The relationship between anxiety levels and clinicopathological characteristics in patients with papillary thyroid carcinoma

doi:10.16139/j.1007-9610.2025.03.10

Abstract

Abstract:

Objective To evaluate the relationship between anxiety levels and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC). Methods Among the patients who underwent surgical treatment in our center from July 2022 to September 2023, 304 patients completed the Hamilton anxiety rating scale (HAM-A) questionnaire. The clinical and pathological characteristics of these patients and their association with anxiety levels were investigated. Results Among the 304 patients, 271 were pathologically confirmed to have PTC. Of the 271 patients, 75 had higher levels of anxiety (according to HAM-A scoring system, a score ≥14 indicates clinically significant anxiety) and were assigned to the anxiety group. Univariate statistical analysis showed that the proportion of patients with elevated thyroid peroxidase antibody (TPOAb) in the anxiety group was higher than that in the non-anxiety group (34.7% vs. 16.8%, P=0.002 4). Moreover, the proportion of patients with multifocal tumors in the anxiety group was also higher than that in the non-anxiety group (33.3% vs. 16.7%, P=0.004 4). Multivariate Logistic regression confirmed that anxiety levels were associated with elevated TPOAb (P=0.005 6) and tumor multifocality (P=0.001 9). Conclusions Anxiety levels may be related to elevated TPOAb and tumor multifocality in PTC patients.

Key words: Papillary thyroid carcinoma (PTC), Anxiety, Pathological characteristics

CLC Number:

R736.1

LIU Zhuoran, ZHAO Qiwu, QIU Weihua, YAN Jiqi, CAI Wei, KUANG Jie. The relationship between anxiety levels and clinicopathological characteristics in patients with papillary thyroid carcinoma[J]. Journal of Surgery Concepts & Practice, 2025, 30(03): 241-246.

Figures/Tables 6

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References 25

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Item		PTC(n=271)	Other(n=33)	OR/χ² value	P value
Age(year)		37(31-45)	42(31-56)	χ²=2.6	0.1
	≥55	23(8.5)	9(27.3)	OR=0.2	0.003
	<55	248(91.5)	24(72.7)	OR=0.2	0.003
Gender	Male	76(28.0)	8(24.2)	OR=0.8	0.8
Gender	Female	195(72.0)	25(75.8)	OR=0.8	0.8
BMI		23.4(21.5-27.0)	22.9(21.2-25.4)	χ²=0.4	0.5
HAM-A score		9(4-14)	10(5-14)	χ²=0.1	0.75
	<14	196(72.3)	24(72.7)	OR=1.0	1.0
	≥14	75(27.7)	9(27.3)	OR=1.0	1.0
FT4		12.6(11.8-13.8) (n=264)	12.9(12.2-14.3) (n=31)	χ²=2.0	0.2
FT3		4.2(3.9-4.6) (n=264)	4.2(4.0-4.7) (n=31)	χ²=0.1	0.7
TSH		1.5(1.0-2.4) (n=264)	1.2(0.8-2.1) (n=31)	χ²=2.8	0.09
TG		12.5(5.0-23.5) (n=261)	62.8(7.5-229.0) (n=31)	χ²=15.9	0.000 07
TPOAb		1.0(0.4-2.6) (n=263)	0.9(0.4-1.9) (n=31)	χ²=0.1	0.7
TGAb		1.8(0.9-10.9) (n=264)	1.2(0.9-2.3) (n=31)	χ²=2.3	0.1

