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不同初潮年龄、生育期及绝经后阶段时长的自然绝经女性甲状腺乳头状癌的临床病理特征及预后

Clinicopathological Characteristics and Prognosis of Papillary Thyroid Carcinoma in Naturally Menopausal Women with Various Durations of Premenarche, Reproductive Periods, and Postmenopausal Stages.

作者信息

Zhu Xuhang, Yu Bin, Huang Yu-Qing, Zhou Jing-Nan, Ge Ming-Hua

机构信息

Second Clinical Medical College, Zhejiang Chinese Medical University, Binjiang District, Hangzhou 310022, China; Department of Head and Neck Surgery, Zhejiang Province Cancer Hospital, Gongshu District, Hangzhou 310022, China.

Department of Equipment, Zhejiang Province Cancer Hospital, Gongshu District, Hangzhou 310022, China.

出版信息

Int J Endocrinol. 2017;2017:5702716. doi: 10.1155/2017/5702716. Epub 2017 Mar 3.

Abstract

Papillary thyroid cancer (PTC) exhibits a higher incidence in women. Due to various ages at menarche and menopause, estrogen levels vary, which may account for the differences in the occurrence, development, and prognosis of female patients with PTC. The aim of this study was to investigate the association between various durations in different estrogen levels and PTC and to provide important information to guide clinical management and treatment of this disease. First, we selected naturally menopausal female study subjects diagnosed with PTC at Zhejiang Cancer Hospital from 2007 to 2012 and then compared the differences in clinicopathological characteristics and prognosis among subjects with various lengths of premenarche, reproductive periods, and postmenopausal stages. We found that all patients showed a significantly higher incidence of tumor multicentricity and intrathyroidal dissemination as the time after menopause increased. Additionally, women with shorter (<30) or longer (>38) reproductive lives had increased recurrence rates of PTC. In this study, we did not find any relationship of self-reported menarche and menopausal ages with the prognosis of PTC patients. More importantly, natural postmenopausal PTC patients with shorter or longer reproductive life, compared to the normal groups, had a higher rate of cancer recurrence and the patients with these characteristics could be recommended a more aggressive surgical treatment.

摘要

甲状腺乳头状癌(PTC)在女性中的发病率较高。由于初潮和绝经年龄各不相同,雌激素水平也会有所变化,这可能是导致PTC女性患者在发病、发展及预后方面存在差异的原因。本研究旨在探讨不同雌激素水平下的不同时长与PTC之间的关联,并为指导该疾病的临床管理和治疗提供重要信息。首先,我们选取了2007年至2012年在浙江省肿瘤医院被诊断为PTC的自然绝经女性研究对象,然后比较了初潮前、生育期和绝经后期时长不同的研究对象在临床病理特征和预后方面的差异。我们发现,随着绝经后时间的增加,所有患者的肿瘤多中心性和甲状腺内播散发生率均显著升高。此外,生育期较短(<30年)或较长(>38年)的女性PTC复发率升高。在本研究中,我们未发现自我报告的初潮年龄和绝经年龄与PTC患者的预后有任何关联。更重要的是,与正常组相比,生育期较短或较长的自然绝经后PTC患者癌症复发率更高,对于具有这些特征的患者,可建议采取更积极的手术治疗。

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