身高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

Correlation analysis of body mass index and clinicopathological characteristics of papillary thyroid carcinoma

目的:本研究探讨身高体质量指数(BMI)与甲状腺乳头状癌(PTC)临床病理特征的相关性。方法:回顾性分析2018年1月1日至2018年12月31日于郑州大学第一附属医院甲状腺外科进行手术治疗的PTC患者临床资料。根据BMI指数将PTC患者分为低体质量组、正常体质量组、超重组和肥胖组。采用单因素及多因素分析等比较不同BMI分组的PTC患者的临床病理特征,采用ROC曲线分析BMI与颈部淋巴结转移的关系。结果:单因素分析显示,性别、肿瘤最大径、中央区淋巴结转移、颈侧区淋巴结转移、包膜侵犯、BRAF基因突变、多灶性及TNM分期在不同BMI分组中的差异有统计学意义(均P<0.05);多因素分析显示,年龄>55岁是颈部淋巴结转移的保护因素,高BMI及肿瘤最大径>10 mm是颈部淋巴结转移的危险因素(均P<0.05)。ROC曲线结果显示,BMI>24.19 kg·m^(-2)的男性患者,以及BMI>24.09 kg·m^(-2)的女性患者,颈部淋巴结转移风险升高。结论:本研究显示低体质量、超重、肥胖均和PTC的某些不良临床病理因素相关。BMI>24.19 kg·m^(-2)的男性患者,以及BMI>24.09 kg·m^(-2)的女性患者,颈部淋巴结转移风险升高,术前需要更加详细的检查评估患者的病灶情况。

Objective:This study was designed to explore the correlation between body mass index(BMI)and clinicopathological characteristics of papillary thyroid carcinoma(PTC).Methods:The clinical data of patients who underwent surgical treatment in the department of thyroid surgery of the First Affiliated Hospital of Zhengzhou University from January 1,2018 to December 31,2018 were retrospectively analyzed.They were assigned to the underweight group,the normal weight group,the overweight group and the obese group according to BMI.Univariate and multivariate analyses were used to compare the clinicopathological characteristics of PTC patients with different BMI groups.The relationship between BMI and cervical lymph node metastasis was analyzed by ROC curve.Results:In the univariate analysis,there was a statistically significant difference in gender,central lymph node metastasis,cervical lateral lymph node metastasis,capsule invasion,BRAF gene mutation,multifocal,TNM stage and tumor maximum diameter among different BMI groups(all P<0.05).Multivariate analysis showed that age>55 years was a protective factor for cervical lymph node metastasis,while high BMI and maximum tumor diameter>10 mm were risk factors for cervical lymph node metastasis(all P<0.05).The ROC curve results suggested a higher risk of cervical lymph node metastasis in men with a BMI of>24.19 kg·m^(-2) and women with a BMI of>24.09 kg·m^(-2).Conclusion:This study showed that low body weight,overweight,and obesity were all associated with some adverse clinicopathological features of PTC.There were high risk of cervical lymph node metastasis in male patients with BMI>24.19 kg·m^(-2) and female patients with BMI>24.09 kg·m^(-2),who needed more detailed preoperative examination to evaluate the tumor status.