Journal of Surgery Concepts & Practice >

2025 , Vol. 30 >Issue 03: 241 - 246

DOI: https://doi.org/10.16139/j.1007-9610.2025.03.10

Original article

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

  • LIU Zhuoran ,
  • ZHAO Qiwu ,
  • QIU Weihua ,
  • YAN Jiqi ,
  • CAI Wei ,
  • KUANG Jie
Expand
  • Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2025-02-25

  Online published: 2025-09-01

Fold

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

Cite this article

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 . DOI: 10.16139/j.1007-9610.2025.03.10

References

[1] HAN B, ZHENG R, ZENG H, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1):47-53.
[2] SEIB C D, SOSA J A. Evolving understanding of the epidemiology of thyroid cancer[J]. Endocrinol Metab Clin North Am, 2019, 48(1):23-35.
[3] BOUCAI L, ZAFEREO M, CABANILLAS M E. Thyroid cancer: a review[J]. JAMA, 2024, 331(5):425-435.
[4] WILMER M T, ANDERSON K, REYNOLDS M. Correlates of quality of life in anxiety disorders: review of recent research[J]. Curr Psychiatry Rep, 2021, 23(11):77.
[5] BOBO W V, GROSSARDT B R, VIRANI S, et al. Association of depression and anxiety with the accumulation of chronic conditions[J]. JAMA Netw Open, 2022, 5(5):e229817.
[6] KROENKE K, SPITZER R L, WILLIAMS J B, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection[J]. Ann Intern Med, 2007, 146(5):317-325.
[7] KERSHAW K A, STORER B, BRAUND T, et al. The Prevalence of anxiety in adult endocrinology outpatients: a systematic review and meta-analysis[J]. Psychoneuroendocrinology, 2023,158:106357.
[8] GORKHALI B, SHARMA S, AMATYA M, et al. Anxiety and depression among patients with thyroid function disorders[J]. J NePal Health Res Counc, 2020, 18(3):373-378.
[9] LEE S Y, PEARCE E N. Hyperthyroidism: a review[J]. JAMA, 2023, 330(15):1472-1483.
[10] WANG Y H, LI J Q, SHI J F, et al. Depression and anxie-ty in relation to cancer incidence and mortality: a syste-matic review and meta-analysis of cohort studies[J]. Mol Psychiatry, 2020, 25(7):1487-1499.
[11] WANG X, WANG N, ZHONG L, et al. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients[J]. Mol Psychiatry, 2020, 25(12):3186-3197.
[12] VAN TUIJL L A, BASTEN M, PAN K Y, et al. Depression, anxiety, and the risk of cancer: an individual participant data meta-analysis[J]. Cancer, 2023, 129(20):3287-3299.
[13] HELVAC? B C, YAL?IN M M, YALCIN ? N G, et al. Differentiated thyroid cancer: effect on quality of life, depression, and anxiety[J]. Hormones (Athens), 2023, 22(3):367-374.
[14] ALEXANDER K, LEE S C, GEORGIADES S, et al. The "not so good" thyroid cancer: a scoping review on risk factors associated with anxiety, depression and quality of life[J]. J Med Life, 2023, 16(3):348-371.
[15] MAIER W, BULLER R, PHILIPP M, et al. The Hamilton anxiety scale: reliability, validity and sensitivity to change in anxiety and depressive disorders[J]. J Affect Disord, 1988, 14(1):61-68.
[16] PATWARDHAN V, GIL G F, ARRIETA A, et al. Diffe-rences across the lifespan between females and males in the top 20 causes of disease burden globally: a systematic analysis of the global burden of disease study 2021[J]. Lancet Public Health, 2024, 9(5):e282-e294.
[17] 赖晓英, 欧阳平, 朱宏, 等. 甲状腺结节检出情况及影响因素:10年309576例体检人群分析[J]. 南方医科大学学报, 2020, 40(2):268-273.
  LAI X Y, OUYANG P, ZHU H, et al. Detection rate of thyroid nodules in routine health check-up and its influencing factors: a 10-year survey of 309 576 cases[J]. J South Med Univ, 2020, 40(2):268-273.
[18] LIU J, KUANG J, SUN H, et al. The alternative value of thyroid stimulating hormone instead of thyroglobulin in differentiation of follicular thyroid neoplasm in Hashimoto's thyroiditis[J]. Front Oncol, 2024,14:1395202.
[19] LI S, REN C, GONG Y, et al. The role of thyroglobulin in preoperative and postoperative evaluation of patients with differentiated thyroid cancer[J]. Front Endocrinol(Lausanne), 2022,13:872527.
[20] RALLI M, ANGELETTI D, FIORE M, et al. Hashimoto's thyroiditis: an update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation[J]. Autoimmun Rev, 2020, 19(10):102649.
[21] LI J, HUANG Q, SUN S, et al. Thyroid antibodies in Hashimoto's thyroiditis patients are positively associated with inflammation and multiple symptoms[J]. Sci Rep, 2024, 14(1):27902.
[22] YALCIN M M, ALTINOVA A E, CAVNAR B, et al. Is thyroid autoimmunity itself associated with psychological well-being in euthyroid Hashimoto's thyroiditis?[J]. Endocr J, 2017, 64(4):425-429.
[23] CARTA M G, HARDOY M C, CARPINIELLO B, et al. A case control study on psychiatric disorders in hashimoto disease and euthyroid goitre: not only depressive but also anxiety disorders are associated with thyroid autoimmunity[J]. Clin Pract EPidemiol Ment Health, 2005,1:23.
[24] GIYNAS AYHAN M, UGUZ F, ASKIN R, et al. The prevalence of depression and anxiety disorders in patients with euthyroid Hashimoto's thyroiditis: a comparative study[J]. Gen HosP Psychiatry, 2014, 36(1):95-98.
[25] COOPER K, CAMPBELL F, HARNAN S, et al. Association between stress, depression or anxiety and cancer: rapid review of reviews[J]. Compr Psychoneuroendocrinol, 2023,16:100215.
Options
Outlines

/

〈 〉