Matrone Antonio, Basolo Alessio, Santini Ferruccio, Elisei Rossella
Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy.
Expert Rev Endocrinol Metab. 2022 Nov;17(6):475-484. doi: 10.1080/17446651.2022.2131529. Epub 2022 Oct 6.
Several studies have focused on the relationship between obesity and differentiated thyroid carcinoma (DTC), particularly papillary histotype (PTC). However, the association of obesity with both incidence and aggressiveness of PTC is still incompletely understood.
We reviewed the mechanisms underlying the cross talk between obesity and thyroid carcinomas and described the most recent evidence evaluating the effect of obesity on the development of PTC, as well as the impact of excessive body weight on the clinicopathologic features and outcome of this type of cancer.
Available evidence suggests that excessive body weight is linked with a higher risk of getting PTC, while its impact on the aggressiveness of the disease, if present, is still not clear. Therefore, while attention should be paid to discover thyroid cancer in patients with obesity earlier, once diagnosed it should be managed following a conventional workup as in normal weight patients, based on the clinical presentation of the disease and including active surveillance if appropriate, as recommended by referral guidelines.
多项研究聚焦于肥胖与分化型甲状腺癌（DTC），尤其是乳头状组织学类型（PTC）之间的关系。然而，肥胖与PTC的发病率及侵袭性之间的关联仍未完全明确。
我们回顾了肥胖与甲状腺癌之间相互作用的潜在机制，并阐述了评估肥胖对PTC发生发展的影响，以及超重对这类癌症临床病理特征和预后影响的最新证据。
现有证据表明，超重与患PTC的较高风险相关，而其对疾病侵袭性的影响（若存在）仍不明确。因此，虽然应关注在肥胖患者中更早发现甲状腺癌，但一旦确诊，应根据疾病的临床表现，按照正常体重患者的常规检查流程进行处理，包括在适当情况下进行主动监测，如参考指南所推荐。
