The Effect of Postoperative TSH Suppression Therapy on the Cellular Immune Function, Tumor Markers, Bone Density and Bone Turnover Markers of Patients with Differentiated Thyroid Carcinoma

  • Gang Pu
Keywords: Differentiated Thyroid Carcinoma, TSH Suppression Therapy, Cellular Immune Function, Tumor Markers, Bone Density, Bone Turnover Markers

Abstract

To investigate the effect of postoperative TSH suppression therapy on the cellular immune function, tumor
markers, bone density and bone turnover markers of patients with differentiated thyroid carcinoma. 160 patients
with thyroid carcinoma admitted to our hospital from March 2014 to April 2018 were selected and divided into
the treatment group (80 cases) and control group (80 cases) using random number table method. The control
group was treated with oral levothyroxine sodium, while the treatment group was treated with levothyroxine
sodium combined with TSH suppression therapy. The cellular immune function (CD3+%, CD4+%, CD8+%,
CD4 + /CD8 + , NK), tumor markers (carcinoembryonic antigen (CEA), carbohydrate antigen (CA50),
carbohydrate antigen (CA125), bone density (femoral neck, hip joint, L1, L2, L3 and L4) and bone turnover
markers (β-Crosslap, blood calcium, blood phosphorus, bone specific alkaline phosphatase (ALP), free
triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), total procollagen type I N-terminal peptide
(tPINP) of both groups of patients with differentiated thyroid carcinoma after treatment were compared and the
differences were analyzed. After treatment, the levels of CD3+%, CD4+%, CD8+% and CD4+/CD8+ of
two groups were lower than before treatment, and the above indicators of the treatment group were significantly
lower than those of the control group (P<0.05), while the level of NK were higher than before treatment, and the
above indicator of the treatment group was significantly higher than that of the control group, and the difference
was statistically significant (P<0.05). After treatment, the levels of CEA, CA50 and CA125 of two groups were
lower than before treatment, and the above indicators of the treatment group were significantly lower than those
of the control group, with statistically significant differences (P<0.05). After treatment, the levels of β-Crosslap
and tPINP of the treatment group were higher than before treatment, and the differences were statistically
significant (P<0.05), while the differences of the above indicators before and after treatment in the control group
were not statistically significant (P>0.05). After treatment, the levels of femoral neck, hip joint, L1, L2, L3 and
L4 in the treatment group were lower than before treatment, and the differences were statistically significant
(P<0.05), while the differences of the above indicators before and after treatment in the control group were not
statistically significant (P>0.05).After treatment, there was no significant difference between the treatment
group and the control group in serum calcium, phosphorus and ALP levels (P > 0.05). The levels of FT4 and
FT3 were higher than before treatment, and the above indexes in the treatment group were significantly higher
than those in the control group (P < 0.05).TSH level was lower than that before treatment, and the above indexes
in the treatment group were significantly lower than that in the control group (P < 0.05). TSH suppression
therapy can promote the recovery of the immune function of patients with differentiated thyroid carcinoma, and
improve the bone turnover of the body. But at the same time, it will also increase the risk of bone fracture, so in
the clinical application of TSH suppression therapy, vigilance should be exercised against the occurrence of
osteoporosis.

Published
2020-02-01