Zhang Jiao, Zhou Le, Dionigi Gianlorenzo, Zhang Daqi, Zhao Lina, Liang Nan, Xue Gaofeng, Sun Hui
Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Engineering Laboratory of Thyroid Disease Prevention and Control, Changchun, China.
Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital G. Martino, University of Messina, Messina, Italy.
Front Oncol. 2021 Mar 11;11:611471. doi: 10.3389/fonc.2021.611471. eCollection 2021.
To investigate the association between the presence of female-specific tumors and aggressive clinicopathological features in papillary thyroid cancer (PTC).
This study retrospectively analyzed 9,822 female cases between June 2008 and December 2017. Odds ratios and corresponding 95% confidence intervals were calculated. Findings were stratified by age and body mass index (BMI) in different models.
1443/9822 (14.7%) patients with PTC had a female-specific tumor. Presence of a benign breast mass was an independent risk factor for a primary PTC lesion > 1 cm in diameter (adjusted OR = 1.446, 95% CI 1.136-1.840, = 0.003), but a protective factor against extrathyroidal extension of PTC (adjusted OR = 0.650, 95%CI 0.500-0.845, = 0.001). Presence of a benign uterine mass was an independent risk factor for multifocal PTC (adjusted OR = 1.305, 95%CI 1.113-1.531, = 0.001). Analyses stratified by age and BMI revealed the presence of a benign breast mass was an independent risk factor for a primary PTC lesion > 1 cm in diameter in patients aged <36 years (adjusted OR = 1.711, 95% CI 1.063-2.754, = 0.027), and a protective factor against extrathyroidal extension of PTC in patients aged ≥36 - <42 years (OR adjusted = 0.533, 95% CI 0.302-0.941, = 0.030) or with a BMI ≥ 23.4 kg/m (BMI ≥ 23.4 to < 25.7 kg/m, adjusted OR = 0.441, 95% CI 0.246-0.792, = 0.006; BMI ≥25.7 kg/m, adjusted OR = 0.558, 95% CI 0.315-0.998, = 0.045). Presence of a benign uterine mass was an independent risk factor for multifocal PTC in patients aged ≥49 years (adjusted OR = 1.397, 95% CI 1.088-1.793, = 0.009) or with a BMI <21.5 kg/m (OR adjusted = 1.745, 95% CI 1.214-2.509, = 0.003).
The presence of a benign breast mass was an independent risk factor for a primary PTC lesion > 1 cm in diameter and a protective factor against extrathyroidal extension of PTC, while the presence of a benign uterine mass was an independent risk factor for multifocal PTC. Data from this study may help surgeons propose more personalized treatment plans when encountering patients with PTC and female-specific benign tumors.
探讨女性特异性肿瘤的存在与甲状腺乳头状癌（PTC）侵袭性临床病理特征之间的关联。
本研究回顾性分析了2008年6月至2017年12月期间的9822例女性病例。计算优势比及相应的95%置信区间。在不同模型中按年龄和体重指数（BMI）进行分层分析。
9822例PTC患者中，1443例（14.7%）有女性特异性肿瘤。存在良性乳腺肿块是直径>1 cm的原发性PTC病变的独立危险因素（校正OR = 1.446，95%CI 1.136 - 1.840，P = 0.003），但对PTC甲状腺外侵犯是一个保护因素（校正OR = 0.650，95%CI 0.500 - 0.845，P = 0.001）。存在良性子宫肿块是多灶性PTC的独立危险因素（校正OR = 1.305，95%CI 1.113 - 1.531，P = 0.001）。按年龄和BMI分层分析显示，存在良性乳腺肿块是年龄<36岁患者中直径>1 cm的原发性PTC病变的独立危险因素（校正OR = 1.711，95%CI 1.063 - 2.754，P = 0.027），是年龄≥36 - <42岁患者或BMI≥23.4 kg/m患者（BMI≥23.4至<25.7 kg/m，校正OR = 0.441，95%CI 0.246 - 0.792，P = 0.006；BMI≥25.7 kg/m，校正OR = 0.558，95%CI 0.315 - 0.998，P = 0.045）中PTC甲状腺外侵犯的保护因素。存在良性子宫肿块是年龄≥49岁患者（校正OR = 1.397, 95%CI 1.088 - 1.793, P = 0.009）或BMI<21.5 kg/m患者（校正OR = 1.745, 95%CI 1.214 - 2.509, P = 0.003）中多灶性PTC的独立危险因素。
存在良性乳腺肿块是直径>1 cm的原发性PTC病变的独立危险因素及PTC甲状腺外侵犯的保护因素，而存在良性子宫肿块是多灶性PTC的独立危险因素。本研究数据可能有助于外科医生在遇到患有PTC和女性特异性良性肿瘤的患者时提出更个性化的治疗方案。
