Incidence and survival of Swedish patients with differentiated thyroid cancer
Incidence and survival of Swedish patients with differentiated thyroid cancer
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DOI：
10.1002/ijc.11275
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发表时间：
2003-09-10
影响因子：
6.4
通讯作者：
Dickman, PW
中科院分区：
文献类型：
--
作者：
Lundgren, CI;Hall, P;Dickman, PW
乳头状癌(PTC)和滤泡性甲状腺癌(FTC)是罕见的疾病，但在40岁以下的人中是最常见的癌症之一。从以人口为基础的瑞典癌症登记中心，我们确定了1958-87年间患有PTC的3588人和患有FTC的1966人。通过检查原始的组织病理学报告来确定组织病理学。以相对存活率(RSR)作为患者生存的指标。PTC和FTC在女性中的发病率都较高，尤其是PTC，尤其是在女性生命的生育阶段。PTC的发病率随着时间的推移显著增加，这一趋势在FTC中没有观察到。与FTC相比，被诊断为PTC的患者的五年相对存活率似乎更高，尽管这种差异几乎完全可以用年龄的混淆效应来解释。PTC患者在确诊后7-20年内死亡率较低。女性的超额死亡率较低，尽管差异的大小因年龄和组织病理学而异。与我们基于临床实践的看法相反，我们观察到PTC和FTC患者在确诊后几年(死亡人数最多的地方)的超额死亡率没有差异。我们的数据表明，在女性生命的生育阶段，可能存在预后较好的甲状腺肿瘤亚群。性激素可能在这些肿瘤的病因中起作用。(C)2003年Wiley-Liss，Inc.
Papillary (PTC) and follicular (FTC) thyroid cancers are rare disorders but are, nevertheless, among the most common cancers in individuals below 40 years of age. From the population-based Swedish Cancer Registry we identified 3,588 individuals with PTC and 1,966 with FTC during 1958-87. Histopathology was determined by examining the original histopathology reports. The relative survival ratio (RSR) was used as the measure of patient survival. Incidence of both PTC and FTC was higher among women, especially for PTC and particularly during the fertile part of female life. Incidence of PTC increased significantly over time, a trend that was not observed for FTC. Five-year relative survival appeared to be higher for patients diagnosed with PTC compared to FTC, although this difference was almost completely explained by the confounding effect of age. Patients with PTC experience lower mortality during the period 7-20 years after diagnosis. Excess mortality was lower among women, although the magnitude of the difference varied with age and histopathology. In contrast to our perceptions based on clinical practice, we observed no difference in excess mortality between patients diagnosed with PTC and FTC during the years immediately after diagnosis (where the majority of deaths occur). Our data suggest that there may exist a subgroup of thyroid tumors with superior prognosis diagnosed in women during the fertile part of female life. Sex hormones may play a role in the etiology of these tumors. (C) 2003 Wiley-Liss, Inc.