摘要目的:分析结直肠癌患者血清肿瘤坏死因子（TNF-α）、白细胞介素（IL-6）水平与甲状腺功能的相关性。方法:选取2017年6月至2018年6月就诊于达州职业技术学院附属医院、达州市中心医院的结直肠癌患者作为结直肠癌组，同时选取结直肠良性病患者作为良性组，健康体检者作为对照组。采用酶联免疫吸附试验（ELISA）法测定3组人群血清TNF-α、IL-6水平，电化学发光法测定甲状腺功能指标[血清游离三碘甲状腺原氨酸（FT 3）、游离甲状腺素（FT 4）及促甲状腺激素（TSH）水平]。采用Pearson相关性分析结直肠癌患者血清TNF-α、IL-6水平与甲状腺功能的相关性。 结果:结直肠癌组患者65人，年龄为（60.27 ± 4.35）岁，男36例、女29例；良性组患者32人，年龄为（59.96 ± 4.27）岁，男18例、女14例；对照组40人，年龄为（60.32 ± 4.38）岁，男22例、女18例。3组血清TNF-α、IL-6及FT 3、FT 4水平比较差异有统计学意义（ P均< 0.05），血清TSH水平比较差异无统计学意义（ P > 0.05）。与对照组[（24.25 ± 8.30）、（24.29 ± 8.27）ng/L，（4.41 ± 0.23）、（15.78 ± 0.26）pmol/L]比较，良性组和结直肠癌组血清TNF-α、IL-6水平[（28.49 ± 7.62）、（30.21 ± 7.60），（74.28 ± 16.73）、（95.37 ± 12.53）ng/L]均显著上升（ P均< 0.05），FT 3、FT 4水平[（3.58 ± 0.18）、（12.35 ± 0.20），（2.27 ± 0.11）、（9.86 ± 0.14）pmol/L]显著下降（ P均< 0.05）；与良性组比较，结直肠癌组血清TNF-α、IL-6水平均显著上升（ P均< 0.05），血清FT 3、FT 4水平显著下降（ P均< 0.05）。不同TNM分期患者血清TNF-α、IL-6及FT 3、FT 4水平比较差异有统计学意义（ P均< 0.05），血清TSH水平比较差异无统计学意义（ P > 0.05）。随着TNM分期升高，血清TNF-α、IL-6水平明显上升，FT 3、FT 4水平明显下降（ P均< 0.05）。结直肠癌组血清TNF-α、IL-6水平与FT 3、FT 4水平呈负相关（ r = - 0.375、- 0.221，- 0.184、- 0.193， P均< 0.05）。 结论:结直肠癌患者随着TNM分级增加，FT 3、FT 4水平明显下降，TNF-α、IL-6水平明显上升，且炎性因子TNF-α、IL-6水平与FT 3、FT 4水平均呈负相关关系。

abstractsObjective:To analyze the correlation between serum tumor necrosis factor α(TNF-α), interleukin-6 (IL-6) levels and thyroid function in patients with colorectal cancer.Methods:Colorectal cancer patients in the Affiliated Hospital of Dazhou Vocational and Technical College and Dazhou Central Hospital from June 2017 to June 2018 were selected as the colorectal cancer group, patients with benign colorectal diseases were selected as the benign group, and healthy people as the control group. The levels of serum TNF-α and IL-6 were determined by enzyme linked immunosorbent assay (ELISA). The thyroid function [free triiodothyronine (FT 3), free thyroxine (FT 4) and thyrotropin (TSH)] were determined by electrochemiluminescence assays. Pearson correlation was used to analyze the correlation between the levels of serum TNF-α and IL-6 and thyroid function in patients with colorectal cancer. Results:There were 65 patients in the colorectal cancer group, aged (60.27 ± 4.35) years old, 36 males and 29 females; 32 patients in the benign group, aged (59.96 ± 4.27) years old, 18 males and 14 females; and control group had 40 persons, aged (60.32 ± 4.38) years old, 22 males and 18 females. The differences in serum TNF-α, IL-6, FT 3 and FT 4 level among the three groups were statistically significant ( P < 0.05), while the difference in serum TSH level was not statistically significant ( P > 0.05). Compared with the control group [(24.25 ± 8.30), (24.29 ± 8.27) ng/L, (4.41 ± 0.23), (15.78 ± 0.26) pmol/L], serum TNF-α, IL-6 levels in the benign group and the colorectal cancer group [(28.49 ± 7.62), (30.21 ± 7.60), (74.28 ± 16.73), (95.37 ± 12.53) ng/L] all increased significantly ( P < 0.05), serum FT 3 and FT 4 levels [(3.58 ± 0.18), (12.35 ± 0.20), (2.27 ± 0.11), (9.86 ± 0.14) pmol/L] significantly decreased ( P < 0.05); compared with the benign group, the colorectal cancer group serum TNF-α, IL-6 levels increased significantly ( P < 0.05), and serum FT 3 and FT 4 levels decreased significantly ( P < 0.05). There were statistically significant differences in serum TNF-α, IL-6, FT 3 and FT 4 levels in patients at different TNM stages ( P < 0.05), but there was no significant difference in TSH level ( P > 0.05). The higher the TNM stage, the gradual increase in serum TNF-α and IL-6 levels, and the gradual decrease in serum FT 3 and FT 4 levels ( P < 0.05). The levels of serum TNF-α and IL-6 in patients with colorectal cancer were negatively correlated with FT 3 and FT 4 ( r = - 0.375, - 0.221, - 0.184, - 0.193, P < 0.05). Conclusion:With the increase of disease grade, the levels of FT 3 and FT 4 have decreased, the levels of TNF-α and IL-6 have increased, and the levels of inflammatory factors are negatively correlated with the levels of FT 3 and FT 4.