A Retrospective Analysis Of Thyroid Carcinoma In Clinical And Pathological Features

OBJECTIVE:To analyze the clinical and pathological characteristics of thyroid carcinoma cases in QiLu hospital in nearly7years. To explore the disease spectrum changes. To provide reliable information in its prevention and early diagnosis.METHODS:Reviewed the medical records of772patients who suffered first thyroidectomy because of thyroid carcinoma confirmed by pathological examination in Qilu hospital of Shandong university from January2005to December2011, analyzed concerned information retrospectively included the number of patients, age structure, sex ratio, medical reasons, preoperative TSH levels and pathological results.RESULTS:1. Individuals suffered from thyroid carcinoma increased rapidly during the past period of2005-2011, especially for papillary thyroid carcinoma.2. The most frequent incidence age group was30-59for both men and women. The age of onset and number of patients were basically positively correlated in childhood and adolescence, especially for girls.3. Thyroid carcinoma was diagnosed in772patients,207men and565women, with a Male-to-female ratio of1:2.73. From2009to2011, sex ratio was relatively stable (P=0.175)4. For PTC, Single nodules were dominant and more than two times of multifocal nodules. 5. The proportion of papillary microcarcinoma showed a growing trend, particularly after2009. Contrarily, non-microcarcinoma decreased in proportion but still won a modest growth in number.6. The rising trends were apparent in papillary thyroid patients with nodular goiter. In2005, it was only accounted for31.82%of all PTC, and reached42.97%in2011.7. The rising trends were apparent in papillary thyroid patients with Hashimoto thyroiditis. It was accounted for3.7%～7.97%of all PTC during2005～2009and reached17.57%～18.07%in2010～2011. Compared with PTC, coexistence of PTC and HT owned younger age of onset and more female cases, both were statistically significant differences (P=0.023, P<0.01)8. Compared with PTC(13.45%), coexistence of PTC and HT owned more common rising preoperative TSH (30.88%)(P<0.01).CONCLUSIONS:1. The occurrence of thyroid carcinoma increased with years and papillary carcinoma made the greatest contribution, to be emphasized, the proportion of papillary microcarcinoma showed a growing trend. With the following factors may be relevant: environmental changes, iodine improper intakes, metabolic syndrome, increased detection rate of microcarcinoma, promotion of health concepts, hospital expansion, et al.2. In childhood and adolescence, the main pathology type was PTC. Thyroid carcinoma was a rare pathology when under5years old. For girls, the greater the age, the incidence was higher.3. The proportion of concurrent PTC in nodular goiter and Hashimoto thyroiditis showed growing trend in recent years. But if they should be regarded as risk factors was uncertain.4. Compared with PTC, coexistence of PTC and HT owned younger average age, more female cases and more common rising preoperative TSH. High TSH level may be a risk factor in the development of PTC. We suggest that early application of thyroxine might beneficial for HT patients with rising TSH...