The relationship of microscopic invasion of papillary thyroid carcinoma in patients with obesity

Background. Papillary Thyroid Carcinoma (PTC) is the malignant neoplasm of thyroid gland constituting up to 80% of all thyroid cancer types. The relationship between PTC and obesity is not well investigated in Ukraine. Aim. To investigate and evaluate the features of the microscopic invasive features of PTC in the obese and overweight patients and compare it with patients with PTC and normal weight. Materials and Methods. This study enrolled 91 patients who were diagnosed with PTC. The patients were divided into a groups depending on their Body Mass Index (BMI): 20 patients with PTC and obesity (BMI >30 kg/m2), the 45 patients with overweight and PTC (BMI 24.0–29.0 kg/m2) and 26 patients with PTC and normal weight (BMI 18.0–23.9 kg/m2). A clinical data and histopathological parameters were retrieved from archived medical records. Written informed consent was to participated was obtained from all patient. Statistica 12 (TIBCO Software Inc., USA) and GraphPad Prism 10 (GraphPad Software, LLC, USA) statistical software were used for data analyses. Statistical significance was set at p<0.05. Ethical approval for the study was obtained the local ethical committee at Verum Expert Clinic. The study was conducted according to Helsinki Declaration and Ukrainian ethical standards. Results. A statistically significant difference in the higher frequency of microscopic damage to the thyroid gland structures by PTC was detected in 6 (30.0%) patients with PTC with obesity, in 3 (6.0%) patients with PTC with overweight, and in 5 (19.0%) patients with PTC with normal weight (p=0.046). Further data analysis revealed a significantly higher frequency of the PTC perineural invasion in 3 (15%) obese patients with PTC, in 3 (2.2%) overweight patients with PTC, and in none of the patients with PTC and normal weight (p=0.031). Conclusions. Patients with PTC and obesity have 1.57 higher frequency of microscopic invasion predominately due to perineural invasion of the carcinoma, which is aggressive biological characteristics of malignant neoplasm. The risk of PTC in the population with obesity should be taken into consideration by medical professional, and aggressive biological characteristics should be considered at follow up and management of the patients. Keywords: neoplasm invasiveness, perineural invasion, body mass index, cancer risk factors.