Picchi P, Salabè G B, Marzullo A, Faloci C, Campana F P
III Clinica Chirurgica, Policlinico Umberto I, Roma.
Minerva Endocrinol. 1996 Dec;21(4):115-21.
The aim of this investigation was to ascertain: 1) temporal trends in the incidence of thyroid carcinoma between 1990-1993; 2) regional differences in the incidence and histotype among the five provinces of Latium; 3) identification of risk factors, particularly of a preexisting thyroid tumour (goitre).
Records of patients submitted to thyroid surgery at the Istitute of III Clinica Chirurgica dell'Università "La Sapienza" di Roma have been reviewed and a questionnaire filled-in.
In the period 1990-1993, 144 cases of thyroid carcinomas were operated; 77.7% of those resided in the Latium region. Average age was 43 +/- 16.2, F:M = 3:1. During the four years observation period there was an increase in all surgical interventions and proportionally increased also thyroid surgery (hyperplasia, thyroiditis, hyperthyroidism and thyroid cancer). Thyroid cancer was found in 10% of thyroid patients, this proportion remains constant in the period 1990-1992, in 1993 rising to 14% (p = 0.032). Differences of incidence although not significant were found in the five provinces of Latium. A higher proportion of follicular histotypes was found in the province of Frosinone (FR vs RM, 20 vs 13.5% p = 0.45). A previous goitre, standing for period of three or more years, was reported in the records of 25% of patients. Seven percent of patients have been previously submitted to a partial thyroidectomy for benign thyroid disease, most of those being operated for thyroid adenoma (8 out 10 cases).
During a four year period of observation an increase of thyroid carcinoma was observed only in 1993. This increase cannot be attributed to an increase in the incidence of thyroid carcinoma. The province of Frosinone, known to be an endemic area, shows a proportion of the follicular histotype higher than that of other provinces. Goiter precedes malignant thyroid neoplasia in a high proportion of patients (25%). Follicular adenoma found frequently at the histology of patients operated for benign thyroid disease suggesting a transformation from benign to a malignant condition.
本调查的目的是确定：1）1990 - 1993年间甲状腺癌发病率的时间趋势；2）拉齐奥大区五个省份在发病率和组织学类型上的区域差异；3）识别风险因素，特别是既往存在的甲状腺肿瘤（甲状腺肿）。
回顾了罗马“La Sapienza”大学第三临床外科研究所接受甲状腺手术患者的记录，并填写了一份问卷。
在1990 - 1993年期间，共进行了144例甲状腺癌手术；其中77.7%的患者居住在拉齐奥大区。平均年龄为43±16.2岁，女性与男性比例为3:1。在四年的观察期内，所有外科手术数量增加，甲状腺手术（增生、甲状腺炎、甲状腺功能亢进和甲状腺癌）也相应增加。甲状腺癌在甲状腺患者中的比例为10%，这一比例在1990 - 1992年期间保持不变，1993年升至14%（p = 0.032）。拉齐奥大区五个省份的发病率虽无显著差异，但弗罗西诺内省滤泡型组织学类型的比例较高（弗罗西诺内省与罗马市相比，分别为20%和13.5%，p = 0.45）。25%的患者记录显示曾患有甲状腺肿三年或更长时间。7%的患者曾因良性甲状腺疾病接受过部分甲状腺切除术，其中大多数是因甲状腺腺瘤手术（10例中有8例）。
在四年的观察期内，仅在1993年观察到甲状腺癌有所增加。这种增加不能归因于甲状腺癌发病率的上升。弗罗西诺内省作为已知的地方性病区，其滤泡型组织学类型的比例高于其他省份。甲状腺肿在高比例患者（25%）中先于甲状腺恶性肿瘤出现。在接受良性甲状腺疾病手术患者的组织学检查中经常发现滤泡性腺瘤，提示存在从良性到恶性的转变。
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