AUTHOR=Zhang Jiao , Zhou Le , Dionigi Gianlorenzo , Zhang Daqi , Zhao Lina , Liang Nan , Xue Gaofeng , Sun Hui 

TITLE=Association Between the Presence of Female-Specific Tumors and Aggressive Clinicopathological Features in Papillary Thyroid Cancer: A Retrospective Analysis of 9,822 Cases

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.611471

DOI=10.3389/fonc.2021.611471

ISSN=2234-943X

ABSTRACT=<sec><title>Objective</title><p>To investigate the association between the presence of female-specific tumors and aggressive clinicopathological features in papillary thyroid cancer (PTC).</p></sec><sec><title>Methods</title><p>This study retrospectively analyzed 9,822 female cases between June 2008 and December 2017. Odds ratios and corresponding 95% confidence intervals were calculated. Findings were stratified by age and body mass index (BMI) in different models.</p></sec><sec><title>Results</title><p>1443/9822 (14.7%) patients with PTC had a female-specific tumor. Presence of a benign breast mass was an independent risk factor for a primary PTC lesion &gt; 1 cm in diameter (adjusted OR = 1.446, 95% CI 1.136–1.840, <italic>P</italic> = 0.003), but a protective factor against extrathyroidal extension of PTC (adjusted OR = 0.650, 95%CI 0.500–0.845, <italic>P</italic> = 0.001). Presence of a benign uterine mass was an independent risk factor for multifocal PTC (adjusted OR = 1.305, 95%CI 1.113–1.531, <italic>P</italic> = 0.001). Analyses stratified by age and BMI revealed the presence of a benign breast mass was an independent risk factor for a primary PTC lesion &gt; 1 cm in diameter in patients aged &lt;36 years (adjusted OR = 1.711, 95% CI 1.063–2.754, <italic>P</italic> = 0.027), and a protective factor against extrathyroidal extension of PTC in patients aged ≥36 - &lt;42 years (OR adjusted = 0.533, 95% CI 0.302–0.941, <italic>P</italic> = 0.030) or with a BMI ≥ 23.4 kg/m<sup>2</sup> (BMI ≥ 23.4 to &lt; 25.7 kg/m<sup>2</sup>, adjusted OR = 0.441, 95% CI 0.246–0.792, <italic>P</italic> = 0.006; BMI ≥25.7 kg/m<sup>2</sup>, adjusted OR = 0.558, 95% CI 0.315–0.998, <italic>P</italic><sub>2</sub> = 0.045). Presence of a benign uterine mass was an independent risk factor for multifocal PTC in patients aged ≥49 years (adjusted OR = 1.397, 95% CI 1.088–1.793, <italic>P</italic> = 0.009) or with a BMI &lt;21.5 kg/m<sup>2</sup> (OR adjusted = 1.745, 95% CI 1.214–2.509, <italic>P</italic> = 0.003).</p></sec><sec><title>Conclusion</title><p>The presence of a benign breast mass was an independent risk factor for a primary PTC lesion &gt; 1 cm in diameter and a protective factor against extrathyroidal extension of PTC, while the presence of a benign uterine mass was an independent risk factor for multifocal PTC. Data from this study may help surgeons propose more personalized treatment plans when encountering patients with PTC and female-specific benign tumors.</p></sec>