Fan Lijun, Tian Qiushi, Xiu Cheng, Wang Fengqian, Yuan Zhennan, He Qian, Guo Lunhua, Sun Qihao, Yang Xianguang, Miao Susheng, Sun Ji, Sun Dianjun
Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.
Department of Head and Neck Oncology, The Third Affiliated Hospital of Harbin Medical University, Harbin, China.
Ann Nutr Metab. 2021;77(2):90-99. doi: 10.1159/000513334. Epub 2021 Jul 21.
The aim of this study was to retrospectively identify the effect of iodine on the papillary thyroid cancer (PTC) process and investigate the risk clinicopathologic characteristics of cervical lymph node metastasis (CLNM) for achieving a better preventive strategy of PTC.
Totally 187 patients with CLNM and 279 without CLNM (NCLNM) were enrolled, and their urinary iodine concentration (UIC) and serum iodine concentration (SIC) were measured. Logistic regressions were used to reveal the effects of iodine nutrition on the CLNM status of PTC.
The levels of thyroid-stimulating hormone (TSH) and thyroglobulin (TG) were higher in the CLNM group than in the NCLNM group. UIC and SIC were positively correlated, and both of them were correlated with TSH, free thyroxine, and TG. The proportions of UIC >300 μg/L and of SIC >90 μg/L were higher in the CLNM than in the NCLNM. Logistic analysis showed that SIC >90 μg/L was an independent predictor for CLNM in PTC. Additionally, age ≥45, female, TG, multifocality, and diameter of cancer invasion >1 cm also affected CLNM status in PTC, and their logistic regression model showed a certain diagnostic accuracy (area under the receiver-operating characteristic curve = 0.72).
Relatively high iodine nutrition seemed to be a significant risk factor for the occurrence of CLNM in PTC and may promote lymphatic metastasis in PTC.
本研究旨在回顾性确定碘对甲状腺乳头状癌（PTC）进程的影响，并调查颈部淋巴结转移（CLNM）的风险临床病理特征，以制定更好的PTC预防策略。
共纳入187例有CLNM的患者和279例无CLNM（NCLNM）的患者，测量他们的尿碘浓度（UIC）和血清碘浓度（SIC）。采用逻辑回归分析来揭示碘营养对PTC患者CLNM状态的影响。
CLNM组的促甲状腺激素（TSH）和甲状腺球蛋白（TG）水平高于NCLNM组。UIC和SIC呈正相关，且二者均与TSH、游离甲状腺素和TG相关。CLNM组中UIC>300μg/L和SIC>90μg/L的比例高于NCLNM组。逻辑分析表明，SIC>90μg/L是PTC患者CLNM的独立预测因素。此外，年龄≥45岁、女性、TG、多灶性以及癌灶浸润直径>1cm也影响PTC患者的CLNM状态，其逻辑回归模型显示出一定的诊断准确性（受试者操作特征曲线下面积=0.72）。
相对高的碘营养似乎是PTC发生CLNM的一个重要危险因素，可能促进PTC的淋巴转移。
