THE ASSOCIATION BETWEEN TUMOR TISSUE CALCIFICATION, OBESITY, AND THYROID CANCER INVASIVENESS IN A COHORT STUDY.

Purpose. We examined the relationships between tumor tissue calcifications of papillary thyroid cancer (PTC), body mass index (BMI), and tumor invasiveness. Methods. This is a retrospective analysis of 13,995 patients with PTC. Comparisons were made between the clinical and pathological features of the tumor tissue calcifications group and non-tumor tissue calcifications group. The odds ratios (OR) of tumor tissue calcifications, BMI, and tumor invasiveness features were calculated using a binary logistic regression model. We analyzed the relationship between tumor tissue calcifications, and certain characteristics of thyroid cancer based on the pathological findings. Results. BMI was positively correlated with tumor tissue calcifications in patients with PTC (OR=1.015, P=0.011), and obesity increased risk of tumor tissue calcifications (OR = 1.374, P=0.038). Calcifications were positively correlated with T-size (OR=1.899, P<0.001), multifocality (OR = 1.217, P<0.001), extra thyroidal extension (ETE) (OR = 1.287, P<0.001), high T-stage (OR = 1.765, P<0.001), N+ (OR = 1.763, P<0.001), and a higher number of lymph node metastases (OR=1.985, P<0.001). Compared with normal-weight patients with tumor tissue calcifications, the obese patients with tumor tissue calcifications had an increased risk of ETE (OR obesity = 1.765 vs. OR normal = 1.300) and N+ (OR obesity = 1.992 vs. OR normal = 1.784). Conclusions. Tumor tissue calcifications are positively correlated with the invasiveness of PTC. Obesity further promotes the risk of tumor invasiveness in PTC combined with tumor tissue calcifications. These findings suggest that more comprehensive evaluations by trained pathologists may help physicians identify the optimal therapeutic regimens in the postoperative period.