Analysis of relationship between diabetes mellitus and clinicopathologic features of thyroid papillary carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YU Xizi , SONG Junlong , LI Lingrui , CHEN Chuang ,  SUN Shengrong

Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, P. R. China;

Corresponding author：

SUN Shengrong, Email: sun137@sina.com

Keywords：

papillary thyroid carcinoma; diabetes mellitus; clinicopathologic features

DOI：

10.7507/1007-9424.202101062

Video：

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Objective To investigate the relationship between clinicopathologic characteristics of patients with papillary thyroid carcinoma (PTC) and diabetes mellitus (DM), and to provide basis for individualized diagnosis and treatment.Methods The patients who underwent the first thyroid surgery in the Renmin Hospital of Wuhan University from January 1, 2017 to September 15, 2020 and were pathologically diagnosed as PTC were collected. According to the presence or absence of DM, the clinical features were compared.Results There were 2859 patients without DM and 133 patients with DM in 2992 patients. In patients with or without DM, there were no differences in lymph node metastasis, multiple, bilateral tumors, and extrathyroid invasion between the two groups (P>0.05). However, compared with the PTC patients without DM, the proportion of women with DM was lower (58.65% versus 76.71%, P<0.01), the proportions of age >55 years old (92.48% versus 66.32%, P<0.01) and capsule invasion (67.21% versus 63.11%, P=0.04) with DM were higer. After adjusting for age and gender, the multivariate analysis showed that the risks of larger tumor and capsular invasion in the patients with DM was 1.51 times [95%CI (1.06, 2.16), P=0.02] and 1.75 times [95%CI (1.16, 2.64), P<0.01] respectively as compared with in the patients without DM.Conclusions In PTC patients with DM, proportion of women is lower, proportions of elderly population (age >55 years old) and patients with capsular invasion are higer, tumor is larger. Therefore, patients with DM must not neglect regular examination of thyroid morphology and function, and PTC patients should also pay attention to control of blood glucose.

Citation： YU Xizi, SONG Junlong, LI Lingrui, CHEN Chuang, SUN Shengrong. Analysis of relationship between diabetes mellitus and clinicopathologic features of thyroid papillary carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(10): 1348-1352. doi: 10.7507/1007-9424.202101062 Copy

