Isaac G, Roubicek M
Servicio de Endocrinología, Hospital Privado de Comunidad, Mar del Plata.
Medicina (B Aires). 1996;56(2):143-9.
A retrospective analysis of 117 cases of thyroid cancer diagnosed and/or treated at the Hospital Privado de Comunidad in Mar del Plata, Argentina, between 1974 and 1993 is presented and compared to previously published reports. Mean age at diagnosis was 54.3 years (range 17-88). Follow-up was 8.2 +/- 5.7 years. One third of patients had a previous history of thyroid disease. Histologic types had frequencies comparable to other series: 67.5% papillary, 15.4% follicular, 6% medullary, 3.4% Hürthle-cell and 6.8% undifferentiated. There was one case of lymphoma. Female to male ratio was 4.2:1 (95 females, 22 males). Higher age at diagnosis (over 63 years), higher tumor staging (TNM III or IV) and histologic type (undifferentiated, Hürthle and medullary) were important unfavorable prognostic factors for recurrence or death from the disease, but sex, type of surgery, postoperative radiation and hormonal therapy were not. Undifferentiated carcinomas (n = 8) had 100% mortality (survival 1-17 months after diagnosis, mean 5.5) and Hürthle-cell cancer had 75% mortality (survival 22-46 months, mean 33). Fine needle aspiration biopsy proved to be a useful diagnostic procedure, with an elevated positive predictive value (96%) and a moderate sensitivity (75%). A gradual decrease in surgical complications was observed, the last case of hypoparathyroidism occurring in 1986.
本文对1974年至1993年间在阿根廷马德普拉塔市私立社区医院诊断和/或治疗的117例甲状腺癌病例进行了回顾性分析，并与先前发表的报告进行了比较。诊断时的平均年龄为54.3岁（范围17 - 88岁）。随访时间为8.2±5.7年。三分之一的患者有甲状腺疾病史。组织学类型的频率与其他系列相当：乳头状癌占67.5%，滤泡状癌占15.4%，髓样癌占6%，许特莱细胞癌占3.4%，未分化癌占6.8%。有1例淋巴瘤。男女比例为4.2:1（95名女性，22名男性）。诊断时年龄较大（63岁以上）、肿瘤分期较高（TNM III或IV期）以及组织学类型（未分化癌、许特莱细胞癌和髓样癌）是疾病复发或死亡的重要不良预后因素，但性别、手术类型、术后放疗和激素治疗不是。未分化癌（n = 8）的死亡率为100%（诊断后存活1 - 17个月，平均5.5个月），许特莱细胞癌的死亡率为75%（存活22 - 46个月，平均33个月）。细针穿刺活检被证明是一种有用的诊断方法，具有较高的阳性预测值（96%）和中等灵敏度（75%）。观察到手术并发症逐渐减少，最后一例甲状旁腺功能减退发生在1986年。
