Wang Xuechang, Liu Wenjing, Zhao Mingjun
Department of Otorhinolaryngology Head and Neck Surgery，Zhongda Hospital Southeast University，Nanjing，210009，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Oct;37(10):796-800. doi: 10.13201/j.issn.2096-7993.2023.10.006.
To investigate the correlation between preoperative platelet parameters and the clinicopathological features of differentiated thyroid cancer. We retrospectively analyzed the medical records of patients with thyroid tumors admitted to Zhongda Hospital affiliated to Southeast University and healthy adults with normal physical examination results in our hospital from January 2019 to December 2020, and collected their general information and preoperative blood routine data. Patients with undifferentiated thyroid cancer, diabetes, coronary heart disease, hematological diseases, kidney diseases, autoimmune diseases, genetic diseases, infectious diseases, other systemic tumors, hepatitis or cirrhosis, or those taking anticoagulants were excluded. The exclusion criteria for healthy adults were the absence of the above diseases and normal physical examination results. Differences in platelet parameters among the three groups were compared, and the correlation between clinicopathological characteristics of thyroid cancer, accompanying cervical lymph node metastasis, and platelet parameters of patients was analyzed. A multivariate logistic regression model was used to analyze the risk factors of thyroid cancer with cervical lymph node metastasis. A total of 117 cases of differentiated thyroid cancer were collected, including 33 males and 84 females, with an average age of （41.64±12.25） years; 46 patients had benign thyroid tumors, including 15 males and 31 females, with an average age of （41.35±12.52） years; 50 healthy adults with normal physical examination results in our hospital during the same period were also included, including 18 males and 32 females, with an average age of（42.02±9.62） years, without underlying diseases. The platelet count of the differentiated thyroid cancer group was higher than that of the benign thyroid tumor group（=-2.219, =0.028） and the normal control group（=2.069, =0.04）, while the platelet distribution width of the differentiated thyroid cancer group was lower than that of the benign thyroid tumor group（=2.238, =0.027） and the normal control group（=-2.618, =0.002）. These differences were statistically significant. Preoperative age ≤45 years（χ²=4.225, =0.04）, tumor diameter>1 cm（χ²=4.415, =0.036）, PLT（=-4.018, <0.01） increase, and PDW（=4.568, <0.01） decrease were significantly correlated with cervical lymph node metastasis of thyroid cancer and had statistical significance. Univariate analysis showed that age ≤45 years（=0.447, 95% 0.206-0.970, =0.042）, tumor diameter>1 cm（=2.3, 95% 1.050-5.039, =0.037）, PLT（=1.012, 95% 1.005-1.019, =0.001）, and PDW（=0.693, 95% 0.518-0.827, <0.01） were risk factors for cervical lymph node metastasis of thyroid cancer. The results of multifactorial logistic regression analysis showed that PLT（=1.008, 95% 1.001-1.016, =0.026） and PDW（=0.692, 95% 0.564-0.848, <0.01） were independent risk factors for thyroid cancer with cervical lymph node metastasis. PLT and PDW may be useful predictive factors for the differentiation of thyroid cancer malignancy and central lymph node metastasis.
探讨术前血小板参数与分化型甲状腺癌临床病理特征之间的相关性。我们回顾性分析了2019年1月至2020年12月在东南大学附属中大医院收治的甲状腺肿瘤患者及本院体检结果正常的健康成年人的病历，收集了他们的一般信息和术前血常规数据。排除未分化甲状腺癌、糖尿病、冠心病、血液系统疾病、肾脏疾病、自身免疫性疾病、遗传性疾病、传染病、其他系统肿瘤、肝炎或肝硬化患者，以及正在服用抗凝剂的患者。健康成年人的排除标准为无上述疾病且体检结果正常。比较三组之间血小板参数的差异，并分析甲状腺癌临床病理特征、伴发颈部淋巴结转移与患者血小板参数之间的相关性。采用多因素logistic回归模型分析甲状腺癌伴颈部淋巴结转移的危险因素。共收集117例分化型甲状腺癌患者，其中男性33例，女性84例，平均年龄（41.64±12.25）岁；46例甲状腺良性肿瘤患者，其中男性15例，女性31例，平均年龄（41.35±12.52）岁；同期本院50例体检结果正常的健康成年人也纳入研究，其中男性18例，女性32例，平均年龄（42.02±9.62）岁，无基础疾病。分化型甲状腺癌组血小板计数高于甲状腺良性肿瘤组（=-2.219，=0.028）和正常对照组（=2.069，=0.04），而分化型甲状腺癌组血小板分布宽度低于甲状腺良性肿瘤组（=2.238，=0.027）和正常对照组（=-2.618，=0.002）。这些差异具有统计学意义。术前年龄≤45岁（χ²=4.225，=0.04）、肿瘤直径>1 cm（χ²=4.415，=0.036）、血小板计数升高（=-4.018，<0.01）和血小板分布宽度降低（=4.568，<0.01）与甲状腺癌颈部淋巴结转移显著相关且具有统计学意义。单因素分析显示，年龄≤45岁（=0.447，95% 0.206 - 0.970，=0.042）、肿瘤直径>1 cm（=2.3，95% 1.050 - 5.039，=0.037）、血小板计数（=1.012，95% 1.005 - 1.019，=0.001）和血小板分布宽度（=0.693，95% 0.518 - 0.827，<0.01）是甲状腺癌颈部淋巴结转移的危险因素。多因素logistic回归分析结果显示，血小板计数（=1.008，95% 1.001 - 1.016，=0.026）和血小板分布宽度（=0.692，95% 0.564 - 0.848，<0.01）是甲状腺癌伴颈部淋巴结转移的独立危险因素。血小板计数和血小板分布宽度可能是甲状腺癌恶性程度及中央区淋巴结转移的有用预测因素。
