Nuclear medicine-thyroid Unit, Institut Jean-Godinot de Reims, 1, rue du Général-Koenig, 51100 Reims, France.
Thyroid Cancer Registry of Marne-Ardennes, Institut Jean-Godinot, 1, rue du Général-Koenig, 51100 Reims, France.
Ann Endocrinol (Paris). 2019 Sep;80(4):229-233. doi: 10.1016/j.ando.2019.06.001. Epub 2019 Jul 8.
Yearly incidence of thyroid cancer has nearly tripled in the past four decades, due to improvements in and better use of diagnostic procedures, enabling detection of smaller tumors, and notably micropapillary carcinoma (MPC: ≤10 mm).
The aim of our study was to confirm increasing incidence, to describe the characteristics and circumstances of discovery, and to examine the reasons for this rise in incidence of MPCs, based on the French Marne-Ardennes registry for 1975-2014.
This was a retrospective observational cohort study.
Two thousand six hundred and seventy-one patients with thyroid cancer were included for the period 1975-2014, with 966 (36.2%) MPCs. The percentage increased from 18.9% for 1975-1984 to 45.1% for 2005-2014. Standardized incidence per 100,000 patient-years increased from 0.86 for 1975-1984 to 6.20 for 2005-2014. Incidence increase was higher in women (ranging from 1.15 to 8.91) than in men (from 0.20 to 2.54). Incidence increased more in ≥50 year-olds (from 0.41 to 4.21) than in <50 year-olds (from 0.45 to 1.99). Most MPCs (84.6%) were discovered incidentally on histology, and were mainly unifocal (79.4%). Incidental MPCs were smaller, affected older patients and were less multifocal than those suspected before surgery. MPCs were associated with excellent survival and low morbidity, with <1.9% progression.
The present study confirmed the large rise in incidence of MPCs reported elsewhere. Most MPCs were discovered incidentally on histological examination in the context of surgery for benign pathology. Changes in access to health care and in physicians' and pathologists' practices are likely explanations for our findings.
在过去的四十年中，由于诊断程序的改进和更好的应用，甲状腺癌的年发病率几乎增加了两倍，这使得更小的肿瘤，尤其是微乳头状癌（MPC：≤10mm）得以检测。
我们研究的目的是确认发病率的增加，描述发现的特征和情况，并根据法国马恩-阿登地区 1975-2014 年的登记册，检查 MPC 发病率上升的原因。
这是一项回顾性观察队列研究。
1975-2014 年期间共纳入 2671 例甲状腺癌患者，其中 966 例（36.2%）为 MPC。该百分比从 1975-1984 年的 18.9%增加到 2005-2014 年的 45.1%。每 100,000 名患者年的标准化发病率从 1975-1984 年的 0.86 增加到 2005-2014 年的 6.20。女性的发病率增加高于男性（从 1.15 到 8.91），而男性的发病率增加高于男性（从 0.20 到 2.54）。≥50 岁的患者发病率增加（从 0.41 到 4.21）高于<50 岁的患者（从 0.45 到 1.99）。大多数 MPC（84.6%）是在组织学检查中偶然发现的，主要是单发（79.4%）。偶然发现的 MPC 较小，影响老年患者，并且比术前怀疑的 MPC 多灶性更小。MPC 与极好的生存率和低发病率相关，进展率<1.9%。
本研究证实了其他地方报道的 MPC 发病率的大幅上升。大多数 MPC 是在良性病变手术中进行组织学检查时偶然发现的。医疗保健的可及性变化以及医生和病理学家的做法可能是我们研究结果的解释。
