Akslen L A, Haldorsen T, Thoresen S O, Glattre E
Department of Pathology, Gade Institute, University of Bergen, Norway.
APMIS. 1990 Jun;98(6):549-58.
In the Norwegian population, a total of 1977 females and 648 males had a diagnosis of thyroid cancer and were reported to the Cancer Registry during 1970-85. Most of the cases (98%) were histologically or cytologically confirmed, and 141 cases were diagnosed at autopsy (5.4%). Of the patients with information available, 13% had not been subjected to radical surgery. The actual number and annual incidence rate of thyroid cancer increased during the period, especially among females, although a possible levelling off was observed at the end. The frequency of papillary carcinoma clearly increased with time, and tumours were more often localized at presentation in later years. Improved detection of smaller tumours and differences in histopathological judgement may in part explain these results, but our findings are so notable that etiological factors must also be accounted for and researched. Associations between sex, age, histology and stage were further studied in a multivariate log-linear model. The results confirm the importance of sex and age when exploring the observed incidence pattern and also show that various histological types are unique with respect to metastatic patterns, when confounding factors have been adjusted for.
在挪威人群中，1970年至1985年间共有1977名女性和648名男性被诊断为甲状腺癌并上报至癌症登记处。大多数病例（98%）经组织学或细胞学确诊，141例在尸检时被诊断出（5.4%）。在有可用信息的患者中，13%未接受根治性手术。在此期间，甲状腺癌的实际病例数和年发病率有所上升，尤其是女性，不过在末期观察到可能出现了趋于平稳的情况。乳头状癌的发病率随时间明显增加，且在后期肿瘤在初诊时更常局限于局部。对较小肿瘤的检测改善以及组织病理学判断的差异可能部分解释了这些结果，但我们的发现非常显著，因此病因因素也必须加以考虑和研究。在多变量对数线性模型中进一步研究了性别、年龄、组织学和分期之间的关联。结果证实了在探究观察到的发病率模式时性别和年龄的重要性，并且还表明，在对混杂因素进行调整后，各种组织学类型在转移模式方面具有独特性。
