瑞典甲状腺癌生存率研究（1999-2018）

Survival in Thyroid Cancer in Sweden From 1999 To 2018

Clinical Epidemiology

影响因子:3.2

分区:医学3区 / 公共卫生2区

发表日期:2024

作者: Frantisek Zitricky, Anni Koskinen, Kristina Sundquist, Jan Sundquist, Vaclav Liska, Asta Försti, Akseli Hemminki, Kari Hemminki

DOI: 10.2147/CLEP.S467874

摘要

甲状腺癌（TC）根据不同的组织学类型具有不同的临床特征和生存率。我们的目的是描述这些类型如何影响瑞典的TC生存情况。数据来源于瑞典癌症登记处，涵盖1999年至2018年，通过相对生存率进行分析。所有TC的相对生存率在十年期间呈改善趋势，且女性的生存改善幅度大于男性。女性的生存优势在某些组织学类型中也有表现，尽管这些类型的病例数较少。女性5年相对生存率：滤泡癌为100%，嗜酸性细胞癌为95.1%，乳头状癌为93.4%，髓样癌为89.7%，未分化癌为6.1%。在临床TNM分期中，只有T4和M1阶段的生存率明显低于T1-3和M0。未分化癌多在高T期和M1期诊断，区别于其他TC类型。有趣的是，未分化M1患者的诊断年龄低于M0患者。未分化和髓样癌在转移概率方面未显示出明显的年龄依赖性，而主要的组织学类型则表现出不同的趋势。这可能提示存在多种未分化和髓样癌的亚型。未分化TC的生存极差，与分化型TC的优异生存形成鲜明对比。由于不足20%的未分化癌患者能存活一年，早期诊断和及时治疗尤为重要。丹麦已建立加快治疗流程的措施，显著改善了患者生存率。未分化癌应成为重点研究对象。

Abstract

Thyroid cancer (TC) is diagnosed in several histological types which differ in their clinical characteristics and survival. We aim to describe how they influence TC survival in Sweden.Cancer data were obtained from the Swedish cancer registry between years 1999 and 2018, and these were used to analyze relative survival.Relative survival for all TC improved when analyzed in 10-year periods, and female survival improved more than male survival. Female survival advantage appeared to be present also for specific histological types, although case numbers were low for rare types. Female 5-year relative survival for TC was 100% for follicular, 95.1% for oncocytic, 93.4% for papillary, 89.7% for medullary, and 6.1% for anaplastic cancer. Among the clinical TNM classes, only T4 and M1 stages were associated with decreased survival compared to T1-3 and M0. Anaplastic cancer presented most often at high T and M1 stages, in contrast to other TC. Curiously, the diagnostic age for anaplastic M1 patients was lower than that for M0 patients. Both anaplastic and medullary cancers did not show age-dependent increases in the probability of metastases, in contrast to the main histological types. This could indicate the presence of several types of anaplastic and medullary cancers.The poor survival for anaplastic TC is an extreme contrast to the excellent survival of differentiated TC. As less than 20% of anaplastic cancer patients survived one year, urgent diagnosis and initiation of treatment are important. Facilitated treatment pathways have been instituted in Denmark resulting in improved survival. Anaplastic cancer should be a target of a major research focus.