摘要
目的探讨解放军总医院20年间甲状腺癌的临床和病理特点变化趋势。方法回顾性分析1994年1月至2013年12月于本院手术治疗并有明确病理结果的7886例甲状腺结节患者临床资料，观察不同年份甲状腺良恶性结节病因构成比变化及3399例甲状腺癌患者的临床和病理特点。结果（1）20年间，甲状腺癌尤其乳头状癌检出率呈逐年上升趋势．甲状腺良性结节及其他少见类型甲状腺癌逐年下降（P〈0．01）；（2）甲状腺癌患者平均年龄（44．30±11．72）岁，高发年龄为30～59岁，不同性别甲状腺癌患者均呈逐年增加趋势，尤以女性增幅明显（P〈0．05）；（3）在3399例甲状腺癌中，56．20％（1910／3399）进行甲状腺次全切除术，20．74％（705／3399）进行甲状腺全切／近全切除术，全切／近全切除术比例呈增长趋势（P〈0．01）；48．87％（1661／3399）患者术前行超声引导下甲状腺结节穿刺活检术，穿刺活检率自2004年始逐年增加（P〈0．01）；（4）术后病理显示，直径≤2．0cm尤以≤1．0cm的甲状腺癌患者比例逐年增加（P〈0．01）；83．96％（2854／3399）患者为TNMI～Ⅱ期，自2006年始，TNMⅢ～IV期患者所占比例呈下降趋势（P〈0．01）。结论解放军总医院20年问甲状腺癌尤其微小乳头状癌检出率呈逐年上升趋势，进行术前超声引导下结节穿刺活检术及全切／近全切除术的患者增加。
Objective To investigate the trends in the clinicopathological characteristics of thyroid cancer patients undergoing surgery from 1994 to 2013. Methods A retrospective analysis was conducted on the clinical data of inpatients with thyroid nodular diasease undergoing thyroidectomy with pathology results from January 1994 to December 2013. The trends in the pathogenic constituent of thyroid nodule and the elinicopathological characteristics of 3 399 patients with thyroid cancer were analyzed. Results （ 1 ） Over the past 20 years, the proportion of patients diagnosed as thyroid cancer was gradually increased, especially those with papillary thyroid cancer （PTC）. Whereas the proportions of benign nodule and other rare thyroid cancer were gradually decreased （P〈0. 01 ）. （2） The average age of patients with thyroid cancer was （44.30 ± 11.72） years, with the peak incidence at 30 - 59 years. The incidence of thyroid cancer was increasing in both males and females, especially more evident in the absolute increase in women（P〈0.05 ）. （3） Among 3 399 patients with thyroid cancer, 56.20% （1 910/3 399 ）underwent subtotal lobectomy. 20.74% （705/3 399 ） underwent totaL/near total thyroidectomy, showing an increase trend （P〈 0.01 ）. Ultrasound-guided aspiration biopsy for thyroid nodule were performed in 48. 87% （ 1 661/3 399 ） patients before operation. The proportion of aspiration biopsy was gradually increased since 2004. （4） An increase in thyroid cancer of tumor sizes less than 2.0 cm was observed, especially those size ~ 1.0 cm （ P〈0.01 ）. 83.96% （ 2 854/3 399 ） patients revealed TNM I - ]I stage, and the proportion of patients with TNM 111 - 1V stage was gradually decreased since 2006 （P〈0.01）. Conclusion Over the past 20 years, the proportion of thyroid cancer, especially papillary thyroid microcarcinoma reveals an ascending tendency. The percentages of patients undertaking totaL/near total thyroidectomy and ultrasound-guided aspiration biopsy before o
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2017年第4期291-295,共5页
Chinese Journal of Endocrinology and Metabolism
基金
全军医学科技“十二五”科研项目（CWS11J063）
关键词
甲状腺癌
临床特点
病理学
趋势
Thyroid cancer
Clinical characteristics
Pathology
Tendency
