Lawal O, Agbakwuru A, Olayinka O S, Adelusola K
Department of Surgery, College of Health Sciences, Ile-Ife, Osun State, Nigeria.
Eur J Surg Oncol. 2001 Mar;27(2):157-61. doi: 10.1053/ejso.2000.1085.
The epidemiology of thyroid cancers in goitre endemic zones has not been recently reviewed, and changes being currently reported have been from studies in non-endemic areas. The aims of this study were to present the clinical pattern of thyroid malignancy in a goitre endemic area and identify recent changes, if any.
The study was conducted at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between January 1983 and December 1993. Records of patients with nodular goitres treated with thyroidectomy were reviewed, and the clinical features, laboratory parameters, treatment, outcome and follow-up of histologically-proven malignant cases were studied.
Thirty-six of 279 (12.9%) patients, aged 13-85 years (mean)=43.7+/-14.7 years), carried malignant goitres, and most (80%) were young or middle-aged women. Of the well-differentiated cancers, follicular type was the most prevalent, being six- and 12-fold as frequent as papillary and medullary cancers (69%vs 11% and 5.6%), respectively. Lymphoma accounted for 5.6%, fibrosarcoma, 5.6% and anaplastic, 2.8%. No relationship was demonstrable between cancer type, duration of goitre and age at diagnosis (r=0.06 and 0.17, respectively).
Thyroid cancers afflict comparatively young women in our environment, and follicular cancer remains the predominant type, partly as a result of persisting dietary iodine deficiency.
甲状腺肿流行地区甲状腺癌的流行病学最近未被综述，目前所报道的变化来自非流行地区的研究。本研究的目的是呈现甲状腺肿流行地区甲状腺恶性肿瘤的临床模式，并确定近期是否有变化。
该研究于1983年1月至1993年12月在尼日利亚伊费的奥巴费米·阿沃洛沃大学教学医院综合院区进行。回顾了接受甲状腺切除术治疗的结节性甲状腺肿患者的记录，并研究了经组织学证实为恶性病例的临床特征、实验室参数、治疗、结局和随访情况。
279例患者中有36例（12.9%）患有恶性甲状腺肿，年龄在13 - 85岁之间（平均年龄 = 43.7±14.7岁），大多数（80%）为年轻或中年女性。在分化良好的癌症中，滤泡型最为常见，分别是乳头状癌和髓样癌的6倍和12倍（69%对11%和5.6%）。淋巴瘤占5.6%，纤维肉瘤占5.6%，未分化癌占2.8%。癌症类型、甲状腺肿持续时间与诊断时年龄之间无明显关联（相关系数分别为0.06和0.17）。
在我们所处的环境中，甲状腺癌主要影响相对年轻的女性，滤泡癌仍然是主要类型，部分原因是饮食中碘缺乏持续存在。
