• 四川大學(xué)華西醫(yī)院甲狀腺乳腺外科(四川成都 610041);

目的  探討2000~2012年期間華西醫(yī)院行初次手術(shù)治療的甲狀腺疾病的構(gòu)成變化,為臨床工作提供參考。
方法  回顧性分析2000~2012年期間華西醫(yī)院行初次手術(shù)治療的甲狀腺疾病患者的臨床資料,包括性別、年齡及病理學(xué)診斷,進行統(tǒng)計學(xué)分析。
結(jié)果  共納入了9 642例甲狀腺疾病患者,男1 893例,女7 749例,男︰女=1︰4.09。男性患者中甲狀腺癌的比例高于女性(P=0.02)。其中,<45歲男性患者中甲狀腺癌的比例高于女性(P<0.01),而≥45歲男性和女性患者甲狀腺癌的比例比較差異無統(tǒng)計學(xué)意義(P=0.90)。2000~2012年期間,甲狀腺癌尤其是甲狀腺乳頭狀癌的比例大體呈增高趨勢;橋本甲狀腺炎的比例及其中合并甲狀腺癌的比例均大體呈增高趨勢;結(jié)節(jié)性甲狀腺腫的比例呈先上升后下降趨勢;甲狀腺腺瘤的比例大體呈下降趨勢。
結(jié)論  近年來,行手術(shù)治療的甲狀腺疾病中甲狀腺癌特別是甲狀腺乳頭狀癌的比例大體呈增高趨勢,需予以足夠的重視。

引用本文: 鄒秀和,孫映荷,朱信心,黃秋實,李志輝,龔日祥,茍菊香,劉楓,杜鎮(zhèn)鴻,朱精強. 2000~2012年期間華西醫(yī)院甲狀腺疾病構(gòu)成的變化分析. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(9): 987-991. doi: 復(fù)制

1. Sherman SI. Thyroid carcinoma[J]. Lancet, 2003, 361(9356):501-511.
2. Schlumberger MJ. Papillary and follicular thyroid carcinoma[J]. N Engl J Med, 1998, 338(5):297-306.
3. Simard EP, Ward EM, Siegel R, et al. Cancers with increasing incidence trends in the United States:1999 through 2008[J]. CA Cancer J Clin, 2012, 62(2):118-128.
4. 錢碧云, 何敏, 陳可欣, 等. 天津城市居民甲狀腺乳頭狀癌發(fā)病率和構(gòu)成比的長期時間趨勢分析[J]. 中國實用外科雜志, 2011, 31(5):420-422.
5. 王冬飛, 李毅本. 杭州市蕭山區(qū)1988年至2009年甲狀腺癌發(fā)病分析[J]. 中華內(nèi)分泌代謝雜志, 2010, 26(10):843-846.
6. 牛麗娟, 郝玉芝, 周純武. 超聲診斷甲狀腺占位性病變的價值[J]. 中華耳鼻咽喉頭頸外科雜志, 2006, 41(6):415-418.
7. 張廣, 邊學(xué)海, 張純海, 等. 超聲引導(dǎo)下粗針組織活檢對甲狀腺結(jié)節(jié)診斷的意義[J]. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(8):815-818.
8. Lee TI, Yang HJ, Lin SY, et al. The accuracy of fine-needleaspiration biopsy and frozen section in patients with thyroid cancer[J]. Thyroid, 2002, 12(7):619-626.
9. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002[J]. JAMA, 2006, 295(18):2164-2167.
10. 趙留芳, 李曉江, 任艷鑫, 等. 2 539例甲狀腺疾病構(gòu)成分析[J]. 中國病案, 2012, 13(11):77-79.
11. 000例病理構(gòu)成[J]. 廣東醫(yī)學(xué), 2011, 32(12):1564-1566.
12. 龐飛雄, 張嘉越, 冷津立, 等. 1991~2010年甲狀腺術(shù)后.
13. 王云龍, 鞏鵬. 甲狀腺癌構(gòu)成比變化分析[J]. 大連醫(yī)科大學(xué)學(xué)報, 2010, 32(5):558-561.
14. Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules:executive summary of recommendations[J]. J Endocrinol Invest,.
15. Cooper DS, Doherty GM, Haugen BR, et al. Revised Americanthyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2009, 19(11):1167-1214.
16. 朱精強. 甲狀腺結(jié)節(jié)的非手術(shù)治療[J]. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(8):794-795.
17. Li Y, Nishihara E, Kakudo K. Hashimoto’s thyroiditis:old concepts and new insights[J]. Curr Opin Rheumatol, 2011, 23(1):102-107.
18. Costanzo M, Caruso LA, Testa R, et al. Hashimoto thyroiditis. Possible cause or consequence of a malignant thyroid tumor[J]. Ann Ital Chir, 2006, 77(6):469-471.
19. Anil C, Goksel S, Gursoy A. Hashimoto’s thyroiditis is not asso-ciated with increased risk of thyroid cancer in patients with thyroidnodules:a single-center prospective study[J]. Thyroid, 2010, 20(6):601-606.
