山东省沿海与内陆甲状腺癌患病模式变迁

The variant trend of thyroid cancer in coastal city and Inland city of Shandong Province China

目的:观察沿海城市(青岛市)和内陆城市(临沂市)11年来甲状腺乳头状癌(PTC)、滤泡型癌(FTC)、髓样癌(MTC)、未分化癌(ATC)患病率的变化趋势,并将内陆城市与沿海城市进行比较,以探讨碘营养与甲状腺癌的关系。方法:根据国际肿瘤分类标准,利用石蜡切片等方法对青岛大学医学院附属医院病理科、临沂市人民医院病理科和临沂市第二人民医院病理科1998年-2008年间收检的甲状腺恶性肿瘤进行重新分类,回顾性分析患者的平均确诊年龄、性别比例、构成比。结果:11年来4类甲状腺恶性肿瘤沿海城市(青岛)的总例数为734例,其中PTC占85.56%、FTC占8.86%、MTC占4.36%、ATC占1.22%。4类中女性发病均高于男性(男女比例1∶1.25-3.94)。PTC的平均确诊年龄最低(45.39岁),ATC最高(61.56岁)。内陆城市(临沂)的总例数为421例,其中PTC占82.90%、FTC占9.74%、MTC占4.75%、ATC占2.61%。4类甲状腺癌中女性发病均高于男性(男女比例1∶2.33-7.20)。PTC的平均确诊年龄最低(42.09岁),ATC最高(67.91岁)。沿海与内陆的PTC均呈逐年递增趋势,FTC、MTC和ATC递增趋势不明显。结论:11年来沿海与内陆的PTC均呈逐年递增趋势,FTC、MTC和ATC递增趋势不明显。内陆PTC患病年龄低于沿海。碘营养等因素可能参与PTC的发生,其确切机制值得进一步研究。

Objective：To investigate the trend of thyroid papillary carcinoma,follicular carcinoma,medullary carcinoma and undifferentiated carcinoma during 11 years both in the cities of Qingdao and Linyi,to discuss the relationship between iodine nutrition and thyroid cancer.Methods： The samples were accessed from the Pathology Division in the affiliated hospital of medical college Qingdao university,Linyi people hospital and Linyi the second people hospital from 1998 to 2008.The paraffin cutting method was used to countercheck by international and to analyze the average diagnosed age,sex ratio and the ratio of annual thyroid cancer in total.Results： The total number of thyroid cancers in 11 years in Qingdao were 734,of which papillary thyroid carcinomas（PTC） accounted for 85.56%,the follicular thyroid carcinomas（FTC） accounted for 8.86%,the medullary thyroid carcinomas（MTC） accounted for 4.36%,the anaplastic thyroid carcinomas（ATC） accounted for 1.22%.The incidence of woman was higher than that of man in four types of thyroid cancer（the ratio of male to female was 1：1.25-3.94）.The average diagnosed age of PTC was the lowest（45.39 years）,and the ATC was the highest（61.56 years）.While the total number of thyroid cancers in Linyi were 421,of which PTC accounted for 82.90%,FTC accounted for 9.74%,MTC accounted for 4.75%,ATC accounted for 2.61%.The incidence of woman was also higher than that of man in four types of thyroid cancer（the ratio of male to female was 1：2.33-7.20）.The average diagnosed age of PTC was the lowest（42.09 years）,and the ATC was the highest（67.91 years）.In both Qingdao and Linyi,the ratio trend in PTC was continuously growing year by year.The data of FTC showed uncontinuously increasing trend.While the increasing trend was not obvious in MTC and ATC.Conclusion： During the 11 years,the ratio trend in PTC both in Qingdao and Linyi was continuously growing year by year,while that was not obvious in FTC,MTC and ATC.The average diagnosed age of PTC in Linyi was lower than that in Qingdao.Including the iodine nutrition,more other factors need to be researched to make sure the mechanisms of occurrence and development of thyroid papillary carcinoma.