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甲状腺乳头状癌的上升趋势。是真正的增加还是过度诊断?

The rising trend in papillary thyroid carcinoma. True increase or over diagnosis?

作者信息

Hajeer Manar H, Awad Heyam A, Abdullah Niveen I, Almuhaisen Ghadeer H, Abudalu Loay E

机构信息

Department of Histopathology, Microbiology and Forensic Medicine, University of Jordan, Amman, Jordan. E-mail.

出版信息

Saudi Med J. 2018 Feb;39(2):147-153. doi: 10.15537/smj.2018.2.21211.

Abstract

To assess the changes in parameters of thyroid carcinoma, particularly papillary type, in the era of widespread use of sensitive diagnostic methods. We aim to investigate whether the increased frequency of thyroid cancer is true or resulted from over diagnosis. Methods: We conducted a retrospective study of 313 cases of thyroid carcinoma diagnosed at Jordan University Hospital and King Hussein Cancer Center from 2007-2015. Papillary carcinoma accounted for 290 (92.7%) of all cases. Cases were sub classified according to demographic features, histological type, size, stage, and other variables. For comparison of data, cases were subdivided into 2 study periods: Group I included patients diagnosed in the period 2007-2010, and Group II in the period 2011-2015. Results: The frequency of thyroid carcinoma has increased across the study period. Papillary carcinoma was the major type accounting for this increase. Papillary micro carcinomas ≤1cm accounted for 34.8% of cases of PTC. Most cases (52.4%) of papillary thyroid carcinoma (PTC) were localized stage tumors. Group II of the study witnessed a more than doubled number of cases of PTC compared to group I, with increased frequency of tumors of all sizes as well as tumors of both localized and regional stages. Conclusions: Our observed trend cannot be totally explained by over diagnosis and increased diagnostic scrutiny. This increase could be of true nature and cannot be explained by single cause.

摘要

为评估在敏感诊断方法广泛应用的时代甲状腺癌(尤其是乳头状癌)参数的变化。我们旨在调查甲状腺癌发病率的增加是真实的还是过度诊断所致。方法:我们对2007年至2015年在约旦大学医院和侯赛因国王癌症中心诊断的313例甲状腺癌病例进行了回顾性研究。乳头状癌占所有病例的290例(92.7%)。病例根据人口统计学特征、组织学类型、大小、分期和其他变量进行亚分类。为比较数据,病例被细分为2个研究时期:第一组包括2007年至2010年诊断的患者,第二组包括2011年至2015年诊断的患者。结果:在整个研究期间甲状腺癌的发病率有所增加。乳头状癌是导致这种增加的主要类型。≤1cm的乳头状微小癌占PTC病例的34.8%。大多数(52.4%)甲状腺乳头状癌(PTC)病例为局限性期肿瘤。与第一组相比,研究的第二组PTC病例数增加了一倍多,所有大小的肿瘤以及局限性和区域性期肿瘤的发病率均有所增加。结论:我们观察到的趋势不能完全用过度诊断和诊断检查增加来解释。这种增加可能是真实的,不能用单一原因来解释。

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