摘要
目的分析27年甲状腺乳头状癌、滤泡癌病理检出率的变化情况，进一步探讨碘与这两种疾病的关系。方法用游程检验、升降趋势检验、方差分析、t或t’检验、x^2检验，对天津医科大学总医院病理科1978年～2004年甲状腺疾病、甲状腺恶性肿瘤、甲状腺乳头状癌、滤泡癌及其“伴发病变”进行统计学分析。结果27年外检总数231837例（平均8587例／年），包括甲状腺疾病6276例（2．70％）、甲状腺恶性肿瘤644例（0．28％）、甲状腺乳头状癌465例（0．20％）、滤泡癌80例（0．03％）。甲状腺疾病外检率1982年后呈下降趋势，1995年后呈明显上升趋势；甲状腺恶性肿瘤外检率无明显变化趋势；1995年后甲状腺乳头状癌外检率呈上升趋势，甲状腺滤泡癌外检率呈下降趋势。27年中这两种疾病及其女性和男性平均确诊年龄均无明显变化趋势，但男性平均确诊年龄均大于女性。27年中甲状腺乳头状癌、滤泡癌的性别比例男性明显低于女性，分别为1：3．31、1：2．81，亦无明显变化趋势。乳头状癌（33．76％）伴有淋巴结转移的病例比滤泡癌（10．00％）高，而伴侵犯血管和结节性甲状腺肿（结甲肿）的病例，滤泡癌（11．25％与13．75％）高于乳头状癌（0．65％与4．52％）。且乳头状癌伴有结甲肿患者平均确诊年龄大于不伴有者，分别为44．3岁与38．1岁。两种癌伴有淋巴结转移的男、女比例高于不伴有者。结论27年甲状腺恶性肿瘤总发病率无明显变化，而乳头状癌与滤泡癌出现相反的变化趋势显示出甲状腺癌总恶性程度下降的结果，提示本地区未处于高碘状态，且与碘摄入量变化无明显相关性。
Objective To analyze the change in the incidence of papillary thyroid carcinoma （PTC） and follicular thyroid carcinoma （FTC） in the past 27 years and to probe the relationship between iodine and these carcinomas. Methods Statistical analysis was performed on data of thyroid diseases, thyroid malignant tumors, PTC , FTC and their complications in Department of Pathology from 1978 to 2004 in General Hospital of Tianjin Medical University with Run test,Cox-Stuart test, ANOVA, t or t＇ test and Chi-square test. Results In 27 years there were 231 837 cases of biopsies （ average 8 587cases/year）. The biopsies were performed in the thyroid diseases as a whole 6 276 cases （2.70%） , thyroid malignant tumors 644 cases （0.28%）, PTCs 465 cases （0.20%）, and FTCs 80 cases （0.03%） in 27 years. Biopsies in thyroid diseases as a whole showed a descending tendency since 1982 but an ascending tendency after 1995. Biopsy in malignant thyroid tumor did not show a significant change, and biopsy in PTC showed an ascending tendency and that in FTC showed a descending tendency after 1995. The average age, both in male and female patients, at the time of diagnosis of PTC and FIG showed no significant change during 27 years, but the mean age of male at the time of diagnosis was older than that of female. The ratios of male to female in PTC and FIC were 1：3.31,1：2.81 respectively, and showed no significant change either. There were more biopsies with lymph node metastasis in PTC （33.76%） than those in FIC （ 10.00% ） and more biopsies with blood vessel involved or nodular goiter in FTC （ 11.25% and 13.75% ） than those in PTC （0.65% and 4.52% ）. Mean age of patients with PTC and nodular goiter （44.3 years old） was older than those without goiter （38.1 years old）. The ratios of male to female with PTC and FTC with lymph node metastasis were higher than those without lymph node metastasis. Conclusion The incidence of thyroid malignant tumors in 27 years has no significant change. The contrary tendency of PTC and FTC suggests that the decreasing malignant degree of carcinoma. It suggests that this area is not in high iodine condition and the change have no relationship with the iodine intake.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2006年第2期105-109,共5页
Chinese Journal of Endocrinology and Metabolism
基金
天津市自然科学基金(033611811)
关键词
甲状腺肿瘤
碘
发病率
病理学
Thyroid neoplasms
Iodine
Incidence
Pathology
