AI, Junaidi1, Wan, Wong Mei1, Miyauchi, Akira2, Ab Hadi, Imisairi1
1 Department of Surgery, Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
2 Department of Surgery, Thyroid and Parathyroid glands, Kuma Hospital, Kobe, Japan
Background: Japan and Malaysia are two countries in Asia with different natural history of thyroid pathology. Japan is known to be a country with an iodine excess whilst Malaysia has several states with endemic iodine deficiency goiter.
Objectives: To view differences of histopathology of thyroid diseases in two Asian countries.
Methods: A retrospective review on both hospital electronic medical records was conducted. Patients who underwent surgery for thyroid pathology in 1st January 2016 until 30th June 2016 was included in the study. Comparison of the final histopathology diagnosis is the main outcome..
Results: Total of 1392 patients enrolled in the study, 749 (53.8%) from Japan and 643 (46.2%) from Malaysia. In Kuma Hospital, Total thyroid malignancy was (65.15%) whereas only (27.37%) was found to be malignant in Malaysia.
The most common malignancy in Japan was Papillary carcinoma (55.9%), followed by follicular carcinoma (5.5%), medullary carcinoma (1.1%), Lymphoma (0.8%) and anaplastic carcinoma (0.1%). Compared to Malaysia, papillary carcinoma was (21.8%), follicular carcinoma 26 (4.0%), Lymphoma (0.5%) and anaplastic carcinoma (0.2%).
Benign thyroid pathology was more common in Malaysia (72.62%) compared to Japan and mostly adenomatous goiter (60.5%). However in Japan follicular adenoma (13.1%) and Grave’s disease (8.4%) were more common.
Discussion: The study confirmed there was different in term of pathology of thyroid diseases distribution between 2 different Asian regions where thyroid malignancy was found more in Kobe, Japan and benign goiter were more common in Kelantan, Malaysia.
Conclusion: There was significant difference benign and malignancy pathological findings between two Asian countries.
- Htwe TT Thyroid malignancy among goitrous thyroid lesions: a review of hospital – based studies in Malaysia and Myanmar. Singapore medical Journal 2013; 53 (3): 159 – 163.
- Ito M, et al. Morphological difference in adult thyroid papillary carcinoma between Japan and Ukraine. Endocrine Journal 2014; 61 (12): 1221- 1228.
- Howlader N, et al. SEER Cancer Statistics Review 1975 -2012, National Cancer Institute.
- Passler C, et al. prognostic factors of papillary and follicular thyroid cancer: differences in iodine – rich and iodine – depleted countries. Cancer medicine 2016; DOI : 10.1002.