Kaliszewski Krzysztof, Diakowska Dorota, Miciak Michał, Jurkiewicz Krzysztof, Kisiel Michał, Makles Szymon, Dziekiewicz Anna, Biernat Szymon, Ludwig Maksymilian, Ludwig Bartłomiej, Sutkowska-Stępień Karolina, Sebastian Maciej, Domosławski Paweł, Sutkowski Krzysztof, Wojtczak Beata
Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland.
Department of Basic Sciences, Faculty of Health Science, Wroclaw Medical University, 50-367 Wrocław, Poland.
Cancers (Basel). 2023 Oct 11;15(20):4941. doi: 10.3390/cancers15204941.
Because of ambiguous and widely debated observations concerning the incidence, trend, and management of TC, we performed this analysis. We drew attention to some events, such as "cancer screening activity", introduction of noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) to TC types, possibility of papillary thyroid microcarcinoma (PTMC) active surveillance (AS), occurrence of personalized medicine in TC management, and, finally, COVID-19 pandemic time. Because of the opinion that all changes have been made mostly by PTC, we compared it to the remaining types of TC in terms of incidence, clinical and pathological characteristics, and treatment. We analyzed patients treated in a single surgical center in eastern Europe (Poland). The prevalence of TC significantly increased from 5.15% in 2008 to 13.84% in 2015, and then significantly decreased to 1.33% in 2022 when the COVID-19 pandemic lasted ( < 0.0001). A similar trend was observed for PTC, when the incidence significantly increased to 13.99% in 2015 and then decreased to 1.38% in 2022 ( < 0.0001). At that time, the NIFTP category was introduced, and observation of PTMC began. The prevalence of FTC and MTC also increased until 2015 and then decreased. Significant differences in age, types of surgery, necessity of reoperation, and pTNM between PTCs and other types of TCs were observed. The average age was significantly lower in PTC patients than in patients with the remaining types of TC ( < 0.0001). Four milestones, including NIFTP introduction, the possibility of PTMC AS, personalized cancer medicine, and the COVID-19 pandemic, may have influenced the general statistics of TC.
由于关于甲状腺癌（TC）的发病率、趋势和管理存在模糊且广泛争议的观察结果，我们进行了此项分析。我们关注了一些事件，如“癌症筛查活动”、将具有乳头状核特征的非侵袭性滤泡性肿瘤（NIFTP）纳入TC类型、甲状腺微小乳头状癌（PTMC）进行主动监测（AS）的可能性、TC管理中个性化医疗的出现，以及最后新冠疫情时期。由于认为所有变化大多由乳头状甲状腺癌（PTC）引起，我们在发病率、临床和病理特征以及治疗方面将其与其他类型的TC进行了比较。我们分析了在东欧（波兰）一个单一外科中心接受治疗的患者。TC的患病率从2008年的5.15%显著增加到2015年的13.84%，然后在2022年新冠疫情持续期间显著下降至1.33%（<0.0001）。PTC也观察到类似趋势，其发病率在2015年显著增加至13.99%，然后在2022年降至1.38%（<0.0001）。当时引入了NIFTP类别，并开始对PTMC进行观察。滤泡性甲状腺癌（FTC）和髓样甲状腺癌（MTC）的患病率也在2015年之前增加，然后下降。观察到PTC与其他类型的TC在年龄、手术类型、再次手术的必要性以及pTNM方面存在显著差异。PTC患者的平均年龄显著低于其他类型TC的患者（<0.0001）。包括引入NIFTP、PTMC进行AS的可能性、个性化癌症医疗以及新冠疫情在内的四个里程碑事件可能影响了TC的总体统计数据。
