Abstract
BackgroundPapillary thyroid cancer (PTC) is the most common type of thyroid cancer and the incidence of PTC has continued to increase over the past decades. Many studies have shown that obesity is an independent risk factor for PTC and obese PTC patients tend to have a relative larger tumor size and higher grade of tumor stage. Obesity is associated with disordered lipid metabolism and the relationship between serum lipids and PTC remains unclear. Therefore, this study aimed to investigate the association between serum lipid level and PTC.MethodsWe retrospectively analyzed 1018 PTC patients diagnosed and treated in our hospital, all these cases were first diagnosed with PTC and had complete clinical information including ultrasound reports before surgery, serum lipid (CHOL, TG, HDL-c, LDL-c, Apo-A1, Apo-B, Apo-E) results, surgical records and pathological reports.ResultsNone of these lipid markers were associated with tumor size in the whole cohort and in the female group. In the male group, on crude analysis, Apo-A1 showed a marginally association with tumor size, [OR = 0.158 (0.021–1.777)], p = 0.072. After adjusting for age and multifocality, Apo-A1 showed a significant association with tumor size [OR = 0.126 (0.016–0.974)], p = 0.047. This association become more apparent in a young male subgroup, [OR = 0.051 (0.005–0.497)], p = 0.009. CHOL, TG, HDL-c, LDL-c, Apo-B, Apo-E did not show significant association with tumor size. As for LNM, neither in the male group nor in the female group were found to be associated with any serum lipid biomarkers.ConclusionAs PTC incidences continues to increase, our findings demonstrated a negatively association between PTC and apoA-1 in male PTC patients, which may contribute to further investigation concerning diagnosing and preventing this most common type of thyroid cancer.
Highlights
Papillary thyroid cancer (PTC) is the most common type of thyroid cancer and the incidence of PTC has continued to increase over the past decades
We found that patients with lower levels of serum Apolipoprotein A1 (Apo-A1) are more likely to be diagnosed with larger tumor sizes of PTC in a male cohort, especially in a young male subgroup (< 55 years old), this correlation was not seen when it comes to the female cohort
We find that lower Apo-A1 levels was significantly associated with larger tumor size in male PTC patients, but they do not show a correlation with lymph node metastasis (LNM)
Summary
Papillary thyroid cancer (PTC) is the most common type of thyroid cancer and the incidence of PTC has continued to increase over the past decades. Obesity is associated with disordered lipid metabolism and the relationship between serum lipids and PTC remains unclear. A pooled analysis in 2014 revealed that body mass index (BMI) and body fat percentage were significantly associated with increased risk of PTC in a population composed of Americans, Italians and Germans [2]. Besides higher risk of morbidity of PTC, obesity was associated with larger tumor size and marginally significantly associated with advanced tumor stage according to a population-based study from Nevada [4]. The aim of this study is to elucidate the relationship between serum lipids and extent of PTC at diagnosis, through the use of a population-based samples. This study explores whether routinely measured serum lipids are associated with tumor size, multiplicity and lymph node metastasis (LNM) of PTC in a Chinese population
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