Cancer hospital of Fudan University, 270 Dong An street, Shanghai, 200032, China.
J Visc Surg. 2010 Feb;147(1):e53-6. doi: 10.1016/j.jviscsurg.2010.02.007. Epub 2010 Mar 19.
Analyze recent clinical features of thyroid cancer in eastern China.
Investigation and comparison of clinical data of thyroid cancer patients from 1996 to 2006 from the Department of Head and Neck Surgery in the Cancer Hospital of Fudan University, Shanghai, China.
The number of patients with thyroid cancer rose from 148 in the year 1996 to 572 in the year 2006, a 3.9-fold increase. Routine ultrasound survey during physical examination revealed four cases (2.7%) in 1996 and 285 cases (49.8%) in 2006. The sensitivity of the ultrasound survey in thyroid cancer diagnosis was 86.66% in 1996 and 88.20% in 2006 (P>0.05). Papillary carcinoma was most prevalent (87.8% in 1996 and 92.8% in 2006). An increasing proportion of small tumors was found. The incidence of microcarcinoma was 35.7% in 2006 in contrast with 20.3% in 1996 (P<0.01). Moreover, tumors with diameter from 1 to 2 cm were found in 38.5% patients in 2006 as opposed to 27.0% in 1996 (P<0.01). Extrathyroid extension was reported in 46 (31.1%) patients in 1996, but only in 39 (6.8%) in 2006 (P<0.01). Central cervical lymph node metastases were found in 98 (66.2%) patients in 1996, contrasting with 301 (52.6%) in 2006 (P<0.05). Thirty-seven (25.0%) patients had lateral cervical lymph node metastasis in 1996 compared with 117 (20.5%) in 2006 (P>0.05). Last, the proportion of stage I cancers in 2006 was higher than that in 1996.
With the increasing incidence of thyroid cancer, cancer was discovered at an earlier stage. This is due to new clinical features of thyroid cancer, such as the decrease in tumor diameter, the lower rate of extrathyroid extension and of cervical lymph node metastasis. Routine ultrasound survey during physical examination has become the most common way to detect thyroid cancer. Increasing usage of diagnostic scrutiny, including the ultrasound survey, has most likely contributed to the increased incidence through detection of small thyroid cancers. Increased use of ultrasound to screen thyroid cancer in early stages should lead to better therapeutic outcome.
分析中国东部地区甲状腺癌的近期临床特征。
对 1996 年至 2006 年复旦大学附属肿瘤医院头颈外科甲状腺癌患者的临床资料进行调查和比较。
甲状腺癌患者人数从 1996 年的 148 例增加到 2006 年的 572 例，增加了 3.9 倍。常规体检超声检查发现，1996 年有 4 例（2.7%），2006 年有 285 例（49.8%）。1996 年超声检查对甲状腺癌诊断的灵敏度为 86.66%，2006 年为 88.20%（P>0.05）。乳头状癌最为常见（1996 年为 87.8%，2006 年为 92.8%）。发现小肿瘤的比例逐渐增加。2006 年微癌的发病率为 35.7%，而 1996 年为 20.3%（P<0.01）。此外，2006 年有 38.5%的患者肿瘤直径为 1 至 2 厘米，而 1996 年为 27.0%（P<0.01）。1996 年有 46 例（31.1%）患者有甲状腺外侵犯，而 2006 年仅有 39 例（6.8%）（P<0.01）。1996 年有 98 例（66.2%）患者有中央颈淋巴结转移，而 2006 年有 301 例（52.6%）（P<0.05）。1996 年有 37 例（25.0%）患者发生侧颈淋巴结转移，而 2006 年有 117 例（20.5%）（P>0.05）。最后，2006 年Ⅰ期癌症的比例高于 1996 年。
随着甲状腺癌发病率的增加，癌症发现得更早。这是由于甲状腺癌的新临床特征，如肿瘤直径减小、甲状腺外侵犯和颈部淋巴结转移的发生率降低。常规体检超声检查已成为发现甲状腺癌最常见的方法。包括超声检查在内的诊断检查的使用增加，很可能通过发现小甲状腺癌而导致发病率增加。在早期阶段增加使用超声筛查甲状腺癌应能带来更好的治疗效果。
