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[法属波利尼西亚的甲状腺上皮瘤]

[Thyroid epitheliomas in French Polynesia].

作者信息

Gras C, Picherit H, Boissin J L, Giraud P, Brisard M, Peccarrere J L, Boz P, Tranier J, Louis P, Barthes C

机构信息

Médecin des Hôpitaux, Centre Hospitalier Territorial, Papeete. Tahiti, Polynésie Française.

出版信息

Med Trop (Mars). 1992 Jan-Mar;52(1):13-9.

PMID:1602949
Abstract

The authors reviewed 34 cases of thyroid epithelioma registered in French Polynesia from 1985 to 1990. Annual incidence classifies French Polynesia as a region with low endemicity. The patients were 31 females and 3 males. In 18 cases, carcinoma was discovered within a multiheteronodular goitre (MHNG) and in 16 cases within an isolated nodule. In each of these sub-groups, 4 micropapilliform cancers discovered at the occasion of a histopathological test. The mean age of the patients carrying a noduliferous cancer is 36.5 years and the one of multiheteronodular goitre is 50. No particular risk factor was discovered. Mean age of the disease is 2.8 years as far as noduliferous cancers are concerned, and 8.5 years for multiheteronodular goitre. The anatomical and echographic characters are discussed. What demanded a surgery intervention is reviewed. Mortality during intervention is zero. Morbidity recorded 17% of unilateral recurrent paralysis and 50% of transitory parathyroid insufficiency. Extemporaneous anatomopathological test was contributing in 25% of the cases; definitive test revealed 25 (74%) papilliform cancers (of which 8 micropapilliforms) and 9 vesicular cancers (26%). No canceration anaplasia was discovered. Evolutive stage is precised: 7 local invasions (isthm and/or capsule), 4 bifocal localizations, 8 cancers with adenoid metastasis, 4 with osseous and/or pulmonary metastasis. The way to select a therapy is reported and discussed. Cost evaluation is suggested in order to discuss the possibility to acquire for the Territory an equipment for isotopic exams.

摘要

作者回顾了1985年至1990年在法属波利尼西亚登记的34例甲状腺上皮瘤病例。年发病率表明法属波利尼西亚是一个低流行地区。患者中女性31例,男性3例。18例癌在多结节性甲状腺肿(MHNG)内发现,16例在孤立结节内发现。在这些亚组中,各有4例微乳头状癌是在组织病理学检查时发现的。患有结节性癌的患者平均年龄为36.5岁,患有多结节性甲状腺肿的患者平均年龄为50岁。未发现特殊危险因素。就结节性癌而言,疾病的平均年龄为2.8岁,多结节性甲状腺肿为8.5岁。讨论了解剖学和超声特征。回顾了需要手术干预的情况。手术期间死亡率为零。发病率记录显示单侧喉返神经麻痹为17%,暂时性甲状旁腺功能不全为50%。术中病理检查在25%的病例中发挥了作用;最终检查发现25例(74%)乳头状癌(其中8例为微乳头状癌)和9例滤泡状癌(26%)。未发现间变癌。明确了疾病的进展阶段:7例局部侵犯(峡部和/或包膜),4例双灶性定位,8例伴有腺样转移的癌,4例伴有骨和/或肺转移的癌。报告并讨论了治疗方法的选择。建议进行成本评估,以便讨论该地区购置同位素检查设备的可能性。

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