Top

Endocrine

Published in:

01-12-2021 | Metastasis | Original Article

The relationship between lipotoxicity and risk of extrathyroidal extension in papillary thyroid microcarcinoma

Authors: Changlin Li, Haixia Guan, Qiao He, Yishen Zhao, Nan liang, Jiao Zhang, Gianlorenzo Dionigi, Hui Sun

Published in: Endocrine | Issue 3/2021

Abstract

Objective

To explore the relationship between triglyceride (TG) levels and aggressive pathological characteristics in papillary thyroid microcarcinoma (PTMC) patients, especially the relationship between TG, BMI, age, and extrathyroidal extension (ETE).

Methods

A retrospective analysis of 9663 patients with PTMC in a single center from 2010 to 2017 was included in this study. Binary logistic regression was used to analyze the relationship between serum TG and aggressive pathological characteristics of PTMC in different genders. Further analyzing the risk of high TG in different ages and BMI groups.

Results

Even after adjustment for confounding factors, high TG is still a risk factor for ETE in women with PTMC, but not a risk factor for men. Compared with the group with lower than 0.90 mmol/L, when the TG level is higher than 1.93 mmol/L, the risk of ETE in women increased by about 1.35-fold. The remaining two variables (BMI, age) as risk factors for ETE are analyzed. In the normal BMI group, high TG is still a risk factor for ETE. The risk of ETE in women more than 55 years old is significantly increased by 1.96-fold (1.34-fold in less than 55 years).

Conclusion

High TG in women is positively correlated with the risk of ETE in PTMC. PTMC with high TG in elderly women (more than 55 years) has a higher risk of ETE. TG is a potential serological index for predicting the risk of ETE in women with normal BMI.

Available only for authorised users

Y. Ito, A. Miyauchi, T. Kudo, H. Oda, M. Yamamoto, H. Sasai et al. Trends in the implementation of active surveillance for low-risk papillary thyroid microcarcinomas at Kuma Hospital: gradual increase and heterogeneity in the acceptance of this new management option. Thyroid 28(4), 488–95 (2018). https://doi.org/10.1089/thy.2017.0448CrossRefPubMedPubMedCentral

H. Kwon, H.-S. Oh, M. Kim, S. Park, M.J. Jeon, W.G. Kim et al. Active surveillance for patients with papillary thyroid microcarcinoma: a single center’s experience in Korea. J. Clin. Endocrinol. Metab. 102(6), 1917–25 (2017). https://doi.org/10.1210/jc.2016-4026CrossRefPubMed

Q. Zhao, J. Ming, C. Liu, L. Shi, X. Xu, X. Nie et al. Multifocality and total tumor diameter predict central neck lymph node metastases in papillary thyroid microcarcinoma. Ann. surgical Oncol. 20(3), 746–52 (2013). https://doi.org/10.1245/s10434-012-2654-2CrossRef

L. Davies, H.G. Welch, Current thyroid cancer trends in the United States. JAMA Otolaryngol. Head. Neck Surg. 140(4), 317–22 (2014). https://doi.org/10.1001/jamaoto.2014.1CrossRefPubMed

L.G.T. Morris, A.G. Sikora, T.D. Tosteson, L. Davies, The increasing incidence of thyroid cancer: the influence of access to care. Thyroid 23(7), 885–91 (2013). https://doi.org/10.1089/thy.2013.0045CrossRefPubMedPubMedCentral

K.-L. Lin, O.-C. Wang, X.-H. Zhang, X.-X. Dai, X.-Q. Hu, J.-M. Qu, The BRAF mutation is predictive of aggressive clinicopathological characteristics in papillary thyroid microcarcinoma. Ann. surgical Oncol. 17(12), 3294–300 (2010). https://doi.org/10.1245/s10434-010-1129-6CrossRef

M. Yun, T.-W. Noh, A. Cho, Y.-J. Choi, S.-W. Hong, C.-S. Park et al. Visually discernible [18F]fluorodeoxyglucose uptake in papillary thyroid microcarcinoma: a potential new risk factor. J. Clin. Endocrinol. Metab. 95(7), 3182–8 (2010). https://doi.org/10.1210/jc.2009-2091CrossRefPubMed

I. Sugitani, Y. Ito, D. Takeuchi, H. Nakayama, C. Masaki, H. Shindo, et al. Indications and strategy for active surveillance of adult low-risk papillary thyroid microcarcinoma: consensus statements from the Japan Association of Endocrine Surgery Task Force on management for papillary thyroid microcarcinoma. Thyroid 2020. https://doi.org/10.1089/thy.2020.0330.

