Clinicopathological Features Of Papillary Thyroid Carcinoma With Type 2 Diabetes Mellitus

Objective:The purpose of this study is to analyze the general clinical features,pathological features and thyroid function examinations benween the papillary thyroid carcinoma（PTC）patients with type 2 diabetes mellitus（T2DM）and the PTC patients without T2DM.So we can strengthen the clinicians’understandings of the two types of diseases and choose the operative methods reasonably,promote the recovery of patients and improve the prognosis.Materials and methods:A retrospective data,which enrolled 172 patients of PTC who underwent thyroid surgery operation by the same surgeon in the First Hospital of Jilin University from September 2015 to March 2016 was analyzed.47 patients were enrolled in PTC patients with T2DM group and 125 patients were enrolled in PTC patients without T2DM group according to whether patients were diagnosed as T2DM.Patients’information was recorded in detail,such as sex,age,thyroid carcinoma progression,length of stay,surgical extent,with or without ¹³¹I treatment,postoperative levothyroxin dosage,pathological data（the maximum diameter of tumor,location of cancer lesions,number of cancer lesions,invasion of the capsule,invasion of vascular or nerve,comorbidities,lymph node metastasis in central region,TNM staging）,thyroid function examinations,and fasting blood glucose,etc.SPSS 22.0software was used for statistical data analysis.Results:（1）The average age of onset and length of stay in the two groups had significant difference（P<0.01）.Compared with PTC patients without T2DM group,the average age of onset was older and length of stay was longer in PTC patients with T2DM group.However,there was no obvious difference between sex,thyroid cancer progression,surgical extent,¹³¹I treatment and postoperative levothyroxin dosage（P>0.05）.（2）Two groups of patients’incidence of capsular invasion and vascular or nerve invasion and TNM staging（stageⅠ,Ⅱ）was statistically different（P<0.05）.The results showed that compared with the PTC patients without T2DM group,the rate of capsular invasion and vascular or nerve invasion were higher in PTC patients with T2DM group,and the TNM stage was later.But there was no obvious difference between two groups,among tumor maximum diameter,location of cancer lesions（unilateral or bilateral）,the number of cancer lesions（single focus or multifocus）,comorbidities,the rate of lymph node metastasis in central region（P>0.05）.（3）The multifactor analysis of capsular invasion and vascular or nerve invasion showed that the maximum diameter of the cancer,the vascular or nerve invasion,and whether patients were diagnosed as T2DM were associated with capsule invasion（P<0.05）;the maximum diameter of the cancer,the number of cancer lesions,Hashimoto’s thyroiditis,TNM staging,and whether patients were diagnosed as T2DM were associated with vascular or nerve invasion（P<0.05）.（4）The levels of FT₃ and fasting blood glucose in two groups were obviously different between the two groups（P<0.05）.The levels of FT₃in PTC patients with T2DM was lower than that of PTC patients without T2DM group.Besides the level of fasting blood glucose was significantly higher than that of PTC patients without T2DM group.However,there was no statistical difference in TSH,FT₄ levels（P>0.05）.Conclusions:PTC patients with T2DM were compared with those without T2DM:（1）The average age of the PTC with T2DM was older and the length of stay was longer.After the operation,we should pay more close attention to changes of the disease,prevent the postoperative complications and promote the patient’s rapid recovery process.（2）The incidence of invasion and vascular or nerve invasion of the PTC with T2DM were higher,and the clinical staging was relatively later.In the operation,a comprehensive evaluation,reasonable selection of surgical proceduresshould be made in combination with the tumor.Besides T2DM was an independent risk factor for both capsule invasion and vascular or nerve invasion.（3）The levels of FT₃ of PTC with T2DM were lower and the level of fasting blood glucose was higher contrast to the patients without T2DM.In addition to the blood glucose level in perioperative period,we should also pay attention to the changes of thyroid function examinations.