Pelizzo M R, Toniato A, Piotto A, Bernante P
Istituto di Chirurgia Generale I, Policlinico, Università degli Studi di Padova.
Chir Ital. 1994;46(4):1-3.
Thyroid carcinoma represents less than 2% cancers although there is an increasing incidence, mainly of the papillary variety, due in part to improved diagnostic procedures. In contrast there is a remarkably higher prevalence of occult foci in detailed autopsy studies (up to 34%) suggesting the possibility of a spontaneous regression for most of them. Only 1-2% of latent tumours grow larger and become clinically important through environmental, genetic and cellular factors (two-mutational event model by Knudson). Each single histological subgroup has different influencing factors: X ray exposure, iodide diet intake, coexisting (autoimmune and non) thyroid disease such as thyroiditis, Graves' disease, goitre, dyshormonogenesis, heredity and altered cellular oncogenes have been considered. Of a series of 715 thyroid cancers operated on between 1967 and 1992 we analyze sex ratio, mean age, radiation exposure, coexisting thyroid disease, familial occurrence.
甲状腺癌占所有癌症的比例不到2%,尽管其发病率呈上升趋势,主要是乳头状癌发病率上升,部分原因是诊断程序的改进。相比之下,详细尸检研究中隐匿病灶的患病率显著更高(高达34%),这表明大多数隐匿病灶可能会自发消退。只有1%-2%的潜伏肿瘤会因环境、遗传和细胞因素(Knudson的双突变事件模型)而长大并具有临床意义。每个组织学亚组都有不同的影响因素:人们已考虑过X射线照射、碘饮食摄入、并存的(自身免疫性和非自身免疫性)甲状腺疾病,如甲状腺炎、格雷夫斯病、甲状腺肿、激素合成障碍、遗传以及细胞癌基因改变。在1967年至1992年间接受手术的715例甲状腺癌病例中,我们分析了性别比例、平均年龄、辐射暴露、并存的甲状腺疾病以及家族发病情况。