甲状腺癌患者1005例体质量指数分布情况分析

Distribution analysis of body mass index in 1 005 patients with thyroid cancer

目的 分析甲状腺癌患者体质量指数（BMI）的分布情况.方法 对新疆军区总医院2007 年1月至2017年10月间经术后病理确诊的1 005例甲状腺癌患者的病例资料进行回顾性分析,以同期668名体检甲状腺超声、甲状腺功能检查结果无明显异常的健康体检者为对照,比较甲状腺癌患者术前BMI与健康对照者BMI分布情况.结果 根据BMI亚洲标准,1 005例甲状腺癌患者中,肥胖346例（34.43 %）,正常296例（29.45 %）,偏胖275例（27.36 %）,重度肥胖60例（5.97 %）,偏瘦28例（2.79 %）,以肥胖者最多;668名健康对照者中,正常269例（40.27 %）,偏胖168例（25.15 %）,肥胖165例（24.70 %）,偏瘦41例（6.14 %）,重度肥胖25例（3.74 %）,以正常最多.两组间偏瘦、正常、肥胖、重度肥胖者BMI分布差异有统计学意义（χ2=11.400,P=0.001;χ2=20.991,P=0.000;χ2=17.898,P=0.000;χ2=4.129,P=0.042）. 1 005例甲状腺癌患者病理类型主要为乳头状癌[948例（94.33 %）],其次为滤泡样癌[42例（4.18 %）],髓样癌[9例（0.90 %）]及未分化癌[6例（0.60 %）]极少.乳头状癌患者中肥胖321例（33.86 %）,正常282例（29.75 %）,偏胖264例（27.85 %）,重度肥胖57例（6.01 %）,偏瘦24例（2.53 %）;滤泡样癌患者中肥胖19例（45.24 %）,正常9例（21.43 %）,偏胖7例（16.67 %）,偏瘦4例（9.52 %）,重度肥胖3例（7.14 %）;髓样癌患者中肥胖4例,偏胖3例,正常2例;未分化癌患者中正常3例,肥胖2例,偏胖1例.不同病理类型甲状腺癌患者BMI分布差异均无统计学意义（均P＞0.05）.结论 甲状腺癌患者中肥胖、重度肥胖者数量较健康人群增加,而偏瘦、正常者数量较健康人群减少,考虑肥胖与甲状腺癌有一定联系,有助于对甲状腺癌的风险评估和预防.

Objective To analyze the distribution of body mass index （BMI） in the patients with thyroid cancer. Methods The clinical data of 1 005 cases of thyroid cancer diagnosed by the postoperative pathology from January 2007 to October 2017 in Xinjiang Military Region General Hospital were retrospectively analyzed. A total of 668 healthy people who underwent ulltrasonic and functional test of thyroid cancer without obvious abnormal response were chosen as healthy controls. The preoperative BMI of thyroid cancer patients and BMI distribution of healthy controls were compared. Results According to the BMI Asia criteria, 1 005 patients with thyroid cancer included 346 （34.43 %） cases of obesity, 296 （29.45 %）normal cases, 275 （27.36 %） chubby cases, 60 （5.97 %） cases of severe obesity, 28 lean cases and the obese people were the most. Among 668 healthy controls, 269 （40.27 %） cases were normal, 168 （25.15 %） cases were chubby, 165 （24.70 %） cases were obesity, and 41 （6.14 %） cases were lean, 25 （3.74 %） cases were severe obesity and the most common was the normal group. There was a statistically significant difference of BMI distribution between the two groups in the lean, normal, obesity, and severe obesity group （χ2= 11.400, P = 0.001; χ 2= 20.991, P = 0.000; χ 2= 17.898, P = 0.000; χ 2= 4.129, P = 0.042）. The pathological types of 1005 cases of thyroid cancer were mainly papillary carcinoma [948 cases （94.33 %）], successively followed by follicular carcinoma [42 cases （4.18 %）], medullary carcinoma [9 cases （0.90 %）] and undifferentiated carcinoma [6 cases （0.60 %）]. Patients with papillary carcinoma included 321 （33.86 %） obese cases, 282 （29.75 %） normal cases, 264 （27.85 %） chubby cases, 57 （6.01 %） cases of severe obesity, and 24 （2.53 %） lean cases. Patients with follicular carcinoma included 19 cases （45.24 %） obese cases, 9 （21.43 %） normal cases, 7 （16.67 %） chubby cases, 4 （9.52 %） lean cases, and 3 （7.14 %） cases of severe obesity; Patients with medullary carcinoma included 4 obese cases, 3 chubby cases, and 2 normal cases; Patients with undifferentiated cancer included 3 normal cases, 2 obese cases, and 1 chubby case. There was no significant difference in BMI distribution among different pathological types of thyroid cancer patients （all P〉 0.05）. Conclusions The number of obesity and severe obesity in thyroid cancer patients is more than that in healthy people, while the number of lean and normal groups is less than that in healthy controls. Obesity may be related with thyroid cancer, which contributes to the risk assessment and prevention of thyroid cancer.