甲状腺手术后结节和癌症评估：一项 460 例患者的队列研究。

Nodule and cancer assessment following thyroid surgery: a cohort of 460 patients.

机构信息

Department of Medical Oncology, Yüksek İhtisas University, Medicalpark Ankara Hospital, Ankara, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2020 Sep;24(18):9565-9570. doi: 10.26355/eurrev_202009_23042.

DOI:10.26355/eurrev_202009_23042

PMID:33015799

Abstract

OBJECTIVE

Thyroid nodule formation and the cancer risk of these nodules have recently become widely researched topics. Developments in diagnosis and treatment options have correlated with an increased number of diagnosed patients. However, such a high number of malignant patients in a single center is rare, and this advantage is able to assess the patients in reverse by reviewing nodularity in the malignant patient population. In this study, we retrospectively reviewed nodularity and malignancy following thyroid surgery in a high-risk population with high thyroid cancer rates.

PATIENTS AND METHODS

Out of 1,007 thyroid patients either referred to or operated on at Ankara Oncology Training and Research Hospital between January 1995 and December 2003, 460 patients with readily available data were included in the study.

RESULTS

Of the 460 patients, 74.9% were female and 25.1% were male. The mean age of female patients operated on due to thyroid nodules was 43.7 years (SD: 14.7; range: 12-81) and 47.1 years for males (SD: 14.6; range: 14-80) (p = 0.02). The mean age of patients with a solitary thyroid nodule (STN) was 40.57 years (SD: 13.65) and 45 years (SD: 14.49) for multinodular cases, with the number of nodules increasing with age (p = 0.0008). Malignancy was seen in 78% of STN cases and 73% of multinodular goiter (MNG) cases (p = 0.554). Comparing genders, 74.2% of female patients and 79.6% of male patients with an STN showed malignancy (p = 0.556). Similarly, 73.4% of females and 75.7% of males with MNG showed malignancy (p = 0.694). Multicentric malignancy was detected in 65.2% of MNG cases and 26.6% of STN cases (p < 0.001). This was especially prominent in papillary carcinomas, which had multicentric malignancy rates of 66.6% for MNG and 22.4% for STN (p < 0.001).

CONCLUSIONS

The females tended to develop nodules at an earlier age than the males, the MNG risk increased with age, and multicentric malignancy was prominent in MNG in papillary carcinomas.

摘要

目的

甲状腺结节的形成及其癌变风险是目前研究的热点问题。随着诊断和治疗方法的发展，诊断出的患者数量也在不断增加。然而，在单一中心发现如此多的恶性患者是罕见的，通过回顾恶性患者人群中的结节情况，可以对这些患者进行反向评估。本研究回顾性分析了甲状腺癌高发人群中甲状腺手术后的结节和恶性肿瘤情况。

患者和方法

1995 年 1 月至 2003 年 12 月期间，在安卡拉肿瘤培训与研究医院转诊或接受手术的 1007 例甲状腺患者中，有 460 例患者的资料完整，纳入本研究。

结果

460 例患者中，女性占 74.9%，男性占 25.1%。因甲状腺结节而接受手术的女性患者的平均年龄为 43.7 岁（标准差：14.7；范围：12-81），男性为 47.1 岁（标准差：14.6；范围：14-80）（p = 0.02）。单发甲状腺结节（STN）患者的平均年龄为 40.57 岁（标准差：13.65），多发结节性甲状腺肿（MNG）患者的平均年龄为 45 岁（标准差：14.49），随着年龄的增长，结节数量也随之增加（p = 0.0008）。STN 病例中恶性肿瘤占 78%，MNG 病例中恶性肿瘤占 73%（p = 0.554）。比较不同性别，STN 患者中女性占 74.2%，男性占 79.6%（p = 0.556）。同样，MNG 患者中女性占 73.4%，男性占 75.7%（p = 0.694）。MNG 中发现 65.2%的多中心恶性肿瘤，而 STN 中发现 26.6%的多中心恶性肿瘤（p < 0.001）。在乳头状癌中，这种情况更为明显，MNG 中有 66.6%的多中心恶性肿瘤，而 STN 中只有 22.4%（p < 0.001）。