Ma Maoguang, Wang Mingdian, Zhang Zhanqiang, Lin Bo, Sun Zicheng, Guan Haoyan, Lv Weiming, Li Jie
Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan II Road, No 58, Guangzhou, 510000, China.
State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
BMC Endocr Disord. 2021 Apr 14;21(1):69. doi: 10.1186/s12902-021-00714-9.
Papillary thyroid cancer (PTC) is the most common type of thyroid cancer and the incidence of PTC has continued to increase over the past decades. Many studies have shown that obesity is an independent risk factor for PTC and obese PTC patients tend to have a relative larger tumor size and higher grade of tumor stage. Obesity is associated with disordered lipid metabolism and the relationship between serum lipids and PTC remains unclear. Therefore, this study aimed to investigate the association between serum lipid level and PTC.
We retrospectively analyzed 1018 PTC patients diagnosed and treated in our hospital, all these cases were first diagnosed with PTC and had complete clinical information including ultrasound reports before surgery, serum lipid (CHOL, TG, HDL-c, LDL-c, Apo-A1, Apo-B, Apo-E) results, surgical records and pathological reports.
None of these lipid markers were associated with tumor size in the whole cohort and in the female group. In the male group, on crude analysis, Apo-A1 showed a marginally association with tumor size, [OR = 0.158 (0.021-1.777)], p = 0.072. After adjusting for age and multifocality, Apo-A1 showed a significant association with tumor size [OR = 0.126 (0.016-0.974)], p = 0.047. This association become more apparent in a young male subgroup, [OR = 0.051 (0.005-0.497)], p = 0.009. CHOL, TG, HDL-c, LDL-c, Apo-B, Apo-E did not show significant association with tumor size. As for LNM, neither in the male group nor in the female group were found to be associated with any serum lipid biomarkers.
As PTC incidences continues to increase, our findings demonstrated a negatively association between PTC and apoA-1 in male PTC patients, which may contribute to further investigation concerning diagnosing and preventing this most common type of thyroid cancer.
甲状腺乳头状癌（PTC）是最常见的甲状腺癌类型，在过去几十年中，PTC的发病率持续上升。许多研究表明，肥胖是PTC的独立危险因素，肥胖的PTC患者往往肿瘤体积相对较大，肿瘤分期较高。肥胖与脂质代谢紊乱有关，血清脂质与PTC之间的关系仍不清楚。因此，本研究旨在探讨血清脂质水平与PTC之间的关联。
我们回顾性分析了在我院诊断和治疗的1018例PTC患者，所有这些病例均首次诊断为PTC，并拥有完整的临床信息，包括术前超声报告、血清脂质（CHOL、TG、HDL-c、LDL-c、Apo-A1、Apo-B、Apo-E）结果、手术记录和病理报告。
在整个队列和女性组中，这些脂质标志物均与肿瘤大小无关。在男性组中，粗分析显示，Apo-A1与肿瘤大小有微弱关联，[OR = 0.158（0.021 - 1.777）]，p = 0.072。在调整年龄和多灶性后，Apo-A1与肿瘤大小有显著关联[OR = 0.126（0.016 - 0.974）]，p = 0.047。这种关联在年轻男性亚组中更为明显，[OR = 0.051（0.005 - 0.497）]，p = 0.009。CHOL、TG、HDL-c、LDL-c、Apo-B、Apo-E与肿瘤大小均无显著关联。至于淋巴结转移（LNM），在男性组和女性组中均未发现与任何血清脂质生物标志物有关联。
随着PTC发病率持续上升，我们的研究结果表明男性PTC患者中PTC与载脂蛋白A-1呈负相关，这可能有助于进一步研究这种最常见的甲状腺癌的诊断和预防。
