Reverter Jordi L, Colomé Eulàlia, Halperin Irene, Julián Teresa, Díaz Gonzalo, Mora Mireia, Sanmartí Anna, Puig-Domingo Manuel
Servei d'Endocrinologia i Nutrició, Hospital Universitari Germans Trias i Pujol, Departament de Medicina, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
Endocrinol Nutr. 2010 Oct;57(8):364-9. doi: 10.1016/j.endonu.2010.06.004. Epub 2010 Sep 16.
There is little national literature on descriptive series of patients with differentiated thyroid carcinoma (DTC) and long-term monitoring in Spain. The aim of our study was to describe the DTC series in two tertiary hospitals [Hospital Clínic de Barcelona (HC) and Hospital Germans Trias i Pujol (HGTiP)] and compare these series with those described in the National Cancer Data Base (NCDB) and the Mayo Clinic, the leading international series by number of patients and length of follow-up.
We performed a retrospective review of the medical records of patients diagnosed with DTC in two tertiary hospitals in the Barcelona area. The results were compared with those published by the NCDB and the Mayo Clinic.
We reviewed 480 medical records of patients with DTC diagnosed between 1973 and 2006, with a mean follow-up of 16±8 years. No significant differences were observed in clinical characteristics, risk factors or the most frequent form of presentation between the joint HC/HGTiP group and the NCDB series. The most commonly used diagnostic methods were ultrasound and cytology in all series and the main type of surgery was total or nearly total thyroidectomy, with no differences between groups. Postoperative I-131 was administered more often in the HC/HGTiP series (83.9%) than in the NCDB series (55.1%) and in the Mayo Clinic (46%). In the HC/HGTiP group tumor recurrence was 9.3% and mortality 1.8%.
The HC and HGTiP series were comparable and the various diagnostic and therapeutic techniques used were similar. This study highlights historical trends in the use of imaging techniques, as well as differences with large American series in some procedures (such as laryngoscopy) and the use of radioiodine therapy.
在西班牙,关于分化型甲状腺癌(DTC)患者描述性系列研究及长期监测的国内文献较少。我们研究的目的是描述两家三级医院[巴塞罗那临床医院(HC)和德国人特里亚斯普尤尔医院(HGTiP)]的DTC系列病例,并将这些系列与美国国家癌症数据库(NCDB)及梅奥诊所描述的系列病例进行比较,后者是按患者数量和随访时间排序的领先国际系列。
我们对巴塞罗那地区两家三级医院诊断为DTC的患者病历进行了回顾性研究。将结果与NCDB和梅奥诊所发表的结果进行比较。
我们回顾了1973年至2006年间诊断为DTC的480例患者的病历,平均随访时间为16±8年。HC/HGTiP联合组与NCDB系列在临床特征、危险因素或最常见的表现形式上未观察到显著差异。所有系列中最常用的诊断方法是超声和细胞学检查,主要手术类型是全甲状腺切除术或近全甲状腺切除术,各组之间无差异。HC/HGTiP系列术后给予I-131治疗的比例(83.9%)高于NCDB系列(55.1%)和梅奥诊所(46%)。在HC/HGTiP组中,肿瘤复发率为9.3%,死亡率为1.8%。
HC和HGTiP系列具有可比性,所使用的各种诊断和治疗技术相似。本研究突出了成像技术使用的历史趋势,以及在一些操作(如喉镜检查)和放射性碘治疗的使用方面与美国大型系列研究的差异。