Department of Trauma Center and Burns, The First Hospital of China Medical University, Shenyang, Liaoning Province, China.
Department of Anorectal, The First Hospital of China Medical University, Shenyang, Liaoning Province, China.
Medicine (Baltimore). 2021 Aug 13;100(32):e26882. doi: 10.1097/MD.0000000000026882.
Papillary thyroid carcinoma (PTC) incidence has been increasing worldwide. Obesity, that is, having a high body mass index, is associated with the incidence of several cancers including colon, breast, esophageal, and kidney cancer. However, the association between obesity and the clinical features of PTC is still unknown. This study aimed to determine the impact of obesity on the clinical features of PTC.
A database search was conducted for articles published up to 2020 on obesity and clinical features of PTC. Data were extracted from articles that met the meta-analysis inclusion criteria.
A total of 11 retrospective cohorts and 11,729 patients were included. Obesity was associated with the following variables in PTC patients: older age (difference in means = 1.95, 95% confidence interval [CI] 0.16-3.74, P = .03), male sex (odds ratio [OR] = 3.13, 95%CI 2.24-4.38, P < .00001), tumor size ≥1 cm (OR = 1.34, 95%CI 1.11-1.61, P < .002), multifocality (OR = 1.54, 95%CI 1.27-1.88, P < .0001), extrathyroidal extension (OR = 1.78, 95%CI 1.22-2.59, P = .003) and advanced tumor, node, metastasis stage (OR = 1.68, 95%CI 1.44-1.96, P < .00001). Preoperative serum thyroid-stimulating hormone level (difference in means = 0.09, 95%CI 0.35-0.52, P = .70), Vascular invasion (OR = 0.84, 95%CI 0.56-1.26, P = .41), lymph node metastasis (OR = 1.07, 95%CI 0.87-1.32, P = .50), distant metastasis (OR = 1.14, 95%CI 0.64-2.04, P = .66), and recurrence (OR = 1.45, 95%CI 0.97-2.15, P = .07) were not associated with obesity.
Obesity was associated with several poor clinicopathologic prognostic features: older age, male gender, tumor size ≥1 cm, extrathyroidal extension, multifocality, and advanced tumor/node/metastasis stage. However, thyroid-stimulating hormone level, vascular invasion, lymph node metastasis, distant metastasis, and recurrence were not associated with obesity in PTC.
甲状腺乳头状癌（PTC）的发病率在全球范围内呈上升趋势。肥胖，即体重指数较高，与包括结肠癌、乳腺癌、食管癌和肾癌在内的几种癌症的发病率有关。然而，肥胖与 PTC 临床特征之间的关系尚不清楚。本研究旨在确定肥胖对 PTC 临床特征的影响。
对截至 2020 年发表的关于肥胖和 PTC 临床特征的文章进行数据库检索。从符合荟萃分析纳入标准的文章中提取数据。
共纳入 11 项回顾性队列研究和 11729 例患者。肥胖与 PTC 患者的以下变量相关：年龄较大（平均值差异=1.95，95%置信区间[CI]0.16-3.74，P=0.03）、男性（比值比[OR]=3.13，95%CI 2.24-4.38，P<0.00001）、肿瘤大小≥1cm（OR=1.34，95%CI 1.11-1.61，P<0.002）、多灶性（OR=1.54，95%CI 1.27-1.88，P<0.0001）、甲状腺外延伸（OR=1.78，95%CI 1.22-2.59，P=0.003）和晚期肿瘤、淋巴结、转移分期（OR=1.68，95%CI 1.44-1.96，P<0.00001）。术前血清促甲状腺激素水平（平均值差异=0.09，95%CI 0.35-0.52，P=0.70）、血管侵犯（OR=0.84，95%CI 0.56-1.26，P=0.41）、淋巴结转移（OR=1.07，95%CI 0.87-1.32，P=0.50）、远处转移（OR=1.14，95%CI 0.64-2.04，P=0.66）和复发（OR=1.45，95%CI 0.97-2.15，P=0.07）与肥胖无关。
肥胖与多种不良临床病理预后特征有关：年龄较大、男性、肿瘤大小≥1cm、甲状腺外延伸、多灶性和晚期肿瘤/淋巴结/转移分期。然而，PTC 中促甲状腺激素水平、血管侵犯、淋巴结转移、远处转移和复发与肥胖无关。
