摘要
目的 分析手术切除的甲状腺结节大小与甲状腺癌患病风险之间的关系.方法 回顾性分析2001年至2011年于本院进行甲状腺切除手术的5 440例甲状腺结节患者,病历记录的甲状腺结节共7 642个,有病理结果的结节共6 907个,按照结节直径＜1.0cm、≥1.0cm且＜2.0 cm、≥2.0 cm且＜3.0 cm、≥3.0 cm且＜4.0 cm、≥4.0 cm分为5组,对不同直径分组甲状腺结节中甲状腺癌发生率进行分析比较.结果 （1）5 440例甲状腺结节患者中,评价的结节共6 907个,28.94％（1 999/6 907）的结节为甲状腺癌,其中为甲状腺乳头状癌的结节共1 947个（占所有恶性肿瘤的97.39％）.（2）结节直径＜1.0 cm、≥1.0 cm且＜2.0 cm和≥2.0 cm这3组中,甲状腺癌发生率分别为51.6％、26.8％和11.2％ （P＜0.01）.而在结节直径≥2.0 cm且＜3.0 cm、≥3,0cm且＜4.0 cm和≥4.0cm这3组中,甲状腺癌的发生率分别为12.1％、10.0％和9.5％ （P=0.213 2）.（3）组织病理学为甲状腺癌的结节中,甲状腺乳头状癌所占比例呈随结节直径增加呈下降的趋势（＜1.0 cm：99.4％,≥1.0 cm且＜2.0 cm：98.4％,≥2.0cm且＜3.0 cm：90.3％,≥3.0cm且＜4.0 cm：89.5％,≥4.0 cm：68.4％）,而滤泡细胞癌的比例逐渐增加（＜1.0 cm：0.5％,≥1.0cm且＜2.0 cm：1.3％,≥2.0 cm且＜3.0 cm：6.3％,≥3.0cm且＜4.0 cm：5.3％,≥4.0：21.1％）.结论 甲状腺乳头状癌的发病风险随结节直径的增加而呈降低趋势,滤泡细胞癌与其他少见甲状腺癌的发病风险在较大直径的结节中增加.
Objective To evaluate the association of nodule size with thyroid cancer risk.Methods This retrospective study included 5 440 patients undergoing thyroidectomy in Chinese PLA General Hospital from 2001 to 2011.Of these patients,6 907 nodules with histological results were analysed.The nodules were devided into five groups according to nodule size：〈 1.0 cm,≥ 1.0 cm and 〈2.0 cm,≥ 2.0 cm and 〈3.0 cm,≥ 3.0 cm and 〈4.0 cm,≥4.0 cm.Results （1） Of 6 907 evaluated thyroid nodules in 5 4-40 patients,28.94% （1 999/6 907） nodules were malignant.97.39% （1 947/1 999） malignant nodules were papillary thyroid cancer.（2） Of those 〈 1.0 cm,≥ 1.0 cm and 〈 2.0 cm,≥ 2.0 cm in diameter,51.6%,26.8%,and 11.2% were malignant respectively （P〈0.01）.However,nodules in diameter ≥2.0 cm and 〈3.0 cm,≥3.0 cm and 〈4.0 cm,≥4.0 cm,12.1%,10%,and 9.5% of cases were malignant（P=0.213 2）.（3） Of all thyroid cancers,the proportion of papillary carcinoma was decreased as nodules enlarged（〈1.0 cm：99.4%,≥ 1.0 cm and〈2.0 cm：98.4%,≥2.0 cm and〈3.0 cm：90.3%,≥3.0 cm and〈4.0 cm：89.5%,≥4.0 cm：68.4%）,while follicular cancer was increased （〈 1.0 cm：0.5%,≥1.0cmand〈2.0cm：1.3%,≥2.0cmand 〈3.0 cm：6.3%,≥3.0 cmand 〈4.0cm：5.3%,≥4.0 cm：21.1%）.Conclusion The risk of papillary thyroid cancer was decreased and the risk of follicular cancer and other rare thyroid malignancies was increased as nodules enlarged.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2015年第1期10-13,共4页
Chinese Journal of Endocrinology and Metabolism
基金
全军医学科技“十二五”科研项目（CWS11J063）