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3.	Zhao L, Pang P, Zang L, et al. Features and trends of thyroid cancer in patients with thyroidectomies in Beijing, China between 1994 and 2015: a retrospective study. BMJ Open, 2019, 9(1): e023334.
4.	Guraya SY. Association of type 2 diabetes mellitus and the risk of colorectal cancer: A meta-analysis and systematic review. World J Gastroenterol, 2015, 21(19): 6026-6031.
5.	Tseng CH, Tseng FH. Diabetes and gastric cancer: the potential links. World J Gastroenterol, 2014, 20(7): 1701-1711.
6.	Paternoster S, Falasca M. The intricate relationship between diabetes, obesity and pancreatic cancer. Biochim Biophys Acta Rev Cancer, 2020, 1873(1): 188326.
7.	Mu N, Dong M, Liu C, et al. Association between preoperative serum insulin levels and lymph node metastasis in endometrial cancer—a prospective cohort study. Cancer, 2018, 7(4): 1519-1527.
8.	Kang C, LeRoith D, Gallagher EJ. Diabetes, obesity, and breast cancer. Endocrinology, 2018, 159(11): 3801-3812.
9.	NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet, 2016, 387(10027): 1513-1530.
10.	Seo YG, Choi HC, An AR, et al. The association between type 2 diabetes mellitus and thyroid cancer. J Diabetes Res, 2017, 2017: 5850879.
11.	Li H, Qian J. Association of diabetes mellitus with thyroid cancer risk: A meta-analysis of cohort studies. Medicine (Baltimore), 2017, 96(47): e8230.
12.	Lo SF, Chang SN, Muo CH, et al. Modest increase in risk of specific types of cancer types in type 2 diabetes mellitus patients. Int J Cancer, 2013, 132(1): 182-188.
13.	Bae MJ, Kim SS, Kim WJ, et al. High prevalence of papillary thyroid cancer in Korean women with insulin resistance. Head Neck, 2016, 38(1): 66-71.
14.	Malaguarnera R, Vella V, Nicolosi ML, et al. Insulin resistance: any role in the changing epidemiology of thyroid cancer? Front Endocrinol (Lausanne), 2017, 8: 314.
15.	Guo S. Insulin signaling, resistance, and the metabolic syndrome: insights from mouse models into disease mechanisms. J Endocrinol, 2014, 220(2): T1-T23.
16.	Davis PJ, Hercbergs A, Luidens MK, et al. Recurrence of differentiated thyroid carcinoma during full TSH suppression: is the tumor now thyroid hormone dependent? Hormones and Cancer, 2015, 6(1): 7-12.
17.	Biondi B, Kahaly GJ, Robertson RP. Thyroid dysfunction and diabetes mellitus: two closely associated disorders. Endocr Rev, 2019, 40(3): 789-824.
18.	Chen RH, Chen HY, Man KM, et al. Thyroid diseases increased the risk of type 2 diabetes mellitus: A nation-wide cohort study. Medicine (Baltimore), 2019, 98(20): e15631.
19.	Shun CB, Donaghue KC, Phelan H, et al. Thyroid autoimmunity in type 1 diabetes: systematic review and meta-analysis. Diabet Med, 2014, 31(2): 126-135.
20.	Martin-Montalvo A, López-Noriega L, Jiménez-Moreno C, et al. Transient PAX8 expression in islets during pregnancy correlates with β-cell survival, revealing a novel candidate gene in gestational diabetes mellitus. Diabetes, 2019, 68(1): 109-118.
21.	Schmid D, Behrens G, Jochem C, et al. Physical activity, diabetes, and risk of thyroid cancer: a systematic review and meta-analysis. Eur J Epidemiol, 2013, 28(12): 945-958.
22.	Wang P, Lv L, Qi F, et al. Increased risk of papillary thyroid cancer related to hormonal factors in women. Tumour Biol, 2015, 36(7): 5127-5132.
23.	Zane M, Parello C, Pennelli G, et al. Estrogen and thyroid cancer is a stem affair: A preliminary study. Biomed Pharmacother, 2017, 85: 399-411.
24.	Huang Y, Dong W, Li J, et al. Differential expression patterns and clinical significance of estrogen receptor-α and β in papillary thyroid carcinoma. BMC Cancer, 2014, 14: 383.
25.	李书佩, 梁立峰. 女性2型糖尿病、雌激素水平与心血管疾病的相关性分析. 世界最新医学信息文摘(连续型电子期刊), 2019, 19(66): 96-97.
26.	邓媛媛, 柯飒, 刘慧霞, 等. 甲状腺癌合并糖尿病患者的临床病理特征分析. 中国普通外科杂志, 2020, 29(5): 565-573.
27.	Slater T, Haywood NJ, Matthews C, et al. Insulin-like growth factor binding proteins and angiogenesis: from cancer to cardiovascular disease. Cytokine Growth Factor Rev, 2019, 46: 28-35.

