Background Thyroid cancer (TC) is the most common malignant tumor of the endocrine system, and its incidence has increased rapidly in recent years. Papillary thyroid cancer (PTC) is the most common type of thyroid cancer, accounting for 80% of all thyroid cancers. Despite the efficacy of surgical treatment, radioactive iodine therapy, TSH inhibition therapy and novel targeted drug therapy, early diagnosis and intervention are the key to stop its occurrence and development, however, the sensitivity indexes related to PTC are still lacking in clinical practice.
Objective To investigate the correlation between lipid metabolism, inflammatory markers and sex of patients with PTC.
Methods The data of PTC patients (n=370) diagnosed and treated in the Affiliated Hospital of North China University of Science and Technology from January 2018 to December 2020 were selected for retrospective analysis, and the normal population of physical examination in the same period was matched according to age and gender as the control group (n=1 112). Age, gender, smoking status, BMI, peripheral blood white blood cell count (WBC), platelet count (PLT), lymphocyte count (LYM), monocyte count (MON), neutrophil count (NEU), fasting blood glucose (FBG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), were collected in both groups, triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), urea (UREA), creatinine (Cr), and uric acid (UA), and calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-HDL cholesterol ratio (MHR). Analyze the correlation between the above indicators and PTC and their diagnostic value.
Results Compared with control group, WBC, LYM, MON, LDL-C and MHR in case group were higher than those in control group (P<0.001). There were significant differences in PLR, LYM and MHR between the two groups (P<0.05). In correlation analysis, there was a positive correlation between MHR indicators and tumor size in female PTC patients (r=0.582, P<0.05). The correlation between MHR and tumor size in male PTC patients is weak (r=0.355, P<0.05). Binary Logistic regression analysis showed that: in female patients with PTC (papillary thyroid carcinoma), PLR served as a protective factor (OR= 0.475, P=0.004), while LYM and MHR were identified as risk factors[for LYM: OR=1.605, P=0.044; for MHR: OR=2.659, P<0.001]. Conversely, in male patients, PLR and MHR found to be protective factors[ (OR= 0.280, P=0.011), (OR=0.312, P=0.029) ]. The AUC values for MHR in female and male PTC patients were 0.548 and 0.652, respectively, suggesting a higher diagnostic value of the MHR indicator in female PTC patients compared to their male counterparts. The AUC areas of MHR in male and female PTC patients were 0.548 and 0.652, respectively, indicating that the diagnostic value of MHR indicators in female PTC patients is higher than that in males.
Conclusion MHR is associated with the occurrence of thyroid papillary carcinoma, and is an independent risk factor in women, while a protective factor in men.
