2021 年第 3 期 第 16 卷

甲状腺乳头状癌的危险因素分析

Risk factors of papillary thyroid carcinoma

作者：贾明扬1贺建业1陈东2商建峰2汪昊2董方2

英文作者：Jia Mingyang1 He Jianye1 Chen Dong2 Shang Jianfeng2 Wang Hao2 Dong Fang2

单位：1首都医科大学附属北京安贞医院普外科100029；2首都医科大学附属北京安贞医院病理科100029

英文单位：1Department of General Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Pathology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：甲状腺乳头状癌；体重指数；甲状腺功能；淋巴结转移

英文关键词：Papillarythyroidcarcinoma;Bodymassindex;Thyroidfunction;Lymphnodemetastasis

• 摘要：

• 目的 探讨甲状腺乳头状癌（PTC）的危险因素。方法 收集首都医科大学附属北京安贞医院2013年1月至2019年6月行手术切除的886例甲状腺肿瘤患者临床资料，根据其术后病理分为PTC组（430例）和甲状腺良性肿瘤组（对照组，456例）。比较2组术前基线资料、血脂和甲状腺功能指标异常比例以及不同肥胖程度组PTC患者的肿瘤特征。结果 PTC组平均年龄低于对照组［(44±12)岁比（49±13）岁］，体重指数以及血清抗甲状腺过氧化物酶抗体、抗甲状腺球蛋白抗体（TG-Ab）升高比例均高于对照组［（24.8±2.7）kg/m2比（23.7±3.0）kg/m2，24.0%(103/430)比13.8%（63/456），21.4%(92/430)比10.7%（49/456）］（均P＜0.05）。Logistic回归分析结果表明，年龄（比值比=0.971，95%置信区间：0.960~0.981，P＜0.001）为PTC的保护因素，体重指数（比值比=1.867，95%置信区间：1.462~2.385，P＜0.001）和血清TG-Ab水平（比值比=1.770，95%置信区间：1.085~2.887，P=0.022）为PTC的危险因素。根据肥胖程度将PTC患者分为低体重指数组（10例）、正常体重指数组（251例）、超重组（158例）、肥胖组（11例），超重组PTC患者淋巴结转移发生率高于正常体重指数组［62.0%(98/158)比40.6%（102/251）］（P＜0.05）。结论 年龄、体重指数和血清TG-Ab水平为PTC患者的影响因素，与正常体重指数组比较，超重组PTC患者淋巴结转移发生率更高。

• Objective To investigate the risk factors of papillary thyroid carcinoma (PTC). Methods The clinical data of 886 patients with thyroid tumors who underwent surgical resection in Beijing Anzhen Hospital, Capital Medical University from January 2013 to June 2019 were collected. They were divided into PTC group (430 cases) and benign thyroid tumor group (control group, 456 cases) according to postoperative pathology. The preoperative baseline data, abnormal proportions of blood lipid and thyroid function indexes were compared between the two groups. Tumor characteristics of PTC patients in different degrees of obesity groups were compared. Results The average age of PTC group was lower than that of control group ［(44±12)years vs (49±13)years］, while body mass index (BMI), the proportions of serum  thyroid peroxidase antibody and thyroid globulin antibody (TG-Ab) in PTC group were higher than those in control group ［(24.8±2.7)kg/m2 vs (23.7±3.0)kg/m2, 24.0%(103/430) vs 13.8%(63/456), 21.4%(92/430) vs 10.7%(49/456)］(all P<0.05). Logistic regression analysis showed that age ［odds ratio(OR)=0.971, 95% confidence interval(CI): 0.960-0.981, P<0.001］ was the protective factor of PTC, while BMI (OR=1.867, 95%CI: 1.462-2.385, P<0.001) and serum TG-Ab level (OR=1.770, 95%CI: 1.085-2.887, P=0.022) were risk factors for PTC. According to obesity degrees, PTC patients were divided into low BMI group (10 cases), normal BMI group (251 cases), overweight group (158 cases) and obesity group (11 cases). Lymph node metastasis rate of PTC patients in overweight group was higher than that of normal BMI group ［62.0%(98/158) vs 40.6%(102/251)］(P<0.05). Conclusions Age, BMI and serum TG-Ab level are the influencing factors of PTC patients. Compared with normal BMI group, the lymph node metastasis rate of PTC patients in overweight group is higher.