20. Gul K, Dirikoc A, Kiyak G, et al. The association between thyroid carcinoma and Hashimoto’s thyroiditis:the ultrasonographic and histopathologic characteristics of malignant nodules[J]. Thyroid, 2010, 20(8):873-878.
21. Mazokopakis EE, Tzortzinis AA, Dalieraki-Ott EI, et al. Coex-istence of Hashimoto’s thyroiditis with papillary thyroid carcinoma.A retrospective study[J]. Hormones (Athens), 2010, 9(4):312-317.
22. 李鴻濤, 任光輝, 董朝, 等. 橋本氏甲狀腺炎合并甲狀腺癌54例臨床研究[J]. 中南大學(xué)學(xué)報:醫(yī)學(xué)版, 2011, 36(8):765-767.
23. 邵自功, 易德會, 鐘鑫平, 等. 慢性淋巴細胞性甲狀腺炎合并甲狀腺癌104例臨床分析[J]. 中國醫(yī)科大學(xué)學(xué)報, 2011, 40(12):1137-1139.
24. Hyjek E, Isaacson PG. Primary B cell lymphoma of the thyroid and its relationship to Hashimoto’s thyroiditis[J]. Hum Pathol, 1988, 19(11):1315-1326.
25. Derringer GA, Thompson LD, Frommelt RA, et al. Malignant lymphoma of the thyroid gland:a clinicopathologic study of 108 cases[J]. Am J Surg Pathol, 2000, 24(5):623-639.
26. Kim NR, Ko YH, Lee YD. Primary T-cell lymphoma of thethyroid associated with Hashimoto’s thyroiditis, histologically mimicking MALT-lymphoma[J]. J Korean Med Sci, 2010, 25(3):481-484.
27. Di Pasquale M, Rothstein JL, Palazzo JP. Pathologic features of Hashimoto’s-associated papillary thyroid carcinomas[J]. Hum Pathol, 2001, 32(1):24-30.
28. Prasad ML, Huang Y, Pellegata NS, et al. Hashimoto’s thyroiditiswith papillary thyroid carcinoma (PTC)-like nuclear alterations express molecular markers of PTC[J]. Histopathology, 2004, 45(1):39-46.
29. Unger P, Ewart M, Wang BY, et al. Expression of p63 in papillarythyroid carcinoma and in Hashimoto’s thyroiditis:a pathobiologic link?[J]. Hum Pathol, 2003, 34(8):764-769.
30. Fiore E, Rago T, Latrofa F, et al. Hashimoto’s thyroiditis is associated with papillary thyroid carcinoma:role of TSH and of treatment with L-thyroxine[J]. Endocr Relat Cancer, 2011, 18(4):429-437.
31. Paulson LM, Shindo ML, Schuff KG. Role of chronic lymphocytic thyroiditis in central node metastasis of papillary thyroid carcinoma[J]. Otolaryngol Head Neck Surg, 2012, 147(3):444-449.
32. Yoon YH, Kim HJ, Lee JW, et al. The clinicopathologic differences in papillary thyroid carcinoma with or without coexisting chronic lymphocytic thyroiditis[J]. Eur Arch Otorhinolaryngol, 2012, 269(3):1013-1017.
33. , 33(5 Suppl):51-56.
  1. 1. Sherman SI. Thyroid carcinoma[J]. Lancet, 2003, 361(9356):501-511.
  2. 2. Schlumberger MJ. Papillary and follicular thyroid carcinoma[J]. N Engl J Med, 1998, 338(5):297-306.
  3. 3. Simard EP, Ward EM, Siegel R, et al. Cancers with increasing incidence trends in the United States:1999 through 2008[J]. CA Cancer J Clin, 2012, 62(2):118-128.
  4. 4. 錢碧云, 何敏, 陳可欣, 等. 天津城市居民甲狀腺乳頭狀癌發(fā)病率和構(gòu)成比的長期時間趨勢分析[J]. 中國實用外科雜志, 2011, 31(5):420-422.
  5. 5. 王冬飛, 李毅本. 杭州市蕭山區(qū)1988年至2009年甲狀腺癌發(fā)病分析[J]. 中華內(nèi)分泌代謝雜志, 2010, 26(10):843-846.
  6. 6. 牛麗娟, 郝玉芝, 周純武. 超聲診斷甲狀腺占位性病變的價值[J]. 中華耳鼻咽喉頭頸外科雜志, 2006, 41(6):415-418.
  7. 7. 張廣, 邊學(xué)海, 張純海, 等. 超聲引導(dǎo)下粗針組織活檢對甲狀腺結(jié)節(jié)診斷的意義[J]. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(8):815-818.
  8. 8. Lee TI, Yang HJ, Lin SY, et al. The accuracy of fine-needleaspiration biopsy and frozen section in patients with thyroid cancer[J]. Thyroid, 2002, 12(7):619-626.
  9. 9. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002[J]. JAMA, 2006, 295(18):2164-2167.
  10. 10. 趙留芳, 李曉江, 任艷鑫, 等. 2 539例甲狀腺疾病構(gòu)成分析[J]. 中國病案, 2012, 13(11):77-79.
