Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
Second Department of Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui, China.
Biometals. 2021 Aug;34(4):909-921. doi: 10.1007/s10534-021-00317-w. Epub 2021 May 7.
Aim of this study was to evaluate the association between multiple essential microelements exposure and the aggressive clinicopathologic characteristics of papillary thyroid carcinoma (PTC). The concentrations of 10 essential microelements in urine [cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), strontium (Sr), zinc (Zn), and iodine (I)] were measured in 608 patients newly diagnosed with PTC, including 154 males and 454 females. Chi square test and Wilcoxon rank sum test were used to compare general characteristics among males and females. Multivariate logistic regression was used to evaluate the associations between essential microelements and PTC clinicopathologic characteristics in single- and multi-microelement models. In this study, we only observed that the frequency of lymph node metastasis in males was higher than in females, and males had higher levels of zinc than females, but males had lower levels of iodine than females. It was found that high levels of Fe were associated with decreased risk of PTC tumor size > 1 cm, capsular invasion, and advanced T stage (T3/4a/4b). High levels of Co and Mo were associated with decreased risk of capsular invasion and lymph node metastasis, respectively. However, high levels of Mn and Sr were associated with increased risk of capsular invasion and multifocality respectively, and both were associated with increased risk of advanced T stage (T3/4a/4b). These findings indicated that certain essential microelements might have potential effects on PTC progression and aggressiveness. Further studies are required to confirm these findings.
本研究旨在评估多种必需微量元素暴露与甲状腺乳头状癌（PTC）侵袭性临床病理特征之间的关联。对 608 例新诊断为 PTC 的患者（包括 154 名男性和 454 名女性）尿液中的 10 种必需微量元素（钴（Co）、铬（Cr）、铜（Cu）、铁（Fe）、锰（Mn）、钼（Mo）、硒（Se）、锶（Sr）、锌（Zn）和碘（I））浓度进行了测量。使用卡方检验和 Wilcoxon 秩和检验比较了男性和女性之间的一般特征。使用多变量逻辑回归在单元素和多元素模型中评估必需微量元素与 PTC 临床病理特征之间的关系。在本研究中，我们仅观察到男性的淋巴结转移频率高于女性，男性的锌水平高于女性，但男性的碘水平低于女性。研究发现，高水平的 Fe 与 PTC 肿瘤大小＞1cm、包膜侵犯和晚期 T 分期（T3/4a/4b）的风险降低有关。高水平的 Co 和 Mo 与包膜侵犯和淋巴结转移风险降低有关，而高水平的 Mn 和 Sr 与包膜侵犯和多灶性风险增加有关，且均与晚期 T 分期（T3/4a/4b）的风险增加有关。这些发现表明某些必需微量元素可能对 PTC 的进展和侵袭性具有潜在影响。需要进一步的研究来证实这些发现。
