Malignant Disease of the Thyroid Gland
Malignant Disease of the Thyroid Gland
复制标题
甲状腺恶性肿瘤
DOI：
10.1136/pgmj.17.192.166
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发表时间：
1941
影响因子：
5.1
通讯作者：
C. Joll
中科院分区：
文献类型：
--
作者：
C. Joll
七.总结和结论。I.事件。准确估计甲状腺恶性疾病的发病率并不容易，因为几乎没有与此有关的生命统计数据。因此，我们不得不在很大程度上依赖于较重要的甲状腺诊所提供的数字，这些数字使我们能够推断恶性甲状腺肿的发病率与良性甲状腺肿和甲状腺毒性甲状腺肿的发病率相比。在不同的诊所，这一比例差别很大，即，7.4百分之2（Coller）或更低，而且似乎在甲状腺疾病高发地区发现了更大的比率。就死亡率统计而言，我们对英格兰和威尔士的准确数字还不够了解，这些数字表明，1931年5月至1935年5月期间，男性所有年龄段的年平均标准化死亡率为2-4岁，1936年至1939年期间为2-3岁，而女性在这两个时期的相应数字均为5 - 3岁。与世纪的前30年相比，男性和女性的死亡率都有明显的稳步上升。在我自己的7,039例甲状腺切除术中，有127例经组织学检查证实为恶性甲状腺肿，其百分比与甲状腺肿非高发地区的其他几家大型甲状腺诊所的百分比大致相当。Pemberton指出，所有这些数字都是错误的，因为许多无辜的甲状腺肿患者都懒得去诊所，而所有恶性甲状腺肿患者迟早都会去接受治疗，因此恶性甲状腺肿与无辜甲状腺肿的实际比例总是小于我所给出的数字。
VII. Summary and Conclusions. I. INCIDENCE. It is not easy to estimate precisely the incidence of malignant disease of the thyroid, since there are hardly any vital statistics available which relate to the matter. We have to rely largely, therefore, on the figures provided by the more important thyroid clinics which enable us to deduce the incidence of malignant goitre compared with that of benign and thyrotoxic goitres. The ratio varies rather widely in different clinics, viz., 7.4 per cent.' (Kocher) down to I * 2 per cent.2 (Coller) or less, and it appears that the larger ratios are found more particularly in areas of high endemicity for thyroid disease. So far as mortality statistics go, we are fdrtunate in having accurate figures for England and Wales which show for males a mean annual standardized death rate at all ages of 2-4 for the quinquennium I93I-5, and of 2-3 for the period I936-9, whereas for women the corresponding figures are 5 3 for both periods.3 These mortality rates, when compared with those of the first three decades of the century, show a decided and steady increase in both sexes. In my own series* of 7,039 thyroidectomies there have been I27 cases of malignant goitre verified by histological examination, the percentage I * 8 being roughly comparable with that at several other large thyroid clinics in areas not highly endemic for goitre. It has been pointed out by Pemberton4 that there is a fallacy in all such figures, since many patients with innocent goitres do not bother to attend the clinic, while all those with malignant goitres sooner or later present themselves for treatment, and that therefore the actual ratio of malignant to innocent goitre is always smaller than such figures as I have given would imply.