Yamashita H, Nakayama I, Noguchi S, Murakami N, Moriuchi A, Yokoyama S, Mochizuki Y, Noguchi A
Acta Pathol Jpn. 1985 Jul;35(4):781-8. doi: 10.1111/j.1440-1827.1985.tb00620.x.
The relative frequency of thyroid carcinoma in benign thyroid diseases such as toxic diffuse goiter (toxic goiter), adenomatous goiter (goiter), adenoma, and chronic thyroiditis (thyroiditis) was studied using 3,219 surgically removed thyroid glands. Coexistence of carcinoma and benign diseases was found in 257 glands. Among them, 157 glands had minute carcinoma (diameter of cancer nodule is smaller than 10 mm) and 100 glands had advanced carcinoma (larger than 10.1 mm in diameter). The incidence of carcinoma including minute carcinoma was 29.4% in goiter (98/333), 21.0% in thyroiditis (11/53), 8.6% in adenoma (55/638), and 5.3% in toxic goiter (98/1852). Chi-square test also revealed that the rate of carcinoma not only advanced carcinoma but also minute carcinoma was higher in goiter than in the other diseases (P less than 0.01, respectively). Among the patients aged under 39, the incidence of advanced carcinoma and minute carcinoma in thyroiditis were the highest, respectively (83% and 100% in thyroiditis, 9.0% and 11.4% in goiter, 2. 6% and 1.9% in adenoma, and 0.7% and 3.4% in toxic goiter), however, among the patients aged over 40, they were secondary lower and the lowest, respectively (19% and 16.8% in goiter, 5.2% and 7.5% in adenoma, 4.2% and 6.7% in thyroiditis, and 1.4% and 7.5% in toxic goiter). We concluded that adenomatous goiter accompanies carcinoma more frequently than other benign thyroid diseases and the high incidence of carcinoma in chronic thyroiditis is probably due to a preoperative selection of the patients.
利用3219个手术切除的甲状腺，研究了甲状腺癌在毒性弥漫性甲状腺肿（毒性甲状腺肿）、腺瘤性甲状腺肿（甲状腺肿）、腺瘤及慢性甲状腺炎（甲状腺炎）等良性甲状腺疾病中的相对发生率。在257个腺体中发现癌与良性疾病并存。其中，157个腺体有微小癌（癌结节直径小于10毫米），100个腺体有进展期癌（直径大于10.1毫米）。包括微小癌在内的癌发生率在甲状腺肿中为29.4%（98/333），在甲状腺炎中为21.0%（11/53），在腺瘤中为8.6%（55/638），在毒性甲状腺肿中为5.3%（98/1852）。卡方检验还显示，不仅进展期癌而且微小癌的发生率在甲状腺肿中均高于其他疾病（P均小于0.01）。在39岁以下的患者中，甲状腺炎中进展期癌和微小癌的发生率分别最高（甲状腺炎中分别为83%和100%，甲状腺肿中为9.0%和11.4%，腺瘤中为2.6%和1.9%，毒性甲状腺肿中为0.7%和3.4%），然而，在40岁以上的患者中，它们分别为次低和最低（甲状腺肿中为19%和16.8%，腺瘤中为5.2%和7.5%，甲状腺炎中为4.2%和6.7%，毒性甲状腺肿中为1.4%和7.5%）。我们得出结论，腺瘤性甲状腺肿比其他良性甲状腺疾病更常伴有癌，慢性甲状腺炎中癌的高发生率可能是由于术前对患者的选择。
