体质量指数与甲状腺乳头状癌临床病理特征的相关性分析

Relationship between body mass index and the clinicopathologic features of papillary thyroid carcinoma

目的:分析体质量指数(body mass index,BMI)与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)临床病理特征的相关性。方法:回顾性分析2017年1月至2018年6月于西京医院甲乳血管外科行手术的829例PTC患者临床资料,并将入组患者根据BMI的不同分为四组:较轻组(BMI<18.5 kg/m2)、正常组(18.5≤BMI<25 kg/m2)、超重组(25≤BMI<30 kg/m2)及肥胖组(BMI≥30 kg/m2)。通过单因素分析及多元逻辑回归分析BMI与PTC临床病理特征相关性。结果:不同BMI组PTC患者的年龄、性别以及高血压病史之间具有统计学差异(P<0.001)。超重组患者与其他组相比平均年龄较大,肥胖组患者男性居多。单因素分析显示,BMI与肿瘤多灶性、BRAF V600E基因突变以及TNM分期显著相关(P<0.05),而与病灶大小、病灶分布、是否侵犯包膜以及淋巴结转移数目和位置无关(P>0.05)。BMI正常组患者的肿瘤发生灶多为单灶(60.3%),而非正常组患者多灶的发生率显著增加(P=0.040)。随着BMI的增长,BRAF V600E基因突变率显著提高(P=0.001)。经多元逻辑回归分析的校正,PTC患者的TNM分期与BMI无统计学差异(P>0.05),肿瘤多灶性以及BRAF V600E基因突变仍与BMI显著相关。结论:在PTC患者中,非正常BMI组患者肿瘤多灶的发生率较正常BMI组显著增加,且BRAF V600E基因突变率与BMI呈正比,而除多灶性以外的侵袭性病理特征与BMI之间未发现相关性。

Objective:To analyze the relationship between body mass index(BMI)and clinicopathologic features of papillary thyroid carcinoma(PTC).Methods:The medical records of 829 thyroid carcinoma patients were reviewed in this retrospective study.All patients were diagnosed at Xijing Hospital between January 2017 and June 2018.The World Health Organization BMI classification was used to classify patients as underweight(BMI<18.5 kg/m2),normal(18.5≤BMI<25 kg/m2),overweight(25≤BMI<30 kg/m2)or obese(BMI≥30 kg/m2).The correlation was analyzed by univariate analysis and multinomial logistic regression.Results:There were significant differences between BMI and several epidemiological features,including age,gender,and history of hypertension of PTCs(P<0.001).Univariate analysis showed that BMI was significantly associated with tumor multifocality,BRAF V600E mutation,and TNM stage(P<0.05).However,no association was found between BMI and tumor size,tumor site,extrathyroidal invasion,or lymph node metastasis(P>0.05).Most of tumor was single lesion in the normal BMI group(60.3%),and the incidence of multiple lesions was significantly increased in the non-normal group(P=0.040).With the increase of BMI,the rate of BRAF V600E mutation was significantly increased(P=0.001).The association between BMI and TNM stage was insignificant after multivariate adjustment.Conclusion:Except for multifocality,no correlation was found between aggressive clinicopathological features and BMI in PTC patients.