摘要
目的探讨某市2000年至2018年慢性水碘暴露与甲状腺癌发病率的关系。方法选取辽宁省抚顺市清原县、新宾县和抚顺县分别称为A、B和C县,分别代表碘适宜区、高碘区和碘超标区。观察三个县2000年至2004年、2005年至2009年、2010年至2014年及2015年至2018年4个阶段甲状腺癌发病率及与水碘中位值的相关性。结果纳入甲状腺疾病患者8128例,其中1310例诊断为甲状腺癌,甲状腺癌诊断率16.1%。A、B、C三县2000年至2004年、2005年至2009年、2010年至2014年及2015年至2018年4个阶段甲状腺癌发病率均呈逐渐升高趋势。A、B、C三县2015年至2018年甲状腺癌发病率较2000年至2004年分别升高3.35倍、2.41倍和4.00倍。水碘监测的数据及Spearman相关分析显示,水碘中位值与甲状腺癌检出不存在相关性,差异无统计学意义(P>0.05)。四个时间段肿瘤直径≤0.5cm、>0.5cm但≤1cm、>1cm但≤2cm及>2cm但≤3cm直径肿瘤检出率比较,差异均有统计学意义(均P<0.05)。2000年至2018年随时间增加,≤1cm(包括≤0.5和>0.5cm但≤1cm)甲状腺癌检出率明显增加,差异均有统计学意义(均P<0.05)。结论甲状腺癌发病率的增加与水碘暴露可能无关,诊断技术提高和体检意识增强使≤1cm的小肿瘤检出率增加,可能是甲状腺癌发病率升高的重要原因。
Objective To analyze the relationship between chronic exposure to iodine in water and the incidence of thyroid cancer in a city from 2000 to 2018.Methods The three counties of Qingyuan,Xinbin and Fushun in Fushun,Liaoning Province were selected and named county A,B and C,respectively,which represented appropriate iodine area,high iodine area and excess iodine area,respectively.The incidence of thyroid cancer and its correlation with median iodine content in water were observed over the periods of 2000 to 2004,2005 to 2009,2010 to 2014 and 2015 to 2018 in the above three counties.Results A total of 8128 patients with thyroid diseases were included.Of them,1310 were diagnosed with thyroid cancer.The diagnosis rate of thyroid cancer was 16.1%.The cumulative incidence of thyroid cancer in A,B and C counties increased gradually over the periods of 2000 to 2004,2005 to 2009,2010 to 2014 and 2015 to 2018.From 2015 to 2018,the incidence of thyroid cancer increased by 3.35 times,2.41 times and 4.00 times,respectively in counties A,B and C compared with the period from 2000 to 2004.After the detection of iodine in water,the Spearman correlation analysis showed that there was no correlation between median iodine in water and thyroid cancer detection rate(P>0.05).There was significant difference in the detection rate of tumors with diameter≤0.5 cm,>0.5 but≤1 cm,>1 cm but≤2 cm and>2 cm but≤3 cm in above four time periods(all P<0.05).From 2000 to 2008,detection rate of thyroid cancer with diameter≤1 cm increased(all P<0.05).Conclusion The increase of incidence of thyroid cancer may not be associated with exposure to iodine in water.The increase of detection rate of small tumors with diameter≤1 cm due to the advancement of diagnosis technology and physical examination may be the important reason for the increase of incidence of thyroid cancer.
作者
辛维宇
XIN Wei-yu(Fushun Health Service Center/Fushun Municipal Center for Disease Control and Prevention,Fushun 113006,China)
出处
《中国肿瘤临床与康复》
2020年第2期185-188,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
水碘监测
甲状腺肿瘤
发病率
Detection of iodine in water
Thyroid neoplasms
Incidence
