis (HT).Methods:A retrospective analysis was performed with patients who were diagnosed as papillary thyroid microcarcinoma combined with Hashimoto's thyroiditis from January 2012 to May 2014 in Wuhan Tongji Hospital. Chi-square test, threshold effect, multivariate Logistic Regression analysis was performed with serum TPO-Ab titer and CLNM. Results:75 cases were collected in our analysis. The preoperative serum TPO-Ab titer was associated with CLNM. Logistic Regression analysis revealed that high TPO-Ab titer corelated with low CLNM rate in these cases (OR=0.993, 95%CL=0.987,0.999, P=0.018).Conclusion:The corelation between serum TPO-Ab and CLNMin PTMC combined with HT may have threshold effect, and high titer may lead to low CLNMrate. But the detail study need to undertake in the future.

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