Choi Ji Soo, Kim Eun-Kyung, Moon Hee Jung, Kwak Jin Young
Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Endocrine. 2015 Feb;48(1):264-71. doi: 10.1007/s12020-014-0293-z. Epub 2014 May 25.
Recently, higher body mass index (BMI) has been associated with aggressive pathologic features of papillary thyroid carcinoma. The aim of this study was to clarify the relationship between BMI and aggressive pathologic features of papillary thyroid microcarcinoma (PTMC) and to evaluate whether the BMI can be a prognostic factor of PTMC. This retrospective study included 612 PTMC patients who underwent surgical excision at a referral center between April 2006 and December 2007. Patients were grouped according to BMI (<25 or ≥25 kg/m2). Multivariable logistic regression analysis was performed to determine independent predictors of aggressive pathologic features (advanced stage, extrathyroidal extension, and lymph node metastasis), with adjustment for age, gender, tumor size, multifocality, thyroid stimulating hormone (TSH) level, and BMI (value/group). PTMC patients with a BMI≥25 kg/m2 showed significantly higher prevalences of extrathyroidal extension, advanced pathologic TNM stage, and male gender, compared to those of patients with a BMI<25 kg/m2. Lymph node metastasis and mean TSH level were not significantly different between the two BMI subgroups. In multivariable analysis, the BMI≥25 kg/m2 group was positively associated with the presence of extrathyroidal extension (adjusted odds ratio 1.49, P=0.05). Higher BMI was associated with extrathyroidal extension in PTMC patients. This study suggests that the BMI could be considered as a prognostic factor for predicting the presence of extrathyroidal extension and it may help decide the appropriate surgical extent for PTMC patients.
最近，较高的体重指数（BMI）已与甲状腺乳头状癌的侵袭性病理特征相关联。本研究的目的是阐明BMI与甲状腺微小乳头状癌（PTMC）侵袭性病理特征之间的关系，并评估BMI是否可作为PTMC的预后因素。这项回顾性研究纳入了2006年4月至2007年12月期间在一家转诊中心接受手术切除的612例PTMC患者。患者根据BMI（<25或≥25 kg/m²）分组。进行多变量逻辑回归分析以确定侵袭性病理特征（晚期、甲状腺外侵犯和淋巴结转移）的独立预测因素，并对年龄、性别、肿瘤大小、多灶性、促甲状腺激素（TSH）水平和BMI（值/组）进行校正。与BMI<25 kg/m²的患者相比，BMI≥25 kg/m²的PTMC患者甲状腺外侵犯、高级别病理TNM分期和男性的患病率显著更高。两个BMI亚组之间的淋巴结转移和平均TSH水平无显著差异。在多变量分析中，BMI≥25 kg/m²组与甲状腺外侵犯的存在呈正相关（校正比值比1.49，P = 0.05）。较高的BMI与PTMC患者的甲状腺外侵犯相关。本研究表明，BMI可被视为预测甲状腺外侵犯存在的预后因素，并且它可能有助于确定PTMC患者合适的手术范围。
