57例飞行人员甲状腺癌临床特征分析

Analysis of clinical characteristics of thyroid carcinoma in 57 flying personnel

目的分析飞行人员甲状腺癌患者的临床特征,提高飞行人员甲状腺癌的诊治水平。方法回顾性分析2010年1月—2022年12月空军特色医学中心诊治的飞行人员甲状腺癌患者的临床及病理资料,分别采集年龄、飞行时间、飞行机种、确诊时的甲状腺功能等临床特征,以及肿瘤部位和大小、淋巴结转移情况、钙化及砂粒体情况、Ki-67阳性比例等病理特征,并对临床特征和病理特征进行统计分析。结果本组57例飞行人员甲状腺癌均以体检检出甲状腺结节为首发,发病年龄22~58岁,中位年龄37岁,飞行时间4~18000 h,中位飞行时间2000 h;双侧甲状腺均有检出甲状腺癌,组织学类型均为甲状腺乳头状癌,检出时甲状腺功能多数正常。甲状腺癌淋巴结转移与肿瘤大小呈低度正相关(r=0.304,P=0.021),与Ki-67阳性比例呈低度正相关(r=0.360,P=0.006);其余临床和病理特征未见明确相关性。随着飞行时间的延长,飞行人员甲状腺癌发生淋巴结转移的概率增大,差异有统计学意义(χ^(2)=6.32,P=0.012);而不同年龄、飞行机种飞行人员的临床特征差异无统计学意义(P>0.05)。结论飞行人员甲状腺癌确诊时往往无临床症状,甲状腺功能基本正常,应加强体检中甲状腺超声的检查,对检出甲状腺结节的飞行人员应行进一步检查。

Objective To improve the diagnosis and treatment of thyroid carcinoma in flying personnel by analyzing the clinical characteristics of thyroid carcinoma.Methods The clinical and pathological data of flying personnel with thyroid carcinoma diagnosed and treated by Air Force Medical Center of PLA from January of 2010 to December of 2022 were retrospectively analyzed.Clinical characteristics such as age,flying hours,aircraft types,thyroid function at diagnosis,and pathological characteristics such as tumor site,tumor size,lymph node metastasis,calcification and sand and Ki-67 positive ratio were collected,and the clinical and pathological characteristics were statistically analyzed.Results Thyroid nodule was found as the first diagnosis of thyroid carcinoma in 57 flying personnel.The age of onset was 22-58 years old,the median age was 37 years old,the flying hours was 4-18000 h,and the median flying hours was 2000 h.Thyroid carcinoma was detected in both thyroid glands,and the histological type was papillary thyroid carcinoma.Thyroid function was normal in most cases when thyroid carcinoma was detected.Lymph node metastasis of thyroid carcinoma was low positively correlated with tumor size(r=0.304,P=0.021),and was low positively correlated with the positive proportion of Ki-67(r=0.360,P=0.006).Other clinical and pathological characteristics did not show clear correlation.With the extension of flying hours,the incidence of lymph node metastasis of thyroid carcinoma increased,and the difference was statistically significant(χ^(2)=6.32,P=0.012).There was no statistical difference among the clinical characteristics of flying personnel with different age and aircraft types(P>0.05).Conclusions The thyroid carcinoma is usually diagnosed without clinical symptoms and the thyroid function is basically normal.The thyroid ultrasound examination should be emphasized during physical examination,and further examination should be conducted for the flying personnel with thyroid nodules.