| Backgrounds:The incidence of differentiated thyroid carcinoma which is one of the most common malignant tumors in human endocrine system has been growing throughout the world in recent decades.More and more epidemiological studies have suggested that there is a correlation between obesity and the incidence of differentiated thyroid carcinoma.But the correlation between Obesity and the incidence of differentiated thyroid carcinoma or the correlation between Obesity and surgical effect of differentiated thyroid carcinoma remain unclear.The primary treatment of differentiated thyroid carcinoma is surgical treatment,there are a variety of factors can affect the surgical treatment effect.Obesity for the differentiated thyroid carcinoma surgery effect is not clear.So we sought to evaluate the relationship between obesity and incidence or surgical effect in patients with differentiated thyroid carcinoma.Methods:This study retrospectively analyzed information of 428 cases of differentiated thyroid carcinoma and nodular goiter patients who underwent thyroid surgery and were confirmed pathologically in Shandong Provincial Hospital Breast and Thyroid Surgery Department from January 2011 to December 2011.Then divided these patients into two groups according to gender.Chi-square test was used to search correlation between obesity that the Body Mass Index(BMI)of patients was Greater than or equal thirty percent or not and pathology in each group to evaluate the correlation between Obesity and the incidence of differentiated thyroid carcinoma.Then we retrospectively analyzed the information of 246 cases of thyroid cancer patients of all patients.We used single factor analysis method to study the influence of obesity on operation time,the amount of bleeding,volume of drainage of the first day,the total of volume of drainage,the time before pulling out of drainage tube and complications to evaluate the influence of obesity on operation result of differentiated thyroid carcinoma.All data are used SPSS 19.0 software chi-square test that P<0.05 is statistically significant.Results:In the 428 cases of differentiated thyroid carcinoma and nodular goiter patients,there are 353 women patients including 205 cases of patients with differentiated thyroid carcinoma in which 48 cases are obese and 157 cases are non-obesity and 148 cases of nodular goiter patients in which 22 cases are obese and 126 cases are non-obesity.There was a positive correlation between obesity and the incidence of differentiated thyroid carcinoma(OR>1,P=0.047<0.05).A total of 75 cases of men patients include 41 cases of patients with differentiated thyroid carcinoma in which 12 cases are obese and 29 cases are non-obesity and 34 cases of nodular goiter patients in which 3 cases are obese and 31 cases are non-obesity.There was a positive correlation between obesity and the incidence of differentiated thyroid carcinoma(OR>1,P=0.028<0.05).Analyzing the 246 cases of patients with differentiated thyroid carcinoma,The single factor analysis method suggested that obesity or not was associated with operation time(P<0.001)and the amount of bleeding(P<0.001)and volume of drainage of the first day(P=0.007<0.05)and the total of volume of drainage(P=0.01<0.05)and the time before pulling out of drainage tube(P<0.001)which affect the surgical effect in patients with differentiated thyroid carcinoma.A total of 246 cases of patients with differentiated thyroid carcinoma were divided into two groups,one group of patients with thyroid gland lobectomy for near total thyroidectomy group and another group of patients with thyroid full cut methods for total thyroidectomy group.The patient of intro-operative hemorrhage in near total thyroidectomy group was 1 case who was obese.The patient of intro-operative hemorrhage in total thyroidectomy group were 4 cases in which 3 was obese and 1 was non-obesity,(P=0.009,OR=11.893,95%CI=1.19-118.72).The infected patients in near total thyroidectomy group were 9 cases in which 6 were obese and 3 were non-obesity,(P=0.005,OR=6.545,95%CI=1.51-28.35).The infected patients in total thyroidectomy group were 13 cases in which 6 were obese and 7 were non-obesity,(P=0.025,OR=3.600,95%CI=1.11-11.65).The patients who recurrent laryngeal nerve were injured in near total thyroidectomy group were 6 cases in which 4 was obese and 2 were non-obesity,(P=0.025,OR=6.08395%CI=1.05-35.32).All of them were temporary damage.The patients who recurrent laryngeal nerve were injured in total thyroidectomy group were 10 cases in which 7 was obese,one patients with permanent damage and the others with temporary damage,and 3 were non-obesity who was temporary damage,(P=0.001,OR=9.083,95%CI=2.12-38.90).The patients who superior laryngeal nerve were injured in near total thyroidectomy group were 8 cases in which 5 was obese and 3 was non-obesity,(P=0.019,OR=5.217,95%CI=1.16-23.53),All of them were temporary damage.The patients who superior laryngeal nerve were injured in total thyroidectomy group were 10 cases in which 6 was obese and 4 was non-obesity,(P=0.002,OR=6.480,95%CI=1.70-24.69),All of them were temporary damage.The patients who parathyroid glands were injured in near total thyroidectomy group were 7 cases in which 4 was obese and 3 were non-obesity,(P=0.065>0.05,OR=4.000,95%CI=0.84-19.16).All of them were temporary damage.The patients who parathyroid glands were injured in total thyroidectomy group were 8 cases in which was obese and 3 were non-obesity,(P=0.004,OR=6.987,95%CI=1.57-31.12),All of them were temporary damage.The patient of lymphatic fistula in near total thyroidectomy group was 1 case who was obese.The patients of lymphatic fistula in total thyroidectomy group were 4 cases in which 3 was obese and 1 was non-obesity,(P=0.009,OR=11.893,95%CI=1.19-118.72).The patient of Homer syndrome was 1 case who was obese in total thyroidectomy group.Conclusions:The obesity has an increased risk of differentiated thyroid carcinoma.The surgical effects of patients with differentiated thyroid carcinoma in obesity patients are worse than non-obesity patients. |
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