New clinical features of thyroid cancer in eastern China
New clinical features of thyroid cancer in eastern China
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DOI：
10.1016/j.jviscsurg.2010.02.007
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发表时间：
2010-02-01
影响因子：
2.1
通讯作者：
Guan, Q.
中科院分区：
文献类型：
--
作者：
Xiang, J.;Wu, Y.;Guan, Q.
目的：方法：对1996 ~ 2006年复旦大学附属肿瘤医院头颈外科甲状腺癌患者的临床资料进行调查和比较。甲状腺癌患者人数从1996年的148人增加到2006年的572人，增加了3.9倍。体检中常规超声检查发现1996年有4例（2.7%），2006年有285例（49.8%）。1996年超声检查对甲状腺癌诊断的敏感性为86.66%，2006年为88.20%（P > 0.05）。乳头状癌最常见（1996年为87.8%，2006年为92.8%）。微小肿瘤的发生率由1996年的20.3%上升到2006年的35.7%（P < 0.01）。肿瘤直径1 ~ 2cm者2006年占38.5%，1996年占27.0%（P < 0.01）。1996年有46例（31.1%）患者报告甲状腺外扩展，而2006年仅为39例（6.8%）（P < 0.01）。1996年有98例（66.2%）有中央颈淋巴结转移，2006年有301例（52.6%）有中央颈淋巴结转移（P < 0.05）。1996年有37例（25.0%）患者有颈外侧淋巴结转移，2006年有117例（20.5%）患者有颈外侧淋巴结转移（P > 0.05）。2006年Ⅰ期癌比例高于1996年。结论：随着甲状腺癌发病率的上升，甲状腺癌的发现越来越早。这是由于甲状腺癌的新的临床特征，如肿瘤直径减小，甲状腺外扩散和颈淋巴结转移率降低。体检期间的常规超声检查已成为检测甲状腺癌的最常见方法。越来越多地使用诊断检查，包括超声波检查，很可能是通过检测小甲状腺癌而导致发病率增加的原因。在早期阶段增加使用超声波筛查甲状腺癌应该会导致更好的治疗结果。(C)2010年Elsevier Masson SAS。All rights reserved.
Objective: Analyze recent clinical features of thyroid cancer in eastern China.Methods: Investigation and comparison of clinical data of thyroid cancer patients from 1996 to 2006 from the Department of Head and Neck Surgery in the Cancer Hospital of Fudan University, Shanghai, China.Results: The number of patients with thyroid cancer rose from 148 in the year 1996 to 572 in the year 2006, a 3.9-fold increase. Routine ultrasound survey during physical examination revealed four cases (2.7%) in 1996 and 285 cases (49.8%) in 2006. The sensitivity of the ultrasound survey in thyroid cancer diagnosis was 86.66% in 1996 and 88.20% in 2006 (P > 0.05). Papillary carcinoma was most prevalent (87.8% in 1996 and 92.8% in 2006). An increasing proportion of small tumors was found. The incidence of microcarcinoma was 35.7% in 2006 in contrast with 20.3% in 1996 (P < 0.01). Moreover, tumors with diameter from 1 to 2 cm were found in 38.5% patients in 2006 as opposed to 27.0% in 1996 (P < 0.01). Extrathyroid extension was reported in 46 (31.1%) patients in 1996, but only in 39 (6.8%) in 2006 (P < 0.01). Central cervical lymph node metastases were found in 98 (66.2%) patients in 1996, contrasting with 301 (52.6%) in 2006 (P < 0.05). Thirty-seven (25.0%) patients had lateral cervical lymph node metastasis in 1996 compared with 117 (20.5%) in 2006 (P > 0.05). Last, the proportion of stage I cancers in 2006 was higher than that in 1996.Conclusion: With the increasing incidence of thyroid cancer, cancer was discovered at an earlier stage. This is due to new clinical features of thyroid cancer, such as the decrease in tumor diameter, the lower rate of extrathyroid extension and of cervical lymph node metastasis. Routine ultrasound survey during physical examination has become the most common way to detect thyroid cancer. Increasing usage of diagnostic scrutiny, including the ultrasound survey, has most likely contributed to the increased incidence through detection of small thyroid cancers. Increased use of ultrasound to screen thyroid cancer in early stages should lead to better therapeutic outcome. (C) 2010 Elsevier Masson SAS. All rights reserved.