1954-2009年间天津市肿瘤医院收治的甲状腺癌构成分析

Analysis of variation trends of thyroid cancer treated in Tianjin Cancer Hospital form 1954 to 2009

目的分析天津市肿瘤医院1954-2009年间住院患者甲状腺癌构成方面的变化趋势及其原因。方法回顾性分析天津市肿瘤医院头颈科1954--2009年间不同时间段收治的4342例甲状腺癌患者的发病情况、病理类型及临床特征。结果4342例甲状腺癌患者中，1954--1969年、1970--1979年、1980--1989年、1990--1999年、2000--2009年间甲状腺乳头状癌占同期收治甲状腺癌的比例分别为68．1％、78．3％、81．3％、82．1％和85．8％，呈上升趋势。其中甲状腺乳头状癌并发桥本氏甲状腺炎例数增多，肿瘤直径≤2cm所占比例呈上升趋势；甲状腺滤泡癌、甲状腺未分化癌所占比例呈减少趋势；甲状腺髓样癌所占比例变化不明显。结论1954--2009年间天津市肿瘤医院收治的甲状腺癌的构成比有显著变化，其中甲状腺乳头状癌所占比例升高，甲状腺滤泡癌及甲状腺未分化癌所占比例下降，其变化原因可能与检诊水平提高及高碘饮食等因素有关。

Objective To investigate and analyze the variation trends in the pathological composition of thyroid cancer patients treated in Tianjin Cancer Hospital from 1954 to 2009. Methods To retrospectively analyze the incidence and clinical features of different pathological types of thyroid cancers in 4342 patients between different time periods from 1954 to 2009. Results In the four main pathological types of thyroid cancers, the component ratio of papillary thyroid cancer in every period was 68. 1% , 78.3%, 81.3%, 82.1%, 85.8%, respectively, while the morbidity of patients with papillary thyroid carcinoma concurrent with Hashimoto＇s thyroiditis was increased, so was the proportion of tumors in diameter ~〈 2 cm. The proportion of follicular thyroid carcinoma and anaplastic thyroid carcinoma was decreasing accordingly; however, the proportion of medullary thyroid carcinoma did not change significantly. Conclusions The pathological classification of the thyroid carcinoma patients has significant changes in the 4342 cases treated in our Hospital from 1954 to 2009. The proportion of papillary carcinoma is increased, while that of follicular carcinoma and anaplastic carcinoma is decreased. The reasons might attribute to the improved level of consultations and iodized diet or other factors.