Postoperative serum oxidative stress measures in women with papillary thyroid cancer

Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, with a steadily rising incidence worldwide and a marked female predominance. While prognosis is generally favorable, certain histopathological features, particularly angioinvasion, are associated with increased recurrence risk and reduced responsiveness to radioactive iodine (RAI) therapy. Emerging evidence implicates oxidative stress in thyroid tumorigenesis and progression, potentially influencing tumor aggressiveness. Given the higher disease burden in women and the potential influence of hormonal status on oxidative balance, this hypothesis-generating study focused exclusively on female patients to minimize hormonal variability and to explore associations between peripheral oxidative stress measures, DXA-derived body composition parameters, and angioinvasion as a feature of tumor aggressiveness in PTC. A total of 80 women were enrolled, including 36 with angioinvasive PTC, 15 with non-angioinvasive PTC, and 29 healthy controls. Blood samples were collected post-thyroidectomy. A broad panel of biochemical, hormonal, and oxidative stress markers including 3-nitrotyrosine (3-NT), 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), protein carbonyls, 8-oxoguanine DNA glycosylase-1 (OGG1), and total antioxidant/oxidant capacity (TAS/TAC, TOS) was assessed. Among oxidative stress markers, OGG1 and MDA were significantly elevated in the PTC groups (both, p < 0.001). Additionally, android fat distribution and the android-to-gynoid fat ratio were significantly higher in the angioinvasive group (p = 0.03 and p = 0.01, respectively). Among the evaluated models, the panel combining MDA and TOS demonstrated the highest diagnostic performance (AUC = 0.83), suggesting its potential exploratory value for distinguishing angioinvasive from non-angioinvasive PTC in a postoperative setting.