| Objective:To explore the relationship between glucose and lipid metabolism indexes,uric acid and BMI with the risk and clinicopathological characteristics of papillary thyroid carcinoma(PTC),and independent risk factors affecting PTC extracapsular invasion and lymph node metastasis.Method:Patients who underwent thyroid nodule resection in Qingdao University Affiliated Hospital from June 2018 to June 2020,and postoperative pathology confirmed PTC or benign thyroid nodules were selected.(1)To collect clinical pathological data of patients,such as gender,age,height,weight,BMI,FBG,TG,TC,LDL-C,HDL-C,UA,TPOAb,TGAb,TSH,FT4 and FT3;primary cancer Diameter,number,unilateral and bilateral,extracapsular invasion and location,lymph node metastasis area and number,distant metastasis and location;and assess patient recurrence risk stratification and TNM staging.(2)To explore the correlation between glucose and lipid metabolism indexes,uric acid,BMI and the risk of PTC in the overall and different gender and age groups.(3)To analyze the correlation between thyroid function and the risk of PTC.(4)Multivariate analysis of independent risk factors affecting the onset of PTC.(5)To analyze correlation between glucose and lipid metabolism indexes,uric acid and BMI with the clinicopathological characteristics of PTC.(6)Analyze the relationship between thyroid function and different pathological characteristics of PTC.(7)Compare the differences in glucose and lipid metabolism indexes,uric acid and BMI levels in different thyroid function groups.(8)The relationship among the indicators of glucose and lipid metabolism,uric acid and BMI levels were analyzed.(9)Multivariate analysis of independent risk factors affecting PTC extracapsular invasion and lymph node metastasis.Results:(1)1784 patients were enrolled,including 1038 patients(58.18%)with PTC and746 patients(41.82%)with benign thyroid nodules.(2)Correlation analysis of FBG,BMI and PTC incidence risk showed that FBG≥5.35mmol/L and BMI≥25kg/m~2are positively correlated with the incidence risk of PTC,the increased levels of FBG and BMI were positively correlated with the risk of PTC,regardless of male,female,age<55 and≥55years old(all P<0.05).(3)The reduction of HDL-C levels in the female group and the age≥55 years old group was positively correlated with the risk of PTC(all P<0.05);in the overall,male group and the age group less than 55 years old,the blood lipid indexes and the risk of PTC incidence were all positively correlated.No significant correlation(all P>0.05).(4)There was no correlation between high uric acid and the incidence of PTC in each subgroup regardless of overall,male,female,age<55 years and≥55 years old(all P>0.05).(5)Multivariate analysis showed that compared with benign nodules,the risk of PTC was positively correlated with males,age<55 years,FBG≥5.35mmol/L,BMI≥25kg/m~2,TPOAb and TSH increase(OR:1.464,2.468,1.422,1.323,1.003,1.674,all P<0.05),negatively correlated with the increase of FT3(OR:0.777,P<0.05).(6)The proportion of FBG≥5.44mmol/L in PTC patients with extracapsular invasion group,lymph node metastasis group and lateral cervical lymph node metastasis group,middle and high risk group of recurrence,and TNM-III/IV stage group increased;by gender After multivariate adjustment for,age,and TSH,FBG≥5.44mmol/L is still positively correlated with extracapsular invasion,lymph node metastasis,lateral neck lymph node metastasis,medium/high risk of recurrence,and risk of TNM-III/IV stage(all P<0.05).(7)PTC patients with multifocal group,bilateral group,cancer focus diamete>1cm group,extracapsular invasion group,lymph node metastasis group,middle/high risk group of recurrence,TNM-III/IV stage BMI≥25kg/m~2accounted for After multivariate adjustment for gender,age,and TSH,BMI≥25kg/m~2is still associated with multifocal,bilateral,cancer foci>1cm in diameter,extracapsular invasion,lymph node metastasis,medium/high risk of recurrence The risk of occurrence was positively correlated(all P<0.05).(8)The proportion of TG≥1.30mmol/L and HDL-C<1.43mmol/L in the extracapsular invasion group of PTC patients increased,and HDL-C<1.43mmol/L and UA≥298.05umol/L in the middle/high risk group of recurrence.The proportion of L increased,and the proportion of TG≥1.30mmol/L,TC≥5.02mmol/L,and LDL-C≥2.91mmol/L in the TNM-III/IV stage group increased;after multivariate adjustment for gender,age,and TSH TG≥1.30mmol/L,HDL-C<1.43mmol/L are positively correlated with the risk of extracapsular invasion,TC≥5.02mmol/L is positively correlated with the risk of TNM-III/IV stage(all P<0.05).(9)TSH levels increased in the extracapsular invasion group;TPOAb levels in the lymph node metastasis group,recurrence risk stratification medium/high-risk group,and TNM-III/IV stage groups were significantly increased,and the differences were statistically significant(both P<0.05).(10)The diameter of primary cancer lesions>1cm,FBG≥5.44mmol/L,BMI≥25kg/m~2,TSH≥1.66/m IU/L are all positively correlated with the risk of extracapsular invasion of PTC(OR:3.375,2.350,1.456,1.536,both P<0.05);male,age<55 years,diameter of primary cancer>1cm,multifocal,extracapsular invasion,FBG≥5.44mmol/L,BMI≥25kg/m~2,TPOAb≥20.05/IU/m L was positively correlated with the risk of PTC lymph node metastasis(OR:1.841,2.200,2.392,2.284,1.393,1.471,1.412,1.616,all P<0.05).Conclusion:(1)FBG≥5.35mmol/L and BMI≥25kg/m~2can increase the risk of PTC;the reduction of HDL-C level increases the risk of PTC in women and patients≥55 years of age.(2)Compared with benign thyroid nodules,male,age<55 years,FBG≥5.35mmol/L,BMI≥25kg/m~2,TPOAb,TSH increase and FT3 decrease are all independent risk factors for PTC.(3)High levels of FBG,BMI,TG,TC,and low levels of HDL-C can increase the occurrence of malignant pathological features of PTC to varying degrees.(4)Diameter of primary cancer>1cm,BMI≥25kg/m~2,high FBG and TSH levels are independent risk factors for extracapsular invasion of PTC.(5)Males,age<55 years,diameter of primary cancer>1cm,multifocality,extracapsular invasion,BMI≥25kg/m~2,high levels of FBG and TPOAb are all independent risk factors for PTC lymph node metastasis.(6)Uric acid has nothing to do with PTC occurrence and malignant pathological characteristics. |
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