Ding Haoran, Xu Fazhan, Guan Wenxian, Sang Jianfeng
Division of Thyroid Surgery, Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Division of Thyroid Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Gland Surg. 2024 Aug 31;13(8):1400-1407. doi: 10.21037/gs-24-164. Epub 2024 Aug 23.
Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid gland, with lymph node metastasis significantly affecting patient prognosis. In recent years, body mass index (BMI) has garnered widespread attention as a potential factor influencing cancer development. This study aimed to explore the relationship between BMI and lymph node metastasis in patients with PTC, particularly focusing on the risk of metastasis in the lateral and central neck compartments.
This retrospective study comprised 993 patients who underwent surgical treatment and were pathologically confirmed to have PTC. Patient BMI data were collected, and their relationship with lymph node metastasis in the lateral and central neck compartments was analyzed. Logistic regression models were employed to analyze the correlation between BMI and lymph node metastasis.
The study found a significant correlation between BMI and the risk of lateral neck lymph node metastasis in patients (P=0.008), along with a corresponding increase in extrathyroidal extension risk (P=0.02). While elevated BMI did not directly increase the risk of central compartment metastasis, a significant increase was observed in the number of central compartment lymph node metastases (P=0.009) and their proportion among the total central compartment lymph nodes (P=0.01) in patients with higher BMI. Additionally, multifocality, age, and gender were identified as risk factors for lateral neck lymph node metastasis, whereas Hashimoto's thyroiditis did not exhibit a similar impact.
This study highlights that higher BMI is an important risk factor for lateral neck lymph node metastasis in patients with PTC and may exacerbate the severity of central compartment lymph node metastasis. These findings underscore the importance of considering BMI in the management of thyroid cancer and provide data support for future prevention and intervention strategies.
甲状腺乳头状癌（PTC）是甲状腺最常见的恶性肿瘤，淋巴结转移显著影响患者预后。近年来，体重指数（BMI）作为影响癌症发展的潜在因素受到广泛关注。本研究旨在探讨PTC患者BMI与淋巴结转移之间的关系，尤其关注侧颈部和中央颈部区域的转移风险。
这项回顾性研究纳入了993例行手术治疗且经病理确诊为PTC的患者。收集患者的BMI数据，并分析其与侧颈部和中央颈部区域淋巴结转移的关系。采用逻辑回归模型分析BMI与淋巴结转移的相关性。
研究发现患者BMI与侧颈部淋巴结转移风险之间存在显著相关性（P = 0.008），同时甲状腺外侵犯风险相应增加（P = 0.02）。虽然BMI升高并未直接增加中央区域转移风险，但在BMI较高的患者中，中央区域淋巴结转移数量（P = 0.009）及其在中央区域总淋巴结中的比例显著增加（P = 0.01）。此外，多灶性、年龄和性别被确定为侧颈部淋巴结转移风险因素，而桥本甲状腺炎未表现出类似影响。
本研究强调，较高的BMI是PTC患者侧颈部淋巴结转移的重要风险因素，可能会加重中央区域淋巴结转移的严重程度。这些发现强调了在甲状腺癌管理中考虑BMI的重要性，并为未来的预防和干预策略提供了数据支持。