1. Tuminello S, van Gerwen MAG, Genden E, et al. Increased incidence of thyroid cancer among World Trade Center First Responders: A descriptive epidemiological assessment. Int J Environ Res Public Health, 2019, 16(7): 1258.
2. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: a systematic analysis for the Global Burden of Disease Study. JAMA Oncol, 2018, 4(11): 1553-1568.
3. Zhao L, Pang P, Zang L, et al. Features and trends of thyroid cancer in patients with thyroidectomies in Beijing, China between 1994 and 2015: a retrospective study. BMJ Open, 2019, 9(1): e023334.
4. Guraya SY. Association of type 2 diabetes mellitus and the risk of colorectal cancer: A meta-analysis and systematic review. World J Gastroenterol, 2015, 21(19): 6026-6031.
5. Tseng CH, Tseng FH. Diabetes and gastric cancer: the potential links. World J Gastroenterol, 2014, 20(7): 1701-1711.
6. Paternoster S, Falasca M. The intricate relationship between diabetes, obesity and pancreatic cancer. Biochim Biophys Acta Rev Cancer, 2020, 1873(1): 188326.
7. Mu N, Dong M, Liu C, et al. Association between preoperative serum insulin levels and lymph node metastasis in endometrial cancer—a prospective cohort study. Cancer, 2018, 7(4): 1519-1527.
8. Kang C, LeRoith D, Gallagher EJ. Diabetes, obesity, and breast cancer. Endocrinology, 2018, 159(11): 3801-3812.
9. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet, 2016, 387(10027): 1513-1530.
10. Seo YG, Choi HC, An AR, et al. The association between type 2 diabetes mellitus and thyroid cancer. J Diabetes Res, 2017, 2017: 5850879.
11. Li H, Qian J. Association of diabetes mellitus with thyroid cancer risk: A meta-analysis of cohort studies. Medicine (Baltimore), 2017, 96(47): e8230.
12. Lo SF, Chang SN, Muo CH, et al. Modest increase in risk of specific types of cancer types in type 2 diabetes mellitus patients. Int J Cancer, 2013, 132(1): 182-188.
13. Bae MJ, Kim SS, Kim WJ, et al. High prevalence of papillary thyroid cancer in Korean women with insulin resistance. Head Neck, 2016, 38(1): 66-71.
14. Malaguarnera R, Vella V, Nicolosi ML, et al. Insulin resistance: any role in the changing epidemiology of thyroid cancer? Front Endocrinol (Lausanne), 2017, 8: 314.
15. Guo S. Insulin signaling, resistance, and the metabolic syndrome: insights from mouse models into disease mechanisms. J Endocrinol, 2014, 220(2): T1-T23.
16. Davis PJ, Hercbergs A, Luidens MK, et al. Recurrence of differentiated thyroid carcinoma during full TSH suppression: is the tumor now thyroid hormone dependent? Hormones and Cancer, 2015, 6(1): 7-12.
17. Biondi B, Kahaly GJ, Robertson RP. Thyroid dysfunction and diabetes mellitus: two closely associated disorders. Endocr Rev, 2019, 40(3): 789-824.
18. Chen RH, Chen HY, Man KM, et al. Thyroid diseases increased the risk of type 2 diabetes mellitus: A nation-wide cohort study. Medicine (Baltimore), 2019, 98(20): e15631.
19. Shun CB, Donaghue KC, Phelan H, et al. Thyroid autoimmunity in type 1 diabetes: systematic review and meta-analysis. Diabet Med, 2014, 31(2): 126-135.
20. Martin-Montalvo A, López-Noriega L, Jiménez-Moreno C, et al. Transient PAX8 expression in islets during pregnancy correlates with β-cell survival, revealing a novel candidate gene in gestational diabetes mellitus. Diabetes, 2019, 68(1): 109-118.
21. Schmid D, Behrens G, Jochem C, et al. Physical activity, diabetes, and risk of thyroid cancer: a systematic review and meta-analysis. Eur J Epidemiol, 2013, 28(12): 945-958.
22. Wang P, Lv L, Qi F, et al. Increased risk of papillary thyroid cancer related to hormonal factors in women. Tumour Biol, 2015, 36(7): 5127-5132.
23. Zane M, Parello C, Pennelli G, et al. Estrogen and thyroid cancer is a stem affair: A preliminary study. Biomed Pharmacother, 2017, 85: 399-411.
24. Huang Y, Dong W, Li J, et al. Differential expression patterns and clinical significance of estrogen receptor-α and β in papillary thyroid carcinoma. BMC Cancer, 2014, 14: 383.
25. 李书佩, 梁立峰. 女性2型糖尿病、雌激素水平与心血管疾病的相关性分析. 世界最新医学信息文摘(连续型电子期刊), 2019, 19(66): 96-97.
26. 邓媛媛, 柯飒, 刘慧霞, 等. 甲状腺癌合并糖尿病患者的临床病理特征分析. 中国普通外科杂志, 2020, 29(5): 565-573.
27. Slater T, Haywood NJ, Matthews C, et al. Insulin-like growth factor binding proteins and angiogenesis: from cancer to cardiovascular disease. Cytokine Growth Factor Rev, 2019, 46: 28-35.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of relationship between diabetes mellitus and clinicopathologic features of thyroid papillary carcinoma

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