老年人甲状腺乳头状癌的危险因素分析

A study of risk factors of papillary thyroid carcinoma in the elderly

目的探讨65岁及以上老年患者中甲状腺乳头状癌致病因素。方法784例经彩色超声筛查有甲状腺结节患者按照不同碘摄人量、性别、年龄、饮食习惯、吸烟史及放射治疗史分组，比较不同组问甲状腺乳头状癌检出率，分析甲状腺乳头状癌致病因素。结果共检出甲状腺乳头状癌患者55例（7．0％），性别、年龄、碘摄人量、吸烟史及放射治疗史均为甲状腺乳头状癌的危险因素，年龄较大的女性、碘摄人量过高及有放射治疗史的人群为甲状腺乳头状癌易发人群。其中高碘摄人人群中甲状腺乳头状癌检出率22．8％（31／136），高于适碘摄入1．9％（10／517）和低碘摄人10．7％（14／131），差异有统计学意义（x^2=75．07，P〈0．01）；老年女性患者中甲状腺乳头状癌检出率为8．0％（49／612），高于老年男性3．5％（6／172），（P〈0．05）；有放射治疗史患者中甲状腺乳头状癌检出率为11．6％（14／121），高于未接受过放射治疗患者6．2％（41／663），差异有统计学意义（P〈0．05）。结论甲状腺乳头状癌的主要危险因素为生活环境、性别、年龄、饮食习惯、吸烟及放射治疗史等，受外界因素影响较多。

Objective To study the risk factors for thyroid papillary carcinoma m patients aged over 65 years, and to investigate the etiology of thyroid papillary carcinoma. Methods A total of 784 patients with thyroid nodules screened by ultrasound were grouped according to different iodine intakes, gender, age, diet, smoking history and history of radiation therapy. The incidence of thyroid papillary carcinoma was compared among the different groups. Pathogenic factors for thyroid papillary carcinoma were analyzed. Results 55 patients （7.0%） were diagnosed as thyroid papillary carcinoma among 784 patients. Gender, age, iodine intake, smoking history and history of radiation therapy were the pathogenic factors for papillary thyroid carcinoma. Thyroid papillary carcinoma was common in older women, patients with high-iodine intake and patients with the history of radiation therapy. The incidence of thyroid papillary carcinoma was higher in patients with high-iodine intake than with normal-iodine intake or low-iodine intake （22.8% （31/136） vs. 1.9G （10/517）, 10.7X （14/131）,）%2：75.07, P〈0. 01. The incidence of thyroid papillary carcinoma was higher in female than in male elderly patients 8.0% （49/612） vs. 3.5% （6/172）, P〈0.05. The incidence of thyroid papillary carcinoma was higher in patients with the history of radiation therapy than without the history of radiation 11.6%（14/121） vs. 6.2% （41/663）, P〈0.05. Conclusions The main risk factors for thyroid papillary carcinoma are living environment, gender, age, diet, smoking history and history of radiation therapy, which are more influenced by external factors.