中青年良性甲状腺结节患者恶变与工作、生活行为方式的相关性研究

doi:10.12183/j.scjpm.2025.0748

摘要/Abstract

摘要： 目的研究中青年良性甲状腺结节恶变在工作、生活中的影响因素。方法选择2023年1月至2024年12月在徐州医科大学附属宿迁医院经穿刺或手术病理切片确诊为甲状腺癌的患者作为病例组,以性别相同、年龄±3岁、甲状腺结节病程±1年为原则,按1∶3的比例选择在医院体检中心体检的甲状腺结节患者作为对照组。对2组人群工作、生活相关因素进行问卷调查,并采用单、多因素分析方法对病例组与对照组相关因素进行分析。结果本研究共纳入病例组患者包括男性41例、女性172例,平均年龄（41.98±9.54）岁,甲状腺结节平均病程（5.56±2.32）年;对照组患者包括男性123例、女性516例,平均年龄（41.77±9.47）岁,甲状腺结节平均病程（5.44±2.29）年;共包括男性417例,女性432例。2组患者的性别分布、年龄分布、病程比较差异均无统计学意义（χ²=0.005、0.492,t=0.724,均P>0.05）。多因素logistic回归分析结果显示,BMI（超重OR=2.015,肥胖OR=5.533）、有工作压力（OR=1.454）、每日睡眠时间<6 h（OR=1.808）、食用油炸烧烤食品>5次/月（OR=1.932）、食用海鲜鱼类>5次/月（OR=2.076）、食用碘盐（OR=1.503）、每年接受CT或X射线检查（OR=1.702）、既往甲状腺功能异常（OR=3.681）、甲状腺肿瘤家族史（OR=2.008）是中青年良性甲状腺结节恶变的影响因素（均P<0.05）。结论中青年良性甲状腺结节恶变受多因素影响。超重或肥胖、工作压力大、睡眠不足、常吃油炸烧烤及海鲜鱼类、食用碘盐、每年接受CT或X射线检查、既往甲状腺功能异常、有甲状腺肿瘤家族史,都会增加恶变风险。临床及健康管理中,可针对这些因素,通过调整生活方式、减少辐射接触等干预,降低恶变风险。

关键词: 中青年, 甲状腺结节, 良性, 恶变, 影响因素

Abstract: Objective To investigate the impact of work and lifestyle factors on the malignant transformation of benign thyroid nodules in young and middle-aged patients. Methods Patients pathologically confirmed to have thyroid cancer via biopsy or surgery from January 2023 to December 2024 at the Suqian Hospital Affiliated to Xuzhou Medical University were selected as the case group. For the control group, thyroid nodule patients undergoing health check-ups at the hospital were selected at a 1∶3 ratio, matched by gender, age (±3 years), and nodule duration (±1 year). Questionnaires surveyed work and lifestyle factors, with univariate and multivariate analyses comparing the two groups. Results The study included 213 case group patients (41 males, 172 females, mean age 41.98±9.54 years, mean nodule duration 5.56±2.32 years) and 639 control group patients (123 males, 516 females, mean age 41.77±9.47 years, mean nodule duration 5.44±2.29 years). No significant differences were found in gender, age, or nodule duration between groups (χ²=0.005, 0.492; t=0.724; all P>0.05). Multivariate logistic regression identified BMI (overweight OR=2.015, obese OR=5.533), work stress (OR=1.454), daily sleep <6 h (OR=1.808), consumption of fried/grilled foods >5 times/month (OR=1.932), seafood/fish >5 times/month (OR=2.076), iodized salt use (OR=1.503), annual CT/X-ray exposure (OR=1.702), history of thyroid dysfunction (OR=3.681), and family history of thyroid cancer (OR=2.008) as significant risk factors (all P<0.05). Conclusions Malignant transformation of benign thyroid nodules in young and middle-aged patients is influenced by multiple factors. Risks increase with overweight/obesity, work stress, insufficient sleep, frequent consumption of fried/grilled and seafood/fish, iodized salt use, radiation exposure, thyroid dysfunction history, and family history of thyroid cancer. Interventions targeting these factors, such as lifestyle adjustments and reduced radiation exposure, may lower transformation risk.

Key words: Young and middle-aged, Thyroid nodules, Benign, Malignant transformation, Influence factors

中图分类号:

R181.3

黄娟娟, 袁方, 单思维, 陈军, 韩涵, 蒋瑶瑶. 中青年良性甲状腺结节患者恶变与工作、生活行为方式的相关性研究[J]. 华南预防医学, 2025, 51(7): 748-752.

HUANG Juanjuan, YUAN Fang, SHAN Siwei, CHEN Jun, HAN Han, JIANG Yaoyao. Correlation between malignant transformation and work,life and behavior style in young and middle-aged patients with benign thyroid nodules[J]. South China Journal of Preventive Medicine, 2025, 51(7): 748-752.

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