Dorairajan N, Pandiarajan R, Yuvaraja S
Department of Surgery, Madras Medical College, Chennai, Madras, India.
Asian J Surg. 2002 Oct;25(4):300-3. doi: 10.1016/S1015-9584(09)60195-0.
In the 1994 Chennai population-based cancer registry, thyroid carcinoma constituted 1% and 2% of all incident cancers among males and females, respectively. The aim of our study was to conduct an epidemiological survey of the pattern of papillary thyroid carcinoma in the Chennai Government General Hospital and the Chennai Cancer Institute.
Our data base included a total of 264 (58 males and 206 females) consecutive cases of papillary thyroid carcinoma admitted to the Government General Hospital and 164 (42 males and 122 females) cases from the Chennai Cancer Institute.
There was a female preponderance (100 males and 328 females) (p < 0.001). The median age at diagnosis was 39 years among males and 32 years among females. The distribution of cases by residential area lay scattered from < 1 km to > 100 km, with the majority (28%) from the city of Chennai and its suburbs in the Government General Hospital, while 52% of the cases in the cancer institute were from the neighbouring state. Iodine intake was present in 75% of cases (p < 0.001). The diagnosis of thyroid cancer was confirmed by fine needle aspiration cytology in most (88%) of the cases. The extent of disease in the Government General Hospital and the Cancer Institute were as follows: localized in 66% vs 32%; spread to surrounding structure with or without nodal involvement in 26% and 59% presence of only secondary nodal involvement in 3% and 1%, distant metastasis in 5% and 8%, respectively. The primary modality of treatment was surgery with total thyroidectomy being performed in 82%, while the rest underwent a hemithyroidectomy.
The cumulative life-time risk of thyroid cancer in Chennai was one in 970 in males and one in 565 in females. High dietary intake of iodine was the most significant risk factor for the etiology of papillary thyroid carcinoma in our study.
在1994年基于金奈人群的癌症登记中，甲状腺癌分别占男性和女性所有新发癌症的1%和2%。我们研究的目的是对金奈政府总医院和金奈癌症研究所的乳头状甲状腺癌模式进行流行病学调查。
我们的数据库包括政府总医院收治的264例（58例男性和206例女性）连续乳头状甲状腺癌病例以及金奈癌症研究所的164例（42例男性和122例女性）病例。
女性占优势（100例男性和328例女性）（p<0.001）。男性诊断时的中位年龄为39岁，女性为32岁。病例按居住区域分布，从<1公里到>100公里不等，政府总医院中大多数（28%）来自金奈市及其郊区，而癌症研究所52%的病例来自邻近邦。75%的病例碘摄入量正常（p<0.001）。大多数（88%）病例通过细针穿刺细胞学检查确诊为甲状腺癌。政府总医院和癌症研究所的疾病范围如下：局限期分别为66%和32%；扩散至周围结构伴或不伴淋巴结受累分别为26%和59%，仅存在继发性淋巴结受累分别为3%和1%，远处转移分别为5%和8%。主要治疗方式为手术，82%进行了全甲状腺切除术，其余进行了半甲状腺切除术。
金奈男性甲状腺癌的累积终生风险为970分之一，女性为565分之一。高碘饮食摄入是我们研究中乳头状甲状腺癌病因的最显著危险因素。