  11. 11. 000例病理構(gòu)成[J]. 廣東醫(yī)學(xué), 2011, 32(12):1564-1566.
  12. 12. 龐飛雄, 張嘉越, 冷津立, 等. 1991~2010年甲狀腺術(shù)后.
  13. 13. 王云龍, 鞏鵬. 甲狀腺癌構(gòu)成比變化分析[J]. 大連醫(yī)科大學(xué)學(xué)報, 2010, 32(5):558-561.
  14. 14. Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules:executive summary of recommendations[J]. J Endocrinol Invest,.
  15. 15. Cooper DS, Doherty GM, Haugen BR, et al. Revised Americanthyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2009, 19(11):1167-1214.
  16. 16. 朱精強. 甲狀腺結(jié)節(jié)的非手術(shù)治療[J]. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(8):794-795.
  17. 17. Li Y, Nishihara E, Kakudo K. Hashimoto’s thyroiditis:old concepts and new insights[J]. Curr Opin Rheumatol, 2011, 23(1):102-107.
  18. 18. Costanzo M, Caruso LA, Testa R, et al. Hashimoto thyroiditis. Possible cause or consequence of a malignant thyroid tumor[J]. Ann Ital Chir, 2006, 77(6):469-471.
  19. 19. Anil C, Goksel S, Gursoy A. Hashimoto’s thyroiditis is not asso-ciated with increased risk of thyroid cancer in patients with thyroidnodules:a single-center prospective study[J]. Thyroid, 2010, 20(6):601-606.
  20. 20. Gul K, Dirikoc A, Kiyak G, et al. The association between thyroid carcinoma and Hashimoto’s thyroiditis:the ultrasonographic and histopathologic characteristics of malignant nodules[J]. Thyroid, 2010, 20(8):873-878.
  21. 21. Mazokopakis EE, Tzortzinis AA, Dalieraki-Ott EI, et al. Coex-istence of Hashimoto’s thyroiditis with papillary thyroid carcinoma.A retrospective study[J]. Hormones (Athens), 2010, 9(4):312-317.
  22. 22. 李鴻濤, 任光輝, 董朝, 等. 橋本氏甲狀腺炎合并甲狀腺癌54例臨床研究[J]. 中南大學(xué)學(xué)報:醫(yī)學(xué)版, 2011, 36(8):765-767.
  23. 23. 邵自功, 易德會, 鐘鑫平, 等. 慢性淋巴細胞性甲狀腺炎合并甲狀腺癌104例臨床分析[J]. 中國醫(yī)科大學(xué)學(xué)報, 2011, 40(12):1137-1139.
  24. 24. Hyjek E, Isaacson PG. Primary B cell lymphoma of the thyroid and its relationship to Hashimoto’s thyroiditis[J]. Hum Pathol, 1988, 19(11):1315-1326.
  25. 25. Derringer GA, Thompson LD, Frommelt RA, et al. Malignant lymphoma of the thyroid gland:a clinicopathologic study of 108 cases[J]. Am J Surg Pathol, 2000, 24(5):623-639.
  26. 26. Kim NR, Ko YH, Lee YD. Primary T-cell lymphoma of thethyroid associated with Hashimoto’s thyroiditis, histologically mimicking MALT-lymphoma[J]. J Korean Med Sci, 2010, 25(3):481-484.
  27. 27. Di Pasquale M, Rothstein JL, Palazzo JP. Pathologic features of Hashimoto’s-associated papillary thyroid carcinomas[J]. Hum Pathol, 2001, 32(1):24-30.
  28. 28. Prasad ML, Huang Y, Pellegata NS, et al. Hashimoto’s thyroiditiswith papillary thyroid carcinoma (PTC)-like nuclear alterations express molecular markers of PTC[J]. Histopathology, 2004, 45(1):39-46.
  29. 29. Unger P, Ewart M, Wang BY, et al. Expression of p63 in papillarythyroid carcinoma and in Hashimoto’s thyroiditis:a pathobiologic link?[J]. Hum Pathol, 2003, 34(8):764-769.
  30. 30. Fiore E, Rago T, Latrofa F, et al. Hashimoto’s thyroiditis is associated with papillary thyroid carcinoma:role of TSH and of treatment with L-thyroxine[J]. Endocr Relat Cancer, 2011, 18(4):429-437.
  31. 31. Paulson LM, Shindo ML, Schuff KG. Role of chronic lymphocytic thyroiditis in central node metastasis of papillary thyroid carcinoma[J]. Otolaryngol Head Neck Surg, 2012, 147(3):444-449.
  32. 32. Yoon YH, Kim HJ, Lee JW, et al. The clinicopathologic differences in papillary thyroid carcinoma with or without coexisting chronic lymphocytic thyroiditis[J]. Eur Arch Otorhinolaryngol, 2012, 269(3):1013-1017.
  33. 33. , 33(5 Suppl):51-56.
  • 下一篇

    納米碳甲狀旁腺負顯影辨認(rèn)保護技術(shù)在甲狀腺癌手術(shù)中的應(yīng)用△