Freitag T, Baier A, Dewitz D
Klinik für Allgemeinchirurgie, Klinikum Neubrandenburg.
Zentralbl Chir. 1999;124(4):331-5.
Data of all (239) patients suffering from thyroid carcinoma and operated on between January 1st, 1982, and December, 31st, 1997 in our center, were analyzed retrospectively with respect to age- and sex-distribution in relation to the histological type of cancer. The change of frequency in the histological groups was observed over a 16 years period.
From all 239 cases, 202 (84.5%) were females and 37 (15.5%) males. The most common histological type with 70.3% in both male and female was the papillary carcinoma, followed by follicular carcinoma with 21.6% of male and 17.8% of female patients. A medullary carcinoma was seen in 8.1% and 5.9%, respectively and an anaplastic carcinoma in only 5.9% of female patients. There was no significant gender difference regarding the histological type. In male patients there was also no influence of age on histological groups. Females with papillary and medullary cancer were significantly younger than those suffering from follicular and anaplastic cancer. Beside, we observed an increase in papillary and a decrease in anaplastic carcinoma during the examination period.
Although the relation of 1 male to 5 females with thyroid carcinoma shows a clear dependence on sex, the histological type distribution is identical in both male and female. Therefore, several different factors seem to influence the development of thyroid carcinoma. One of these factors depends on sex and supports an increased development of carcinoma in female patients. Another factor doesn't depend on sex and causes different histological types. Causes for that could be as well hormonal and reproductive ones as regional differences in iodine availability.
回顾性分析1982年1月1日至1997年12月31日期间在本中心接受手术的所有239例甲状腺癌患者的数据，分析其年龄和性别分布与癌症组织学类型的关系。观察16年间各组织学组别的频率变化。
在所有239例病例中，女性202例（84.5%），男性37例（15.5%）。男女中最常见的组织学类型均为乳头状癌，占70.3%，其次是滤泡状癌，男性患者占21.6%，女性患者占17.8%。髓样癌分别占8.1%和5.9%，未分化癌仅占女性患者的5.9%。组织学类型在性别上无显著差异。男性患者中，年龄对组织学组也无影响。患有乳头状癌和髓样癌的女性明显比患有滤泡状癌和未分化癌的女性年轻。此外，在检查期间，我们观察到乳头状癌增加，未分化癌减少。
虽然甲状腺癌患者男女比例为1:5，显示出明显的性别依赖性，但男女的组织学类型分布相同。因此，似乎有几个不同的因素影响甲状腺癌的发生。其中一个因素取决于性别，支持女性患者癌症发病率的增加。另一个因素不取决于性别，导致不同的组织学类型。其原因可能是激素和生殖因素，也可能是碘供应的地区差异。
