Department of Surgery, University of Athens, Medical School, Laiko Hospital, Athens, Greece.
Anticancer Res. 2009 Dec;29(12):5163-9.
To examine existing evidence, trends and possible factors that may have affected the incidence of papillary thyroid cancer (PTC) among patients undergoing thyroidectomies in an iodine-sufficient population of Greece.
All histology records from the patients who had undergone thyroid surgery at the Department of Surgery Laiko Hospital, Athens, Greece from January 1991 to December 2006 were retrospectively analyzed. Records were placed in a database which included patients' demographics, history, and medical condition, clinical and surgical parameters.
One thousand four hundred and twenty-six patients (265 males and 1161 females) had undergone thyroidectomy during the above period of time. All surgeons favoured total thyroidectomy with resection of pro- and paratracheal lymph nodes. Thyroid tumors were classified according to the WHO classification system and were staged according to the TNM staging system.
In 278 patients, PTC was histologically diagnosed. From 1999 onwards, thyroid surgery shifted towards total thyroidectomy, while statistically significantly increased incidence of PTC and papillary microcarcinoma detection and decreased incidence of PTC greater than 10 mm detection in the whole population were noticed. Moreover, from 1999 onwards, smaller size of primary tumors, higher incidence of T1 tumors, lower incidence of T4 tumors, lower incidence of metastatically infiltrated peritracheal lymph nodes, higher incidence of stage I tumors and lower incidence of stage IV tumors were documented. Finally, a higher incidence of PTC in males, females and the whole population aged 51-70 years compared to the other age groups since 2003 was noticed.
The increased incidence of PTC clearly correlated to the increased incidence of papillary microcarcinoma detection, reflecting the proportion for total thyroidectomy as well as changes in the diagnostic approach boosted by more careful pathological examination, rather than the effect of environmental factors such as the Chernobyl accident. Whether the Chernobyl accident has any predisposing effect on the increased incidence of PTC remains to be proven.
研究在碘充足人群中，对在希腊拉科医院外科接受甲状腺切除术的患者，可能影响甲状腺癌（PTC）发病率的现有证据、趋势和因素。
对 1991 年 1 月至 2006 年 12 月期间在拉科医院外科接受甲状腺手术的所有患者的组织学记录进行回顾性分析。记录被放置在一个数据库中，其中包括患者的人口统计学、病史和医疗状况、临床和手术参数。
1426 名患者（265 名男性和 1161 名女性）在上述时间段内接受了甲状腺切除术。所有外科医生都赞成全甲状腺切除术，并切除了气管前和气管旁的淋巴结。甲状腺肿瘤根据世卫组织分类系统进行分类，并根据 TNM 分期系统进行分期。
在 278 名患者中，组织学诊断为 PTC。自 1999 年以来，甲状腺手术逐渐转向全甲状腺切除术，同时在整个人群中，PTC 和乳头状微癌的检出率呈统计学显著增加，而 PTC 大于 10mm 的检出率呈下降趋势。此外，自 1999 年以来，原发性肿瘤的体积变小，T1 肿瘤的发生率更高，T4 肿瘤的发生率更低，转移性浸润性气管旁淋巴结的发生率更低，I 期肿瘤的发生率更高，IV 期肿瘤的发生率更低。最后，自 2003 年以来，51-70 岁的男性、女性和整个人群中 PTC 的发生率均高于其他年龄组。
PTC 的发病率增加与乳头状微癌检出率的增加明显相关，反映了全甲状腺切除术的比例以及更仔细的病理检查促进的诊断方法的变化，而不是切尔诺贝利事故等环境因素的影响。切尔诺贝利事故是否对 PTC 发病率的增加有任何易感性影响仍有待证明。
