are risk factors common to thyroid cancer and nodule a forty years observational time-trend study常见的危险因素是甲状腺癌结节一百四十年观测时间学习.pdfVIP

Are Risk Factors Common to Thyroid Cancer and Nodule? A Forty Years Observational Time-Trend Study 1 2 3 3 1 Angelo Carpi *, Giuseppe Rossi , Rossana Romani , Giancarlo Di Coscio , Andrea Nicolini , Tommaso Simoncini1, Matteo Russo4,5, Jeffrey Mechanick6 1 Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy, 2 CNR, Institute of Clinical Physiology, Unit of Epidemiology and Biostatistics, Pisa, Italy, 3 Department of Oncology-Pathology, University Hospital, Pisa, Italy, 4 Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy, 5 Department of Cellular and Molecular Pathology, IRCCS San Raffaele Pisana, Rome, Italy, 6 Division of Endocrinology, Diabetes and Bone, Mount Sinai School of Medicine, New York, New York, United States of America Abstract A progressive increase in the incidence of thyroid cancer (TC) has been reported over the last few decades. This either reflects the increased number of newly discovered and accurately selected thyroid nodules with more sensitive technologies and a relative more potent carcinogenic effect of pathogenetic factors in malignant, but not benign nodules. This observational time-trend study addresses this issue by analysing the proportion of TC within 8411 consecutive thyroid nodule (TN) patients evaluated in Pisa by the same pathology Department and individual clinician over a four-decade period. From 1972 to 1979 surgery was used to detect TC among the TN patients: 1140 TN patients were operated on and 35 cancers were detected (3.1% of all the TN patients). Subsequently, needle aspiration techniques were used to select TN for surgery. From 1980 to 1992, 5403 TN patients were examined, 483 were selec