Section of Endocrinology and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines.
Endocrinol Metab (Seoul). 2016 Mar;31(1):72-9. doi: 10.3803/EnM.2016.31.1.72.
Well-differentiated thyroid cancer (WDTC) is the most common form of thyroid malignancy. While it is typically associated with good prognosis, it may exhibit higher recurrence and mortality rates in selected groups, particularly Filipinos. This paper aims to describe the experience of a Philippine Hospital in managing patients with differentiated thyroid cancer.
We performed a retrospective cohort study of 723 patients with WDTC (649 papillary and 79 follicular), evaluating the clinicopathologic profiles, ultrasound features, management received, tumor recurrence, and eventual outcome over a mean follow-up period of 5 years.
The mean age at diagnosis was 44±13 years (range, 18 to 82), with a majority of cases occurring in the younger age group (<45 years). Most tumors were between 2 and 4 cm in size. The majority of papillary thyroid cancers (PTCs, 63.2%) and follicular thyroid cancers (FTCs, 54.4%) initially presented as stage 1, with a greater proportion of FTC cases (12.7% vs. 3.7%) presenting with distant metastases. Nodal metastases at presentation were more frequent among patients with PTC (29.9% vs. 7.6%). A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy and thyroid stimulating hormone suppression, resulting in a disease-free state. Excluding patients with distant metastases at presentation, the recurrence rates for papillary and FTC were 30.1% and 18.8%, respectively.
Overall, PTC among Filipinos was associated with a more aggressive and recurrent behavior. FTC among Filipinos appeared to behave similarly with other racial groups.
分化型甲状腺癌（WDTC）是最常见的甲状腺恶性肿瘤。虽然它通常与良好的预后相关，但在某些特定人群中，尤其是菲律宾人，它可能表现出更高的复发率和死亡率。本文旨在描述一家菲律宾医院在管理分化型甲状腺癌患者方面的经验。
我们对 723 例 WDTC 患者（649 例为乳头状癌，79 例为滤泡状癌）进行了回顾性队列研究，评估了临床病理特征、超声特征、接受的治疗、肿瘤复发以及平均 5 年随访期后的最终结果。
诊断时的平均年龄为 44±13 岁（范围为 18 至 82 岁），大多数病例发生在较年轻的年龄组（<45 岁）。大多数肿瘤大小在 2 至 4cm 之间。大多数乳头状甲状腺癌（PTC，63.2%）和滤泡状甲状腺癌（FTC，54.4%）最初表现为 I 期，FTC 病例中更多（12.7% vs. 3.7%）出现远处转移。PTC 患者在就诊时发生淋巴结转移的比例较高（29.9% vs. 7.6%）。大多数病例采用全甲状腺切除术治疗，然后进行放射性碘治疗和甲状腺刺激素抑制治疗，使大多数患者达到无病状态。不包括就诊时发生远处转移的患者，乳头状癌和 FTC 的复发率分别为 30.1%和 18.8%。
总体而言，菲律宾人的 PTC 表现出更具侵袭性和复发性的行为。菲律宾人的 FTC 似乎与其他种族群体的行为相似。
