摘要
目的研究肥胖指标体质量指数(BMI)和腰围(waist circumference,WC)与甲状腺癌的关系。方法选取2018年10月~2021年6月唐山市人民医院收治的104例甲状腺癌患者为研究组,同期诊治的100例良性甲状腺疾病患者为对照组。比较两组受试者病历资料差异,采用多因素Logistic回归分析甲状腺癌的影响因素。ROC曲线分析BMI和WC评估发生甲状腺癌的价值,分析其与甲状腺癌临床病理特征的关系。结果两组患者BMI、WC、促甲状腺激素(TSH)以及尿碘浓度比较差异有统计学意义(P<0.05)。BMI评估甲状腺癌发生风险的曲线下面积(area under the curve,AUC)为0.794(95%CI=0.702~0.985),敏感度为70.19%,特异度为83.00%;WC评估甲状腺癌发生风险的AUC为0.858(95%CI=0.778~0.939),敏感度为79.81%,特异度为88.00%,其中WC的AUC高于BMI(P<0.05)。多因素Logistic回归分析显示,BMI(OR=1.893,95%CI=1.106~3.238)、WC(OR=2.277,95%CI=1.226~4.231)、TSH(OR=2.617,95%CI=1.054~6.498)及尿碘浓度(OR=2.100,95%CI=1.041~4.236)均是影响甲状腺癌的影响因素。超重组(BMI≥24 kg/m^(2),WC≥75.68 cm)和正常组(18.5 kg/m^(2)≤BMI<24 kg/m^(2),WC<75.68 cm)患者的最大癌灶平均直径、淋巴结转移及TNM分期差异有统计学意义,其中超重组最大癌灶平均直径较高,且多发生淋巴结转移,TNM分期多为III~IV期。结论肥胖指标BMI和WC均是发生甲状腺癌的危险因素,且与甲状腺癌的淋巴结转移、TNM分期等临床病理特征有关,其中WC对于甲状腺癌具有更高的危险评估效能。
OBJECTIVE To study the relationship between obesity index body mass index(BMI)and waist circumference(WC)and thy roid cancer.METHODS A total of 104 patients with thyroid cancer admitted to Tangshan People's Hospital from October 2018 to June 2021 were selected as the study group,and 100 patients with benign thyroid disease admitted to Tangshan People's Hospital during the same period were selected as the control group.The clinical medical records of the patients were collected,the differences between the two groups were compared,and the influencing factors of thyroid cancer were analyzed by multivariate logistic regression.ROC curve was used to analyze the value of BMI and WC in the diagnosis of thyroid cancer,and the relationship between BMI,WC and clinicopathological features of thyroid cancer.RESULTS The differences in BMI,WC,TSH and urine iodine concentration between the two groups were statistically significant(P<0.05).The area under the curve(AUC)of BMI to assess the risk of thyroid cancer was 0.794(95%CI=0.702-0.985),and the sensitivit y and specif icit y were 70.19%and 83.00%,respectively.The AUC of WC to assess the risk of thyroid cancer was 0.858(95%CI=0.778-0.939),and the sensitivity and specificity were 79.81%and 88.00%,respectively.The AUC of WC was higher than that of BMI(P<0.05).Multivariate logistic regression analysis showed that BMI(OR=1.893,95%CI=1.106-3.238),WC(OR=2.277,95%CI=1.226-4.231),TSH(OR=2.617,95%CI=1.054-6.498)and urine iodine concentration(OR=2.100,95%CI=1.041-4.236)were the influencing factors of thyroid cancer(P<0.05).The average diameter of the largest cancer foci,lymph node metastasis,and TNM staging were statistically significant in the overweight(BMI≥24 kg/m^(2),WC≥75.68 cm)and normal weight groups(18.5 kg/m^(2)≤BMI<24 kg/m^(2),WC<75.68 cm).Among them,the overweight group had a higher average diameter of the largest cancer foci,and more lymph node metastasis,and the TNM staging was mostly stage III-IV.CONCLUSION Obesity index BMI and WC are risk factors for thyroid cancer,and are related to clinicopathological features such as lymph node metastasis and TNM stage of thyroid cancer.WC has higher risk assessment performance for thyroid cancer.
作者
张宏伟
石福民
薛荣
翟健
韩晓晨
梁金屏
ZHANG Hongwei;SHI Fumin;XUE Rong;ZHAI Jian;HAN Xiaochen;LIANG Jinping(Department of Oncology,Tangshan People's Hospital,Tangshan,Hebei,063000,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2022年第6期373-377,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
河北省卫生厅科研基金项目(20191601)。
关键词
甲状腺肿瘤
肥胖
人体质量指数
腰围
Thyroid Neoplasms
Adiposity
Body Mass Index
Waist Circumference
