カテゴリー「甲状腺ガン」
Title: Recent trends in the incidence, geographical distribution, and survival from thyroid cancer in Wales: 1985-2010.
Author: Amphlett B, Lawson Z, Abdulrahman GO, White C, Bailey R, Premawardhana L, Okosieme OE.
Reference: Thyroid. 2013 Mar 14. [Epub ahead of print]
Keywords:
Abstract: Abstract Background Previous studies of thyroid cancer incidence in Wales have given varying results with suggestions of an excess of cases in geographic areas that were previously exposed to the radioactive fallout from the 1986 Chernobyl nuclear reactor incident. Our objective in this study was to provide an up to date comprehensive analysis of time trends in the incidence, geographical distribution, and survival from thyroid cancer in Wales. Methods We identified thyroid cancer cases, registered from 1985 through 2010 in the Welsh Cancer Intelligence and Surveillance Unit (WCISU). Age standardised rates were determined from the European standard population. A Poisson regression model was fitted to assess temporal trends and rate ratios (RR) and 95% confidence intervals (CI) were determined and compared across consecutive time periods: 1985-1997 and 1998-2010. Standardised incidence ratios were calculated for each of the 22 local authority areas. Relative survival and Kaplan Meier curves were computed to analyse all cause and thyroid cancer-specific survival. Results A total of 1747 thyroid cancer cases were registered from 1985-2010. Age standardised incidence rates were 2.8 and 1.2 per 100,000 population per year for females and males, respectively. Incidence rates increased with time (rate ratio 1.3, 95% CI 1.2-1.5, p<0.001, 1998-2010 vs.1985-1997). The incidence of papillary cancer increased progressively over the study period (RR 2.22, 95% CI 1.91-2.57, p<0.001; 1998-2010 vs.1985-1997), while rates for other (non-papillary) histological subtypes remained static (RR 0.95, 95% CI 0.84-1.08, p=0.45; 1998-2010 vs.1985-1997). We identified two geographical areas of increased incidence but the spatial distribution of cases was inconsistent with exposure to radioactive fallout. Five-year relative survival from all-cause mortality improved from 74.2 (95% CI 66.8-80.1) in 1985-1989, to 82.6 (95% CI 77.1-86.9) in 2000-2004 but remained poor for patients >65 years (p<0.001, >65 yrs vs. 15-64 years) and patients with anaplastic thyroid cancer (p<0.001, anaplastic vs. other histological varieties). Conclusions The incidence of thyroid cancer has increased in Wales, predominantly due to an increase in papillary cancers. The current geographical distribution of cases does not support a radiation effect in the region. Survival has remained poor for patients aged >65 years and those with anaplastic carcinoma.
URL: http://www.ncbi.nlm.nih.gov/pubmed/23488941
Title: Chernobyl cleanup workers from Estonia: follow-up for cancer incidence and mortality.
Author: Rahu K, Auvinen A, Hakulinen T, Tekkel M, Inskip PD, Bromet EJ, Boice Jr JD, Rahu M.
Reference: J Radiol Prot. 2013 Mar 27;33(2):395-411. [Epub ahead of print]
doi:
Keywords: incidence, mortality, cleanup workers
Abstract: This study examined cancer incidence (1986-2008) and mortality (1986-2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. The cohort of 4810 men was followed through nationwide population, mortality and cancer registries. Cancer and death risks were measured by standardised incidence ratio (SIR) and standardised mortality ratio (SMR), respectively. Poisson regression was used to analyse the effects of year of arrival, duration of stay and time since return on cancer and death risks. The SIR for all cancers was 1.06 with 95% confidence interval 0.93-1.20 (232 cases). Elevated risks were found for cancers of the pharynx, the oesophagus and the joint category of alcohol-related sites. No clear evidence of an increased risk of thyroid cancer, leukaemia or radiation-related cancer sites combined was apparent. The SMR for all causes of death was 1.02 with 95% confidence interval 0.96-1.08 (1018 deaths). Excess mortality was observed for mouth and pharynx cancer, alcohol-related cancer sites together and suicide. Duration of stay rather than year of arrival was associated with increased mortality. Twenty-six years of follow-up of this cohort indicates no definite health effects attributable to radiation, but the elevated suicide risk has persisted.