S.-M. Chow, S.C.K. Law, J.K.C. Chan, S.-K. Au, S. Yau, W.-H. Lau, Papillary microcarcinoma of the thyroid-Prognostic significance of lymph node metastasis and multifocality. Cancer 98(1), 31–40 (2003)CrossRefPubMed

10.

J.-S. Pyo, J.H. Sohn, G. Kang, Detection of tumor multifocality is important for prediction of tumor recurrence in papillary thyroid microcarcinoma: a retrospective study and meta-analysis. J. Pathol. Transl. Med. 50(4), 278–86 (2016). https://doi.org/10.4132/jptm.2016.03.29CrossRefPubMedPubMedCentral

11.

J.C. Riss, I. Peyrottes, E. Chamorey, J. Haudebourg, A. Sudaka, D. Benisvy et al. Prognostic impact of tumour multifocality in thyroid papillary microcarcinoma based on a series of 160 cases. Eur. Ann. Otorhinolaryngol. Head. Neck Dis. 129(4), 175–8 (2012). https://doi.org/10.1016/j.anorl.2011.11.003CrossRefPubMed

12.

Y.K. So, M.W. Kim, Y.-I. Son, Multifocality and bilaterality of papillary thyroid microcarcinoma. Clin. Exp. Otorhinolaryngol. 8(2), 174–8 (2015). https://doi.org/10.3342/ceo.2015.8.2.174CrossRefPubMedPubMedCentral

13.

H. Shimano, Novel qualitative aspects of tissue fatty acids related to metabolic regulation: lessons from Elovl6 knockout. Prog. Lipid Res 51(3), 267–71 (2012). https://doi.org/10.1016/j.plipres.2011.12.004CrossRefPubMed

14.

D. Janković, P. Wolf, C.-H. Anderwald, Y. Winhofer, M. Promintzer-Schifferl, A. Hofer et al. Prevalence of endocrine disorders in morbidly obese patients and the effects of bariatric surgery on endocrine and metabolic parameters. Obes. Surg. 22(1), 62–9 (2012). https://doi.org/10.1007/s11695-011-0545-4CrossRefPubMed

15.

M. Zhao, X. Zhang, L. Gao, Y. Song, C. Xu, C. Yu et al. Palmitic acid downregulates thyroglobulin (TG), sodium iodide symporter (NIS), and thyroperoxidase (TPO) in human primary thyrocytes: a potential mechanism by which lipotoxicity affects thyroid? Int. J. Endocrinol. 2018, 4215848 (2018). https://doi.org/10.1155/2018/4215848CrossRefPubMedPubMedCentral

16.

M. Zhao, X. Tang, T. Yang, B. Zhang, Q. Guan, S. Shao et al. Lipotoxicity, a potential risk factor for the increasing prevalence of subclinical hypothyroidism?. J. Clin. Endocrinol. Metab. 100(5), 1887–94 (2015). https://doi.org/10.1210/jc.2014-3987CrossRefPubMed

17.

Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP), Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285(19), 2486–97 (2001)CrossRef

18.

D.S. Cooper, B. Biondi, Subclinical thyroid disease. Lancet (Lond., Engl.) 379(9821), 1142–54 (2012). https://doi.org/10.1016/S0140-6736(11)60276-6CrossRef

19.

J.R. Garber, R.H. Cobin, H. Gharib, J.V. Hennessey, I. Klein, J.I. Mechanick et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid 22(12), 1200–35 (2012). https://doi.org/10.1089/thy.2012.0205CrossRefPubMed

20.

M.P.J. Vanderpump, Should we treat mild subclinical/mild hyperthyroidism? No. Eur. J. Intern. Med. 22(4), 330–3 (2011). https://doi.org/10.1016/j.ejim.2011.03.009CrossRefPubMed

21.

Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization technical report series. 894:i–xii, 1–253 (2000). Epub 2001/03/10.

22.

B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1) (2016). https://doi.org/10.1089/thy.2015.0020

23.

C. Tomoda, T. Uruno, Y. Takamura, Y. Ito, A. Miya, K. Kobayashi et al. Ultrasonography as a method of screening for tracheal invasion by papillary thyroid cancer. Surg. today 35(10), 819–22 (2005)CrossRefPubMed

24.

K. Shimamoto, H. Satake, A. Sawaki, T. Ishigaki, H. Funahashi, T. Imai. Preoperative staging of thyroid papillary carcinoma with ultrasonography. Eur. J. Radiol. 29(1) (1998).

25.

J.Y. Kwak, E.-K. Kim, J.H. Youk, M.J. Kim, E.J. Son, S.H. Choi et al. Extrathyroid extension of well-differentiated papillary thyroid microcarcinoma on US. Thyroid 18(6), 609–14 (2008). https://doi.org/10.1089/thy.2007.0345CrossRefPubMed

26.

C.Y. Lee, S.J. Kim, K.R. Ko, K.-W. Chung, J.-H. Lee, Predictive factors for extrathyroidal extension of papillary thyroid carcinoma based on preoperative sonography. J. Ultrasound Med. 33(2), 231–8 (2014). https://doi.org/10.7863/ultra.33.2.231CrossRefPubMed

27.

A. Kamaya, A.M. Tahvildari, B.N. Patel, J.K. Willmann, R.B. Jeffrey, T.S. Desser, Sonographic detection of extracapsular extension in papillary thyroid cancer. J. Ultrasound Med. 34(12), 2225–30 (2015). https://doi.org/10.7863/ultra.15.02006CrossRefPubMed

28.

Z. Al-Qurayshi, N. Nilubol, R.P. Tufano, E. Kandil, Wolf in sheep’s clothing: papillary thyroid microcarcinoma in the US. J. Am. Coll. Surg. 230(4), 484–91 (2020). https://doi.org/10.1016/j.jamcollsurg.2019.12.036CrossRefPubMedPubMedCentral

29.

T. Diker-Cohen, D. Hirsch, I. Shimon, G. Bachar, A. Akirov, H. Duskin-Bitan, et al. Impact of minimal extra-thyroid extension in differentiated thyroid cancer: systematic review and meta-analysis. J. Clin. Endocrinol. Metab. 2018. https://doi.org/10.1210/jc.2018-00081.

30.

J.E. Paes, K. Hua, R. Nagy, R.T. Kloos, D. Jarjoura, M.D. Ringel, The relationship between body mass index and thyroid cancer pathology features and outcomes: a clinicopathological cohort study. J. Clin. Endocrinol. Metab. 95(9), 4244–50 (2010). https://doi.org/10.1210/jc.2010-0440. Epub 2010/06/04CrossRefPubMedPubMedCentral

31.

S.T. Yu, W. Chen, Q. Cai, F. Liang, D. Xu, P. Han et al. Pretreatment BMI is associated with aggressive clinicopathological features of papillary thyroid carcinoma: a multicenter study. Int J. Endocrinol. 2017, 5841942 (2017). https://doi.org/10.1155/2017/5841942. Epub 2017/11/01CrossRefPubMedPubMedCentral

32.

J. Lee, C.R. Lee, C.R. Ku, S.W. Kang, J.J. Jeong, D.Y. Shin et al. Association between obesity and BRAFV600E mutation status in patients with papillary thyroid cancer. Ann. surgical Oncol. 22(Suppl 3), S683–90 (2015). https://doi.org/10.1245/s10434-015-4765-z. Epub 2015/07/29CrossRef

33.

C. Li, L. Zhou, G. Dionigi, F. Li, Y. Zhao, H. Sun. The association between tumor tissue calcification, obesity, and thyroid cancer invasiveness in a cohort study. Endocr. Pract. 2020. https://doi.org/10.4158/EP-2020-0057

34.

