Analysis Of Factors Of Papillary Thyroid Carcinoma Combined With Breast Cancer In Female Patients

Objective:This study retrospectively analyzed the clinicopathological characteristics of concomitant papillary thyroid carcinoma（PTC）and breast cancer（BC）in female patients.This study aimed to investigate the relevant factors of PTC combined with BC,which helped improve the understanding of multiple primary carcinomas and guide clinical diagnosis and treatment.Methods:（1）A total of 428 female patients with PTC who underwent surgical resection in The Affiliated Hospital of Qingdao University were included in this study from September2010 to September 2020.None of the patients had any malignant tumors except BC,and the clinicopathological data were relatively complete.（2）Among the 428 female patients with PTC in this study,327 with PTC alone were defined as the control group,and 101 with PTC and BC were defined as the observation group.In addition,age,body mass index（BMI）,menstrual status,family history,pathological features of PTC(including tumor size,BRAF^V600Emutation,multiple foci,extrathyroidal extension,Hashimoto’s disease,lymph node metastasis,and distant metastasis),and pathological features of BC（including pathological type,estrogen receptor[ER],progesterone receptor[PR],human epidermal growth factor receptor-2[HER2],and Ki-67）were collected from the two groups.（3）BRAF^V600Edetection:We obtained a PTC tissue wax block from the Department of Pathology of The Affiliated Hospital of Qingdao University.First,hematoxylin and eosin（HE）staining was performed after cutting white tablets to determine if it was PTC tumor tissue.Then we used the immunohistochemical method to detect BRAF^V600Emutations.In addition,we tested for BRAF^V600Emutations in patients with BC tissue in the observation group.The interpretation of the results was carried out by our experienced pathologists.（4）Statistical Package for the Social Sciences（SPSS）26.0 software was used for analysis.First,univariate analysis was performed for the above factors.Then we selected meaningful indicators of univariate analysis or clinically significant indicators using multivariate analysis.Finally,we used logistic regression to determine the relevant factors of PTC combined with BC.Results:（1）In the observation group,the average age of PTC was 50.33±8.90 years old,BMI was 25.61±3.40 kg/m²,and tumor size was 0.83±0.61 cm.A total of 50 patients were menopausal at the time of PTC diagnosis.In addition,there was 1 patient who had a family history of PTC,74 were BRAF^V600E（+）,33 with multiple lesions,16 with Hashimoto’s thyroiditis,16 with Hashimoto’s thyroiditis,34 with capsular infiltrates,26with lymph node metastasis,and 1 with distant metastases,which was bone metastases.The average age of BC onset was 49.19±8.97years old,39.6%of patients were menopausal at the time of BC diagnosis（40 cases）,and 6 had a family history of BC.In terms of pathological type,70 cases of invasive ductal cancer account for 69.3%,and in immune typing,luminal A was the most numerous,accounting for 66%.（2）Univariate analysis showed that there were significant differences in age（t=-5.105,P<0.001）,tumor size（t=4.933,P<0.001）,menstrual status（X²=8.298,P=0.004）,extrathyroidal extension（X²=8.440,P=0.004）,and lymph node metastasis（X²=13.665,P<0.001）,while there were no significant differences in BMI,BRAF^V600Emutation,multiple foci,Hashimoto’s disease,and distant metastasis.（3）Multivariate logistic regression analysis showed that age（OR=1.062,95%CI:1.027-1.100,P=0.001）was positively correlated with the risk of prime BC and PTC in female patients,while tumor size（OR=0.457,95%CI:0.282-0.740,P=0.001）and cervical lymph node metastasis rate（OR=0.555,95%CI:0.319-0.966,P=0.037）were negatively correlated.Conclusion:There is a certain correlation between PTC and BC.Most patients with PTC combined with BC are menopausal.In addition,their thyroid tumors are more than>1cm in diameter,and the rate of extrathyroidal extension and cervical lymph node metastasis is lower.Older patients with PTC are more likely to have BC.Therefore,after surgery,breast screening should be strengthened for older patients after menopause.However,BRAF^V600Emutations may not play a role in the process of PTC complicated by BC.