The Relationship between Body Mass Index and Thyroid Cancer Pathology Features and Outcomes: A Clinicopathological Cohort Study
The Relationship between Body Mass Index and Thyroid Cancer Pathology Features and Outcomes: A Clinicopathological Cohort Study
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DOI：
10.1210/jc.2010-0440
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发表时间：
2010-09-01
影响因子：
5.8
通讯作者：
Ringel, Matthew D.
中科院分区：
文献类型：
--
作者：
Paes, John E.;Hua, Keding;Ringel, Matthew D.
背景：肥胖被认为是癌症的诱发因素和疾病缓解因素。流行病学研究表明，肥胖与甲状腺癌风险增加有关；然而，肥胖与甲状腺癌分期或行为之间的关系尚不确定。我们假设较高的体重指数 (BMI) 与侵袭性甲状腺癌特征和较高的持续性/复发性疾病发生率相关。方法：连续 259 名甲状腺癌患者参加了这项回顾性队列研究。根据图表审查确定肿瘤组织病理学特征、诊断分期以及研究期间和结束时的疾病状态。 BMI 是在我们机构第一次临床就诊时计算的。评估了 BMI 和这些参数之间的关系。结果：该组的平均随访时间为 6.2 年（0.11-46 年）。单变量或多变量分析未发现 BMI 与诊断时的 T、N 或 M 分期、血管侵犯或复发或持续性疾病之间存在正相关。 BMI 四分位数分析也证明了不存在关联。在单变量和多变量分析中，BMI与淋巴结转移和肿瘤侵袭之间发现了意想不到的负相关，这表明肥胖可能与侵袭性较低的肿瘤特征相关，这一发现需要进行验证性研究。结论：虽然肥胖与甲状腺癌发病率增加有关，但发现较高的BMI与分析时间段内更具侵袭性的肿瘤特征或复发或持续的可能性更大无关。 （临床内分泌代谢杂志 95：4244-4250，2010）
Background: Obesity has been implicated as a predisposing and disease-modifying factor in cancer. Epidemiological studies suggest that obesity is associated with an increased risk of thyroid cancer; however, the relationships between obesity and thyroid cancer stage or behavior are uncertain. We hypothesized that a higher body mass index (BMI) would be associated with aggressive thyroid cancer features and a higher incidence of persistent/recurrent disease.Methods: Two hundred fifty-nine consecutive patients with thyroid cancer were enrolled in this retrospective cohort study. Histopathological tumor features, stage at diagnosis, and disease status during and at the end of the study were determined based on chart review. BMI was calculated at the first clinical visit to our institution. The relationships between BMI and these parameters were assessed.Results: Mean follow-up time for the group was 6.2 yr (0.11-46 yr). No positive associations were identified between BMI and T, N, or M stage at diagnosis, vascular invasion, or recurrent or persistent disease on univariate or multivariate analyses. The absence of an association was also demonstrated on analysis by BMI quartiles. An unexpected inverse association was identified between BMI and nodal metastasis and tumor invasion on both univariate and multivariate analyses, suggesting that obesity may be associated with less aggressive tumor features, a finding that requires confirmatory studies.Conclusion: Although obesity has been associated with increased thyroid cancer incidence, a higher BMI was found not to be associated with more aggressive tumor features or a greater likelihood of recurrence or persistence over the analyzed time period. (J Clin Endocrinol Metab 95: 4244-4250, 2010)