目的:探讨1996年普遍食盐碘化(USI)政策实施前后甲状腺癌发病的变化及临床特点.方法:查阅本院病理科保存的1992-2002年期间住院患者的手术病理报告,计算各种类型甲状腺癌的检出率和在甲状腺恶性肿瘤中的构成比.对1999年后的所有甲状腺癌患者,进行淋巴结转移率和伴发疾病的分析.结果:(1)甲状腺癌的总检出率的变化是随机分布的,但1996-2002年间乳头状甲状腺癌(PTC)的检出率显著高于1992-1995年间.(2)PTC在甲状腺癌中的构成比于1996年以后呈现增加的趋势(r=2,P<0.05).(3)PTC的淋巴结转移发生率高于滤泡状甲状腺癌(FTC).32.78%的PTC和28.57%的FTC患者伴发有结节性甲状腺肿.结论:USI政策实施后,甲状腺癌的组织类型发生变化:PTC发病增加,FTC发病减少.
Objective: To analyze the incidence of thyroid carcinoma before and after universal salt iodization since 1996. Methods: The pathological reports of the patients with thyroid diseases who underwent surgery in the First Affiliated Hospital of China Medical University from 1992 to 2002 were collected. The detection rates of each type of thyroid carcinoma and the constituent ratios of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) were determined. Lymphatic metastasis and concomitant thyroid diseases were also analyzed in patients with thyroid carcinoma diagnosed after 1999. Results: The total detection rate of thyroid carcinoma changed randomly, but the detection rate of PTC from 1996 to 2000 was significantly higher than that from 1992 to 1995 ( P 〈0.05). The constituent ratio of PTC in thyroid carcinoma increased significantly after 1996 ( P 〈 0.05). Lymphatic metastasis was more com- mon in patients with PTC. The nodular goiter was found in 32.78% patients with PTC and 28.57% patients with FTC. Conclusion: The histological type of thyroid carcinoma changed after universal salt iodization: the incidence of PTC tends to increase, while that of FTC tends to decrease.