摘要
目的:近期研究表明肥胖是甲状腺癌发病的风险因素,但肥胖与甲状腺癌临床病理因素和预后的相关性仍不明确,本研究探讨体重指数(body mass index,BMI)与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)临床病理因素的相关性,为其合理治疗提供依据。方法:回顾性分析2631例初治并接受手术治疗的PTC的临床病理资料。按照BMI指数将PTC患者分为体重过低组、体重正常组、超重组和肥胖组,分析BMI与PTC临床病理因素的相关性。采用χ^2检验、精确概率法或方差分析比较不同BMI分组的差异,采用Logistic回归模型计算风险比及其置信区间。结果:本研究纳入了体重过低组100例,体重正常组1479例,超重组844例,肥胖组208例。χ^2检验或方差分析显示年龄、性别、肿瘤最大径、包膜累犯、淋巴结转移和TNM分期在不同BMI分组中的差异具有统计学意义(P<0.05)。平均肿瘤最大径、包膜累犯率、淋巴结转移率和较高TNM分期比例在体重正常组中均为最低(P<0.05)。如果将年龄因素排除在Logistic回归模型之外,体重异常显示为较晚TNM分期的风险因素(P=0.003)。结论:体重过低、超重和肥胖均是PTC不良临床病理因素的风险因素,如果不将年龄纳入模型,多因素分析显示BMI异常是PTC较晚TNM分期的独立风险因素,提示体重异常可能是PTC的不良预后因素。
Objective:Recent studies have shown that obesity is a risk factor of thyroid cancer.However,the correlation between obesity and clinicopathological factors and prognosis of thyroid cancer is still unclear.Our study was designed to investigate the correlation between body mass index(BMI)and clinicopathological factors of papillary thyroid cancer(PTC),and provide evidence for reasonable treatment.Methods:Clinicopathological data of 2631 PTC patients undergoing surgery were analyzed retrospectively.PTC patients were assigned to the underweight group,the normal group,the overweight group and the obese group according to BMI.The correlation between BMI and clinicopathological factors was analyzed.Chi-square test,Fisher’s exact test or variance analysis were used to compare the differences among groups,and logistic regression model was used to calculate the risk ratio and its confidence interval.Results:In total,100 patients were underweight,1,479 were normal,844 were overweight,and 208 were obese.According to Chi-square test or variance analysis,differences in age,gender,maximum tumor diameter,capsule invasion,lymph node metastasis and TNM stage were significant among groups(P<0.05).Mean maximum tumor diameter,incidence of capsule invasion,incidence of lymph node metastasis and proportion of advanced TNM stage were the lowest in the normal group(P<0.05).If age was excluded from the logistic regression model,abnormal weight was the risk factor of advanced TNM stage of PTC(P=0.003).Conclusion:Underweight,overweight and obese were risk factors of adverse clinicopathological factors of PTC.If age is excluded from the logistic regression model,abnormal weight is the risk factor of advanced TNM stage of PTC,which suggests that abnormal weight might be an adverse prognostic factor of PTC.
作者
朱栩杭
蒋烈浩
陈善
兰霞斌
周玲燕
谭卓
王佳峰
Zhu Xuhang;Jiang Liehao;Chen Shan;Lan Xiabin;Zhou Lingyan;Tan Zhuo;Wang Jiafeng(Department of Head and Neck Surgery,Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences,Cancer Hospital of University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Hangzhou 3100229 China;Department of Ultrasound,Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences,Cancer Hospital of University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Hangzhou 310022,China;Department of Head and Neck Surgeryy Taizhou Branch of Zhejiang Cancer Hospital,Taizhou 317502,China)
出处
《肿瘤预防与治疗》
2019年第12期1088-1093,共6页
Journal of Cancer Control And Treatment
基金
国家自然科学基金青年基金项目(编号:81602349,81702644,81702645)
台州市科技计划项目(编号:1902ky153)~~
关键词
甲状腺乳头状癌
肥胖
体重指数
临床病理因素
Papillary thyroid carcinoma
Obesity
Body mass index
Clinicopathological factor