URL: http://www.ncbi.nlm.nih.gov/pubmed/23532116
Title: Chernobyl-related thyroid cancer: what evidence for role of short-lived iodines?
Author: J P Bleuer, Y I Averkin, and T Abelin
Reference: Environ Health Perspect. 1997 December; 105(Suppl 6): 1483–1486.
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Abstract: Over 500 cases of thyroid cancer were diagnosed in Belarus between 1986 and 1995 among persons exposed as children (under 15 years of age) to radioactive contamination from the Chernobyl nuclear accident. There is little doubt that radioactive iodine isotopes emitted during the nuclear explosion and subsequent fire were instrumental in causing malignancy in this particular organ. Comparison of the observed geographic distribution of Chernobyl-associated thyroid cancer incidence rates by districts with contamination maps of radioactive fallout shows a better fit for estimated 131I contamination than for 137Cs. Because 131I used for medical purposes had not been considered carcinogenic in humans in the past, and in view of the unusually short latency period between exposure and clinical manifestation of cancer, it is suspected that not only 131I but also energy-rich shorter-lived radioiodines may have played a role in post-Chernobyl thyroid carcinogenesis. Measurements of iodine isotopes are not available, but reconstruction of geographic distributions and estimations of radioactive fallout based on meteorological observations immediately following the accident could provide a basis for comparison with the distribution of thyroid cancer cases. In this paper, data from the Epidemiological Cancer Register for Belarus will be used to show geographic and time trends of thyroid cancer incidence rates in the period from 1986 to 1995 among persons who were exposed as children, and these will be compared with the estimated contamination by radioiodines. Tentative conclusions are drawn from the available evidence and further research requirements discussed.
URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1469926/
Title: Occult thyroid carcinomas in the region of Minsk, Belarus. An autopsy study of 215 patients.
Author: Furmanchuk AW, Roussak N, Ruchti C. Research Institute for Oncology and Medical Radiology, Minsk, Republic of Belarus.
Reference: Histopathology. 1993 Oct;23(4):319-25.
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Abstract: Thyroid glands from 215 patients, aged 19 to 88 years, without known thyroid disease, were serially sectioned at 2-3 mm intervals and microscopically examined for occult disease. Glands were normal in 32.5%, while nodules were observed in 60% and adenomas in 13%. Carcinomas were found in 20 cases (9.3%): occult papillary carcinomas in 19 (8.8%) and one medullary carcinoma. No carcinomas were found in the thyroids of 15 patients less than 40 years of age. There were no significant differences in frequency of occult carcinomas between female and male patients and, for patients over 40 years, with increasing age. Of the 19 papillary tumours more than one focus was found in six cases (a total of 28 foci). The diameter of 27 of these tumours was less than or equal to 5 mm (96.4%), with one exception (diameter 6.3 mm). These findings were compared with those obtained in 86 thyroid glands of children surgically resected for carcinomas between 1986 and 1991. Only 10 of these tumours (11.6%) were less than or equal to 1 cm. These tumours, however, were significantly larger than the occult papillary carcinomas and their morphological features were quite different. Our results are discussed with regard to the possible role of factors other than irradiation due to the nuclear accident at Chernobyl, and the observed sharp numerical increase of thyroid carcinomas in children of the Republic of Belarus after this event.
URL: http://www.ncbi.nlm.nih.gov/pubmed/8300067
Title: Childhood thyroid diseases around Chernobyl evaluated by ultrasound examination and fine needle aspiration cytology.
Author: Ito M, Yamashita S, Ashizawa K, Namba H, Hoshi M, Shibata Y, Sekine I, Nagataki S, Shigematsu I. Department of Pathology, Nagasaki University School of Medicine, Japan.
Reference: Thyroid. 1995 Oct;5(5):365-8.
