目的：分析甲状腺结节（thyroid nodules，TN）的病理特征，探讨湖北省黄冈地区 TN 疾病谱的变迁特点。方法：回顾性分析黄冈市中医医院及黄冈市中心医院2011年-2013年进行甲状腺切除手术的1239例TN 患者术后病理资料。对三年间 TN 各种病理类型的构成比和变化趋势进行统计分析。结果：1239例 TN 患者中单纯结节性甲状腺肿657例（53.03％）、单纯桥本甲状腺炎286例（23.08％）、甲状腺癌199例（16.06％）、滤泡性腺瘤61例（4.92％）、毒性结节性甲状腺肿36例（2.91％）。结节性甲状腺肿、甲状腺癌患者的数量逐年略有增加，同时滤泡性腺瘤、桥本甲状腺炎和毒性结节性甲状腺肿略有下降。甲状腺乳头状癌的发病率呈显著增长的趋势（P ﹤0.05），而甲状腺滤泡性癌、髓样癌、未分化癌年间差异不大（P ﹥0.05）。甲状腺乳头状癌常合并其他良性病变，乳头状癌合并桥本甲状腺炎、合并结节性甲状腺肿分别为26和64例占所有乳头状癌病例的13.90％、34.22％，两者的发病率呈显著增长的趋势（P =0.0369）。结论：黄冈地区部分类型的 TN 发病率近年来明显上升。高碘、辐射、自身免疫和未被发现的环境致癌因素可能是甲状腺乳头状癌发病率增长的原因。%Objective:To investigate the clinicopathological characteristics and trends of thyroid nodules(TN)in Huanggang municipality of Hubei Province. Methods:Clinicopathological data of 1239 cases were retrospectively studied. Results:1239 cases of TN in three years there were 657(53. 03% )nodular goiter,286(23. 08% )Hashimo-toˊs thyroiditis,199(16. 06% )thyroid carcinomas,61(4. 92% )follicular adenoma and 36(2. 91% )toxic nodular goiter. Incidence of nodular goiter,thyroid cancer was increasing during three years,and follicular adenoma,Hash-imotoˊs thyroiditis,toxic nodular goiter decreasing. Incidence of thyroid papillary carcinoma presented significantly in-creasing tendency(P ﹤ 0. 05),however,carcinomas of medullary,follicular and undifferentiated in thyroid gland no significant differences(P ﹥ 0. 05). Thyroid papillary carcinoma coexisted with other benign lesions in some cases:26 cases with Hashimotoˊs thyroiditis and 64 cases contained nodular goiter,accounted for 13. 90% ,34. 22% respectively of total thyroid papillary carcinoma cases,both incidences of disease were significantly increasing(P ﹤ 0. 05). Con-clusion:The incidence of some kinds of TN in Huanggang municipality are significantly increasing in recent years,and the reason is likely due to undiscovered environmental carcinogens.
展开▼