Item		Non-anxiety group (HAM-A<14) (n=196)	Anxiety group (HAM-A≥14) (n=75)	OR/χ² value	P value
Age		37(31-45)	38(32.5-44.5）	χ²=0.8	0.38
	≥55	15(7.7)	8(10.7)	OR=1.4	0.47
	<55	181(92.3)	67(89.3)	OR=1.4	0.47
Gender	Male	64(32.7)	12(16.0)	OR=2.5	0.006
Gender	Female	132(67.3)	63(84.0)	OR=2.5	0.006
BMI		23.5(21.5-26.7)	23.2(21.5-27.6)	χ²=0.01	0.92
FT4		12.6(11.8-13.8) (n=192)	12.4(11.7-13.9) (n=72)	χ²=0.01	0.90
FT3		4.2(3.9-4.5) (n=192)	4.2(3.9-4.6) (n=72)	χ²=0.6	0.43
TSH		1.5(1.1-2.5) (n=192)	1.4(0.8-2.2) (n=72)	χ²=2.1	0.15
TG		11.3(4.8-21.2) (n=190)	16.0(5.3-28.4) (n=71)	χ²=2.5	0.11
TPOAb		0.9(0.4-1.9) (n=191)	1.3(0.5-18.7) (n=72)	χ²=3.7	0.055
	Elevated	32(16.8) (n=191)	25(34.7) (n=72)	OR=2.6	0.002 4
	Normal	159(83.2) (n=191)	47(65.3) (n=72)	OR=2.6	0.002 4
TGAb		1.6(0.9-9.2) (n=192)	2.7(1.0-11.9) (n=72)	χ²=3.1	0.08
	Elevated	59(30.7) (n=192)	31(43.1) (n=72)	OR=1.7	0.08
	Normal	133(69.3) (n=192)	41(56.9) (n=72)	OR=1.7	0.08
BRAF	Mutant	141(87.0) (n=162)	54(85.7) (n=63)	OR=0.9	0.83
BRAF	Wild-type	21(13.0) (n=162)	9(14.3) (n=63)	OR=0.9	0.83
Tumor diameter（cm）		0.6(0.4-1.0) (n=192)	0.7(0.5-1.1)	χ²=1.2	0.28
Multifocality	Yes	32(16.7) (n=192)	25(33.3)	OR=2.5	0.004 4
Multifocality	No	160(83.3) (n=192)	50(66.7)	OR=2.5	0.004 4
Bilaterality	Yes	32(16.5) (n=194)	16(21.3)	OR=1.4	0.38
Bilaterality	No	162(83.5) (n=194)	59(78.7)	OR=1.4	0.38
Central LN metastasis	Yes	84(43.3) (n=194)	33(44.0)	OR=1.0	1.00
Central LN metastasis	No	110(56.7) (n=194)	42(56.0)	OR=1.0	1.00
Lateral LN metastasis	Yes	26(13.5) (n=192)	9(12.3) (n=73)	OR=1.1	1.00
Lateral LN metastasis	No	166(86.5) (n=192)	64(87.7) (n=73)	OR=1.1	1.00
Pathological subtypes	TCV or DSV	19(9.9) (n=192)	8(10.7)	OR=1.1	0.82
Pathological subtypes	Others	173(90.1) (n=192)	67(89.3)	OR=1.1	0.82

Item	Elevated TPOAb (n=57)	Normal TPOAb (n=206)	χ² value	P value
Psychic Anxiety socre	8(4-11)	5(3-8)	9.4	0.002
Somatic Anxiety score	4(1-7)	2(1-4)	5.4	0.02

Item	Multifocal (n=57)	Non-multifocal (n=210)	χ² value	P value
Psychic anxiety socre	7(3-11)	5(3-8)	3.4	0.066
Somatic anxiety score	3(1-7)	2(1-5)	2.7	0.098

Item	OR	Std. Error	z value	95% CI	P value
(Intercept)	0.89	1.22	-0.10	0.08-9.78	0.92
HAM-A score(≥14)	2.489	0.33	2.77	1.3-4.75	0.005 6
Age	0.97	0.02	-1.62	0.94-1.01	0.11
Gender(Female)	3.12	0.49	2.32	1.27-8.9	0.021
BMI	0.94	0.04	-1.41	0.87-1.02	0.16