1 Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine , Seoul, Korea.
2 Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine , Seoul, Korea.
Thyroid. 2016 Mar;26(3):429-33. doi: 10.1089/thy.2015.0516. Epub 2016 Feb 9.
Vitamin D deficiency has been known to be associated with the aggressiveness and prognosis of several cancers. This study evaluated the effect of preoperative serum vitamin D levels on the aggressiveness and prognosis of papillary thyroid cancer (PTC).
In total, 820 patients with PTC were enrolled. 25-hydroxyvitamin D levels were measured in blood samples before surgery. Clinical, pathologic, and recurrence data were accessed to examine the prognostic effects of vitamin D. Patients were categorized into four quartiles by preoperative serum vitamin D levels.
Of the enrolled patients, 795 (97%) had insufficient vitamin D levels (<30 ng/mL). Vitamin D levels showed positive correlations with age and body mass index (BMI), and negative correlations with serum thyrotropin levels and antithyroid peroxidase antibody titers. The association between vitamin D quartile and the risks of extrathyroidal invasion, lymph node metastasis, advanced cancer stages (III or IV), and risk of recurrence were not significant after adjusting for age, sex, BMI, preoperative ionized calcium, and parathyroid hormone. Additionally, serum vitamin D was not associated with recurrent or persistent PTC.
Serum vitamin D levels are not associated with either disease aggressiveness or poor outcomes among patients with PTC and vitamin D insufficiency.
维生素 D 缺乏与多种癌症的侵袭性和预后有关。本研究评估了术前血清维生素 D 水平对甲状腺乳头状癌（PTC）侵袭性和预后的影响。
共纳入 820 例 PTC 患者。在术前采集血样检测 25-羟维生素 D 水平。查阅临床、病理和复发数据，以检验维生素 D 的预后作用。根据术前血清维生素 D 水平将患者分为四组。
820 例患者中，795 例（97%）存在维生素 D 不足（<30ng/mL）。维生素 D 水平与年龄和体重指数（BMI）呈正相关，与促甲状腺激素水平和抗甲状腺过氧化物酶抗体滴度呈负相关。在校正年龄、性别、BMI、术前离子钙和甲状旁腺激素后，维生素 D 四分位组与甲状腺外侵犯、淋巴结转移、晚期癌症分期（III 或 IV 期）和复发风险之间无显著关联。此外，血清维生素 D 与 PTC 复发或持续存在无关。
在维生素 D 不足的 PTC 患者中，血清维生素 D 水平与疾病侵袭性或不良预后无关。
