摘要目的 分析1995-2010年北京城区甲状腺癌发病趋势及病理特征.方法 提取北京市肿瘤登记处1995-2010年肿瘤发病数据库中城区甲状腺癌发病信息,共计4883例,覆盖人口110 574 109人年；其中,男性1185例,覆盖人口56 143 454人年,女性3698例,覆盖人口54 430 655人年.计算甲状腺癌发病率、中国人口结构标化发病率(简称中标率)及世界人口构成标化发病率(简称世标率),以及发病率年度变化率(APC值),分析发病率变化趋势及分性别、病理类型甲状腺癌发病率的变化情况.结果 1995-2010年北京市城区居民甲状腺癌发病共计4883例,包括男性1185例,女性3698例,男女比例为1∶3.发病率由1.55/10万(97/6 245 016)升至9.90/10万(768/7 758 759),增长538.71％,世标率由1995年的1.27/10万升至2010年的6.96/10万,APC值为12.12％ (P＜0.05).其中,男性发病率由0.85/10万(27/3 185 669)升至4.58/10万(179/3 912 458),增长438.82％,世标率由1995年的0.68/10万升至2010年的3.19/10万,APC值为11.09％(P＜0.05),发病顺位由1995年的第18位上升至2010年的第14位；女性发病率则由2.29/10万(70/3 059 347)升至15.31/10万(589/3 846 301),增长568.56％,世标率由1995年的1.89/10万升至2010年的10.82/10万,APC值为12.48％ (P ＜0.05),发病顺位则由第12位上升至第5位4883例新发病例中,以组织学诊断结果作为最高诊断依据的共计4594例,占所有病例的94.08％,其中以乳头状癌最为常见(3775例),占77.31％.同时,乳头状癌在甲状腺癌不同病理类型中的构成比由1995年的51.55％ (50/97)升至2010年的87.63％ (673/768)；滤泡性癌的构成比则由5.15％(5/97)降至1.69％(13/768).结论 北京市城区甲状腺癌发病率逐年增高,其主要表现为乳头状癌在所有甲状腺癌病理类型中发病构成比例的增高.

abstractsObjective To describe the incidence trends and to access the histological changing patterns of thvroid cancer iu urban areas of Beijing.Methods Total of 4883 new cases diagnosed as thyroid cancer in 1995-2010 in urban areas of Beijing were extracted from the population-based data base of Beijing cancer registry,among which 1185 were males and 3698 were females with a coverage population of 56 143 454 person-years and 54 430 655 person-years,respectively.Incidence,age adjusted incidence,annual percentage change (APC) and gender specific incidence change of different histology patterns during last 16 years were calculate.Results There were 4883 cases diagnosed as thyroid cancer during 1995-2010 with the sex ratio of 1∶3 (1185 males and 3698 females).Incidence rate of thyroid cancer in urban areas of Beijing increased dramatically from 1.55/100 000 (97/6 245 016) in 1995 to 9.90/100 000(768/7 758 759) in 2010 with an increase rate of 538.71％.After adjusted by world population,the standardized incidence rate increased from 1.27/100 000 in 1995 to 6.96/100 000 in 2010 with a 12.12％annual percentage change (APC =12.12％,P ＜ 0.05).Among males,incidence rate increased from 0.85/100 000 (27/3 185 669) to 4.58/100 000 (179/3 912 458) with an increase rate of 438.82％.After adjusted by world population,the standardized incidence rate of males increased from 0.68/100 000 in 1995to 3.19/100 000 in 2010 with an 11.09％ annual percentage change (APC =11.09％,P ＜ 0.05).Among females,the incidence rate increased from 2.29/100 000 (70/3 059 347) to 15.31/100 000(589/3 846 301) with an increase rate of 568.56％.After adjusted by world population,the standardized incidence rate of females increased from 1.89/100 000 in 1995 to 10.82/100 000 in 2010 with a 12.48％annual percentage change (APC =12.48％,P ＜0.05).Incidence rate ranked 18th and 12th in 1995 among males and femalcs,respectively; while it ranked 14th and 5th in 2010 respectively.Among 4883 cases,4594 cases were confirmed histologically as primary tumor accounting for 94.08％ of total cases.Papillary carcinoma was the most common subtype accounting for 77.31％ (3775/4883) of total cases.Among all the pathological types of thyroid cancer,the proportiou of papillary carcinoma has risen from 51.55％ (50/97)in 1995 to 87.63％ (673/768) in 2010.However,the proportion of the follicular carcinoma decreased from 5.15％ (5/97) to 1.69％ (13/768).Conclusion Incidence of thyroid cancer in urban areas of Beijing keeps increasing which is mainly due to the rising of papillary carcinoma.Risk factors of papillary thyroid cancer should be focused on when strategies for thyroid cancer prevention and control are conducted.