老年甲状腺癌患者术前血脂、尿酸水平与术后淋巴结转移的相关性

Correlation between preoperative blood lipid,uric acid levels and postoperative cervical lymph node metastasis in senile patients with thyroid cancer

目的:探讨老年甲状腺癌患者术前血脂、尿酸水平与患者术后颈淋巴结转移的关系。方法:回顾性分析,收集2017年4月至2019年10月期间我院完成手术治疗与随访的141例老年甲状腺癌患者作为甲状腺癌组,并收集同期我院体检证实为健康的138例老年人群作为对照组,检测并比较两组血脂及尿酸水平,根据老年甲状腺癌患者术后有无发生颈淋巴结转移将其分为转移组与未转移组,对比两组血脂及尿酸水平,分析血脂水平与尿酸水平之间的相关性及其各自与老年甲状腺癌患者术后颈淋巴结转移的关系。结果:甲状腺癌组与对照组HDL-C水平对比,差异无统计学意义(P>0.05);甲状腺癌组TG、TC、LDL-C水平均高于对照组,尿酸水平低于对照组,差异有统计学意义(P<0.05);141例老年甲状腺癌患者转移80例;转移组与未转移组HDL-C水平对比,差异无统计学意义(P>0.05);转移组TG、TC、LDL-C水平均高于未转移组,尿酸水平低于未转移组,差异有统计学意义(P<0.05);相关性分析结果显示,老年甲状腺癌血脂各主要指标与尿酸两两间均呈正相关(r>0,P<0.05);经回归分析结果显示,术前TG、TC、LDL-C高表达、尿酸低表达是术后颈淋巴结转移的影响因素(OR>1,P<0.05);经ROC曲线分析结果显示,术前TG、TC、LDL-C及尿酸水平预测老年甲状腺癌术后颈淋巴结转移的曲线下面积(AUC)均>0.80,预测价值较理想。结论:术前TG、TC、LDL-C、尿酸表达异常均可能是老年甲状腺癌患者术后颈淋巴结转移的影响因素,临床可通过检测患者术前TG、TC、LDL-C及尿酸水平预测术后颈淋巴结转移风险,为术后制定合理化康复方案提供指导。

Objective:To investigate the relationship between preoperative blood lipid,uric acid levels and postoperative cervical lymph node metastasis of patients.Methods:The retrospective analysis was performed,and 141 senile patients with thyroid cancer who completed surgical treatment and follow-up in the hospital from April 2017 to October 2019 were collected as thyroid cancer group,and 138 senile people who were confirmed as healthy by physical examination in the hospital during the same period were taken as control group.The levels of blood lipid and uric acid were detected and compared between the two groups,and senile patients with thyroid cancer were divided into metastatic group and non-metastatic group according to the occurrence of postoperative cervical lymph node metastasis.The blood lipid and uric acid levels of the two groups were compared,and the correlation between blood lipid level and uric acid level and their relationship with cervical lymph node metastasis in elderly patients with thyroid cancer after surgery were analyzed.Results:There was no statistical difference in the level of HDL-C between thyroid cancer group and control group(P>0.05).The levels of TG,TC and LDL-C in thyroid cancer group were higher than those in control group,and the level of uric acid in thyroid cancer group was lower than that in control group(P<0.05).There were 80 cases of metastasis in 141 senile patients with thyroid cancer.There was no statistical difference in the level of HDL-C between metastatic group and non-metastatic group(P>0.05).The levels of TG,TC and LDL-C in metastatic group were higher than those in non-metastatic group,and the level of uric acid in metastatic group was lower than that in non-metastatic group(P<0.05).The correlation results showed that the main blood lipid indexes were positively correlated with uric acid in senile patients with thyroid cancer(r>0,P<0.05).The results of regression analysis showed that high expression of preoperative TG,TC,LDL-C and low expression of uric acid were the influencing factors of postoperative cervical lymph node metastasis(OR>1,P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of preoperative TG,TC,LDL-C and uric acid levels in predicting postoperative cervical lymph node metastasis in senile thyroid cancer surgery was greater than 0.80,whose predictive value was ideal.Conclusion:Abnormal expression of preoperative TG,TC,LDL-C and uric acid may be the influencing factors of postoperative cervical lymph node metastasis in senile patients with thyroid cancer.Clinically,the risk of postoperative cervical lymph node metastasis can be predicted by detecting preoperative TG,TC,LDL-C and uric acid levels,thus providing guidance for the development of rational postoperative rehabilitation programs.