H.J. Kim, N.K. Kim, J.H. Choi, S.Y. Sohn, S.W. Kim, S.M. Jin et al. Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer. Clin. Endocrinol. (Oxf.) 78(1), 134–40 (2013). https://doi.org/10.1111/j.1365-2265.2012.04506.xCrossRef

35.

C. Wu, L. Wang, W. Chen, S. Zou, A. Yang, Associations between body mass index and lymph node metastases of patients with papillary thyroid cancer: a retrospective study. Medicine (Baltimore) 96(9), e6202 (2017). https://doi.org/10.1097/MD.0000000000006202CrossRef

36.

C. Tresallet, M. Seman, F. Tissier, C. Buffet, R.M. Lupinacci, H. Vuarnesson et al. The incidence of papillary thyroid carcinoma and outcomes in operative patients according to their body mass indices. Surgery 156(5), 1145–52 (2014). https://doi.org/10.1016/j.surg.2014.04.020. Epub 2014/06/01CrossRefPubMed

37.

P. Dieringer, E.M. Klass, B. Caine, J. Smith-Gagen, Associations between body mass and papillary thyroid cancer stage and tumor size: a population-based study. J. Cancer Res. Clin. Oncol. 141(1), 93–8 (2015). https://doi.org/10.1007/s00432-014-1792-2. Epub 2014/08/13CrossRefPubMed

38.

S.H. Kim, H.S. Park, K.H. Kim, H. Yoo, B.J. Chae, J.S. Bae et al. Correlation between obesity and clinicopathological factors in patients with papillary thyroid cancer. Surg. Today 45(6), 723–9 (2015). https://doi.org/10.1007/s00595-014-0984-3. Epub 2014/07/26CrossRefPubMed

39.

C.L. Li, G. Dionigi, Y.S. Zhao, N. Liang, H. Sun. Influence of body mass index on the clinicopathological features of 13,995 papillary thyroid tumors. J. Endocrinol. Invest. 2020. https://doi.org/10.1007/s40618-020-01216-6.

40.

Y. Ito, A. Miyauchi, M. Kihara, T. Higashiyama, K. Kobayashi, A. Miya, Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid 24(1), 27–34 (2014). https://doi.org/10.1089/thy.2013.0367CrossRefPubMedPubMedCentral

41.

Y. Ito, A. Miyauchi, T. Kudo, T. Higashiyama, H. Masuoka, M. Kihara et al. Kinetic analysis of growth activity in enlarging papillary thyroid microcarcinomas. Thyroid 29(12), 1765–73 (2019). https://doi.org/10.1089/thy.2019.0396.CrossRefPubMedPubMedCentral

42.

J. Zhang, R. Jiang, L. Li, P. Li, X. Li, Z. Wang et al. Serum thyrotropin is positively correlated with the metabolic syndrome components of obesity and dyslipidemia in chinese adolescents. Int. J. Endocrinol. 2014, 289503 (2014). https://doi.org/10.1155/2014/289503.CrossRefPubMedPubMedCentral

43.

S.K. Kota, L.K. Meher, S. Krishna, K. Modi, Hypothyroidism in metabolic syndrome. Indian J. Endocrinol. Metab. 16(Suppl 2), S332–3 (2012). https://doi.org/10.4103/2230-8210.104079CrossRefPubMedPubMedCentral

Title: The relationship between lipotoxicity and risk of extrathyroidal extension in papillary thyroid microcarcinoma
Authors: Changlin Li
Haixia Guan
Qiao He
Yishen Zhao
Nan liang
Jiao Zhang
Gianlorenzo Dionigi
Hui Sun
Publication date: 01-12-2021
Publisher: Springer US
Keyword: Metastasis
Published in: Endocrine / Issue 3/2021
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-021-02809-8

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2021

The relationship between the level of exercise and hemoglobin A1c in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Obesity, metabolic syndrome, and cancer: pathophysiological and therapeutic associations

Pediatric multidisciplinary weight management—how can we improve further?

Polycystic ovary syndrome is an independent risk factor for hypertensive disorders of pregnancy: A systematic review, meta-analysis, and meta-regression

Surgical outcomes in the pheochromocytoma surgery. Results from the PHEO-RISK STUDY

Modulation of ACE-2 mRNA by inflammatory cytokines in human thyroid cells: a pilot study

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage