Chigot J P, Ménégaux F, Keopadabsy K, Hoang C, Aurengo A, Leenhardt L, Turpin G
Service de Chirurgie générale, digestive et endocrinienne, Hôpital de la Pitié, 83, boulevard de l'hôpital, F 75651 Paris.
Presse Med. 2000 Nov 25;29(36):1969-72.
The prevalence of thyroid carcinoma in hyperthyroidism remains controversial. The aim of this retrospective study was to evaluate prevalence.
The prevalence of thyroid carcinoma was studied in 861 patients operated for clinical or infraclinical hyperthyroidism between 1992 and 1999. One hundred and fifty patients had a hot nodule, 13 of them with an associated goiter. Four hundred five patients had Graves' disease and 306 had a multinodular goiter. Multiple sections were made in all surgical specimens for pathology study.
Prevalence in solitary nodules was 1.45%. For Graves' disease patients, it was 4.1%. Prevalence among patients with multinodular goiter was 4.9%. Among the cancers, 83% were microcarcinoma. Parathyroid morbidity after subtotal and total thyroidectomy was 0.56% and recurrent hyperthyroidism occurred in 1.6%.
These findings are grossly identical to those observed in simple, nontoxic diffuse multinodular goiter. It would therefore be difficult to incriminate hyperthyroidism as playing a causal role in the development of thyroid cancer. These results do however provide an argument favoring total or near total thyroidectomy when surgery is performed in patients with hyperthyroidism.
甲状腺功能亢进症（甲亢）中甲状腺癌的患病率仍存在争议。本回顾性研究的目的是评估其患病率。
对1992年至1999年间因临床或亚临床甲亢接受手术的861例患者的甲状腺癌患病率进行了研究。150例患者有热结节，其中13例伴有甲状腺肿。405例患者患有格雷夫斯病，306例患者患有结节性甲状腺肿。对所有手术标本制作多个切片进行病理学研究。
孤立性结节的患病率为1.45%。格雷夫斯病患者的患病率为4.1%。结节性甲状腺肿患者的患病率为4.9%。在这些癌症中，83%为微小癌。甲状腺次全切除术和全切除术后甲状旁腺发病率为0.56%，复发性甲亢发生率为1.6%。
这些发现与单纯性、非毒性弥漫性结节性甲状腺肿中观察到的结果大致相同。因此，很难将甲亢归咎于在甲状腺癌发展中起因果作用。然而，这些结果确实为甲亢患者手术时倾向于行甲状腺全切除或近全切除提供了依据。
