Keskin Caglar, Sahin Mustafa, Hasanov Rovshan, Aydogan Berna Imge, Demir Ozgur, Emral Rıfat, Gullu Sevim, Erdogan Murat Faik, Gedik Vedia, Uysal Ali Riza, Baskal Nilgun, Corapcioglu Demet
Department of Endocrinology and Metabolic Disease, School of Medicine, Ankara University, Ankara, Turkey.
Arch Med Sci. 2019 Jan 11;16(2):302-307. doi: 10.5114/aoms.2018.81136. eCollection 2020.
Incidental thyroid cancers are frequently detected in patients operated on for Graves' disease (GD). There are no clear data about the incidence and risk factors of incidental thyroid cancer in operated GD patients. The aim of this study is to evaluate the risk of thyroid carcinoma in surgically treated GD patients.
The data of 121 GD patients who underwent total thyroidectomy in a single center between 2005 and 2015 were retrospectively evaluated. The diagnosis of thyroid cancer was based on pathological examination.
Thyroid cancer was demonstrated in postoperative pathology specimens of 34 patients who were surgically treated for GD (28.1%). Preoperative thyroid ultrasonography (USG) revealed a nodular goiter in 62 (51.2%) patients. Nodules were not detected in the other 59 (48.8%) patients with GD. The frequency of thyroid cancer was significantly higher in patients with nodules (38% vs. 16%; = 0.009). Thirty-two of the 34 cancer cases had papillary thyroid cancer (PTC), and the remaining 2 had follicular thyroid cancer (FTC). Of the 32 PTC patients, 28 were classical type, 2 patients had the follicular variant, 1 was the oncocytic variant, and 1 was a tall cell variant.
The incidence of thyroid cancer was higher in patients who underwent surgery for GD. In addition to a careful physical examination in the follow-up of the patients with GD, ultrasonographic evaluation should be performed. Surgical treatment should not be delayed in patients with GD when indicated.
在因格雷夫斯病（GD）接受手术的患者中，偶然发现甲状腺癌的情况屡见不鲜。目前尚无关于接受手术的GD患者中偶然甲状腺癌的发病率及危险因素的确切数据。本研究旨在评估接受手术治疗的GD患者发生甲状腺癌的风险。
回顾性评估了2005年至2015年间在单一中心接受全甲状腺切除术的121例GD患者的数据。甲状腺癌的诊断基于病理检查。
接受GD手术治疗的34例患者的术后病理标本中证实存在甲状腺癌（28.1%）。术前甲状腺超声检查（USG）显示62例（51.2%）患者有结节性甲状腺肿。其他59例（48.8%）GD患者未检测到结节。有结节的患者中甲状腺癌的发生率显著更高（38%对16%；P = 0.009）。34例癌症病例中有32例为乳头状甲状腺癌（PTC），其余2例为滤泡状甲状腺癌（FTC）。在32例PTC患者中，28例为经典型，2例为滤泡变异型，1例为嗜酸性细胞变异型，1例为高细胞变异型。
接受GD手术的患者中甲状腺癌的发生率较高。除了对GD患者进行仔细的体格检查外，还应进行超声评估。有指征时，GD患者的手术治疗不应延迟。
