甲状腺乳头状癌合并代谢综合征患者的复发特点
Characteristics of recurrent papillary thyroid cancer in metabolic syndrome patients

摘要：目的 分析合并代谢综合征及其组分的甲状腺乳头状癌患者的复发特点。方法 回顾性分析郑州大学第一附属医院2010年1月1日至2015年12月31日，于甲状腺外科初次手术后复发的甲状腺乳头状癌患者。比较伴与不伴代谢异常的复发甲状腺乳头状癌的结节大小、淋巴结转移分区、复发时间及术后浸润几率之间的差异。结果 82例复发甲状腺乳头状癌中，男性34例，女性48例，经典代谢综合征分组方法下的两组差异无统计学意义。当以同时合并2个以上代谢异常为依据分组时，发现代谢综合征组初发时淋巴结转移分级较低，尤其以女性患者显著(P=0.002)，而且复发时间较短，男性差异有统计学意义(P=0.036)；分析合并单一代谢异常组分者，男性患者复发时间较短(P血糖=0.034，P血脂=0.037，PBMI=0.004)。结论 合并代谢异常的甲状腺乳头状癌患者，尤其是同时合并2种以上代谢综合征组分，或超重肥胖的患者，甲状腺癌复发风险增加。
ABSTRACT: Objective To explore the characteristics and components of recurrent papillary thyroid cancer in patients with metabolic syndrome. Methods We retrospectively reviewed the information of the patients with recurrent papillary thyroid cancer after initial surgery during January 1st, 2010 and December 31st, 2015 in the First Affiliated Hospital of Zhengzhou University. We compared tumor size, lymph node metastasis, recurrence time and postoperative invasion rate in metabolic syndrome and non-metabolic syndrome groups. Results Totally 82 patients were included with 34 men and 48 women. There was no significant difference between patients with and those without metabolic syndrome grouped by the classic diagnosis approach. However, the lymph node metastasis grade of recurrent papillary thyroid cancer patients who also suffered from at least two metabolic disorders, was lower, especially in women (P=0.002). Moreover, patients with metabolic disorders had shorter recurrence time (Pdiabetes=0.034, Pdyslipidemia=0.037, PBMI=0.004, PMetS2=0.036). Conclusion Papillary thyroid cancer patients with metabolic disorder, especially with two or more components of metabolic syndrome and overweight and/or obesity, may have an increasing risk of recurrence