Correlation Between Obesity And Papillary Thyroid Cancer Risk And Pathological Characteristics

Objective To explore the influence of obesity on the risk of thyroid papillary carcinoma?PTC?,and analyze the relationship between obesity and the clinicopathological characteristics of PTC.Method Retrospectively analyzed the case data of patients who underwent thyroidectomy at the Affiliated Hospital of Qingdao University from June 2017 to May 2019,and postoperative pathological confirmation of PTC and benign nodules.?1?To collect the basic clinical and pathological data of patients,such as sex,age,height,weight,BMI,diameter,number,location of primary cancer focus,whether extracapsular invasion,whether lymph node metastasis,whether distant metastasis,whether HT and BRAF gene mutations are combined;to evaluate the levels of thyroperoxidase antibody?TPOAb?,thyroglobulin antibody?TgAb?,TSH,FT4 and FT₃ Risk stratification and TNM stage of recurrence;?2?The Chinese obesity standard was used to evaluate the degree of obesity with BMI,and the influence of BMI on the risk of PTC was analyzed in general,gender and age groups;?3?To analyze the relationship between the increase of BMI and the incidence of PTC;?4?Compare the differences in BMI levels between PTC and benign thyroid nodules in different layers;?5?Multivariate analysis of PTC risk factors;?6?Analyze the influence of BMI on the clinicopathological characteristics of patients with PTC in the overall,gender and age groups;?7?Analysis of the relationship between increasing BMI and pathological features;?8?Analyze the differences in BMI levels in various clinical pathological characteristics of PTC patients;?9?Analysis of differences in thyroid antibody and thyroid hormone levels in different BMI groups of PTC patients.Results?1?Among the 1792 patients,1060?59.15%?were in PTC group and 732?40.75%?in benign nodule group.BMI was used to assess the degree of obesity.Among the PTC patients,369?34.81%?in the normal group,481?45.38%?in the super-recombination group,and 210?19.81%?in the obese group;In the benign nodule group,309 cases in the normal group?42.21%?,307 cases in the super-recombination group?41.498%?,and 116 cases in the obese group?15.85%?;?2?In general,male group,male 41-60 years old group and male?61 years old group,the risk of PTC in the super recombination and obesity group was higher than that in the normal group,and there was a positive correlation between the increased risk of PTC and the increase of BMI every 5 kg/m²?all P<0.05?;in the female group,the risk of PTC in the super recombination and fat group was higher than that in the normal group;in the female 41-60 years old group and female?61 years old group There was no significant correlation between the increase of BMI and the risk of PTC?P>0.05?;in male 18-40 year old group and female 18-40 year old group,there was no significant correlation between BMI and the incidence of PTC?all P>0.05?.?3?In male group and male 41-60 years old group,the BMI level of PTC group was higher than that of benign nodule group,the difference was statistically significant?P<0.05?;in general,female group,other male age groups and female age groups,there was no statistically significant difference between benign and malignant groups?all P>0.05?;?4?Multivariate analysis showed that,compared with patients with benign nodules,the occurrence of PTC was positively correlated with males,overweight,obesity,TPOAb,TgAb and TSH increase,OR?95%CI?was 1.530?1.212-2.060?,1.718?1.357-2.176?,1.875?1.383-2.544?,1.002?1.000-1.003?,1.001?1.000-1.001?and 1.778?1.578-2.005??all P<0.05?;it was negatively correlated with the age group41-60 years old,age?60 years old group and the increase of FT₃,OR?95%CI?were0.339?0.256-0.451?,0.155?0.109-0.220?and 0.702?0.601-0.820??all P<0.05?;?5?In the patients with PTC,the risk of male,age?55,diameter of primary cancer>1cm in the super recombination and obesity group was higher than that in the normal group;the risk of multiple primary cancer,bilateral primary cancer and extracapsular invasion in the obesity group was higher than that in the normal group?P<0.05?;with each increase in BMI of 3 kg/m²,males,age?55 years,multiple primary cancer foci,bilateral primary cancer foci,primary cancer foci diameter>1 cm,and the risk of extracapsular invasion gradually increased?all P<0.05?;?6?Comparison of BMI levels in clinicopathological characteristics of PTC patients,males higher than females,age?55 years old group older than age<55 years old group,multifocal group higher than single focus group,bilateral group higher than unilateral group,primary cancer Diameter>1cm group is higher than?1cm group,extracapsular invasion group is higher than non-enveloped invasion group,uncombined HT group is higher than combined HT group?all P<0.05?.However,there was no significant correlation between the increase in BMI and lymph node metastasis,distant metastasis,the presence or absence of BRAF gene mutation,and the recurrence risk stratification?all P>0.05?;?7?In male patients with PTC,the risk of bilateral primary cancer,diameter of primary cancer>1cm and extracapsular invasion in obese group was higher than that in normal group,and the risk increased with the increase of BMI by 3kg/m²;in female PTC patients,the risk of super-recombinant primary cancer with a diameter>1 cm is higher than that of the normal group,and the risk of multiple primary cancers in the obese group is higher than that of the normal group,and the increase in BMI of 3 kg/m² is significantly correlated with multiple cancers;?8?In patients with PTC aged<55 years,the risk of over 1 cm in the diameter of the primary tumor was higher than that in the normal group;the risk of multiple primary cancer,bilateral,diameter>1cm and extracapsular invasion in obesity group was higher than that in normal group,and the risk increased with the increase of BMI by 3kg/m².In the age?55 years old group,the risk of hyperrecombinant lymph node metastasis was higher than that of the normal group,and the risk of hyperrecombinant lymph node metastasis increased gradually with the increase of BMI by 3 kg/m²?P<0.05??9?The level of TGAb in the overweight and obesity group of PTC patients was lower than that in the normal group,the difference was statistically significant?P<0.05?,but there was no statistical difference in TSH,FT₄,FT₃ and TPOAb among the normal,overweight and obesity groups?all P>0.05?.Conclusion?1?Overweight and obesity increase the risk of PTC,and with BMI increasing,the risk of PTC increases gradually,especially in men over 40 years old.?2?Male,overweight,obesity,TSH,TPOAb and TgAb were all independent risk factors of PTC;FT3 and age groups were protective factors of PTC.?3?Obese PTC patients are more common in men,?55 years of age,and the risk of diameter>1cm,multifocal,bilateral and extracapsular invasion increases and risk increases with BMI.?4?With the increase of BMI in patients with PTC,the risk of bilateral cancer,diameter>1cm and extracapsular invasion in the male group increases,while the risk of multiple cancers in the female group increases;in the group of<55 years old,the risk of multiple cancerous lesions,bilateral,diameter>1 cm and extracapsular invasion increased,while in the group of?55 years old,the risk of lymph node metastasis increased.