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Keywords:
Abstract: Screening by ultrasound examination and fine-needle aspiration cytological biopsy (FNA) was conducted in five regions in Belarus, Ukraine, and Russia to investigate the prevalence of childhood thyroid diseases around Chernobyl. Gomel, Zhitomir, Kiev, and the western area of Bryansk are the administrative regions where severe radioactive contamination occurred. The subjects from Mogilev, where contamination was relatively low, served as controls. Among 55,054 subjects (26,406 boys and 28,648 girls), the prevalence of ultrasonographic thyroid abnormalities such as nodule, cyst, and abnormal echogenity was significantly higher in the regions with severe contamination than in Mogilev. Of the 1,396 children showing echographic thyroid abnormalities 197 were selected for FNA, and a sample was successfully obtained for diagnosis from 171 (51 boys and 120 girls) of the 197 subjects. The aspirate was insufficient for diagnosis in the remaining 26 subjects. Thyroid cancer was encountered in four children (2.3%) from the contaminated regions, two children being from Gomel. The other thyroid diseases were follicular neoplasm, 6.4%; adenomatous goiter, 18.7%; chronic thyroiditis, 31.0%; and cyst, 24.0%, suggesting that a major cause of thyroid nodularity is nonneoplastic changes, mainly chronic thyroiditis and cysts. These results will serve as an important data base for further analyses and suggest that childhood thyroid diseases, including both neoplasms and immunological disorders, are consequences of radioactive fallout.
URL: http://www.ncbi.nlm.nih.gov/pubmed/8563473
タイトル：チェルノブイリ原発事故以降の甲状腺癌－1991～1992年ベラルーシ共和国の病理学的研究84の症例
著者： ニキフォロフ、グネップ
典拠：Cancer.- 1994
doi：
キーワード：
概要：ベラルーシ共和国では、1990年から急激に甲状腺癌が増加。ベラルーシ共和国の5～14歳の形態的・臨床的な84の症例。腫瘍の潜伏期間-4～6年（平均5.8年）。
URL: http://www.ncbi.nlm.nih.gov/pubmed/8033057
タイトル：個々のポスト・チェルノブイリ甲状腺乳頭がんにおけるRET/ PTC再配列の分布の不均一性
著者：アンガーK., ジッツェルスバーガーH., サルヴァトーレG., サントロM., ボグダノヴァT., ブラセルマンH., カストナーP., ズルナジーL., トロンコN., ハツラーP., トマスG.
典拠：臨床内分泌学＆代謝学、89、4272-4279頁、2004年。
キーワード：
概要：1986年にチェルノブイリで起こった原子力災害により、特定の病因に関連した甲状腺の乳頭癌という、ヒト腫瘍タイプの分子遺伝学を研究する稀有な機会が与えられた。我々はポスト・チェルノブイリ甲状腺乳頭癌(n = 29)、濾胞性甲状腺腺腫(n=2)、濾胞性甲状腺癌(n=1)におけるRET再配列を、パラフィン包埋組織切片のin situハイブリダイゼーション間期蛍光（FISH）解析によって分析した。パラフィン切片は腫瘍が存在したことを確認するために使用前に顕微解剖された。重複信号に加え、分割FISHシグナルの存在について細胞核がスコア化（赤と緑のシグナルに分離）された。2つの重複する信号もしくは1分割および1重複信号をもつ細胞のみが、唯一の完全な細胞核のみがスコア化されたことを確認するためにカウントされた。合計で、32症例中の23（72％）がFISHの間期分析によって診断されたRET再配列を示した。全ての症例において、腫瘍はFISHのRET転位を伴うもしくは伴わない細胞の混合物から構成されていた。いくつかの症例では、再配置細胞のクラスタリングは同じ腫瘍結節内で検出されたため、この分布は明らかにランダムである。結果的に、FISHの再配置の陽性症例のわずか31％がRT-PCRを使って陽性と記録された。これらの発見により、RET/ PTC再配列は腫瘍細胞の大部分には存在しないため、ポスト・チェルノブイリ甲状腺乳頭腫瘍の細胞は多クローン性の起源を持つか、RETの再配列は後の下位クローンの事象であることが示された。
URL:http://www.ncbi.nlm.nih.gov/pubmed/15356021
タイトル：ベラルーシにおけるチェルノブイリ事故後の甲状腺の直接測定から得られた甲状腺線量推定値に対する全身に分布する放射性核種の影響
著者：ウラノフスキーA., ドロズドヴィチV., ボーヴィレA.
典拠：放射線防護線量測定、112、405-418頁、2004年。
キーワード：
概要：甲状腺線量の再構築は甲状腺の直接測定の結果がもっとも正確であるが、その際甲状腺に存在する放射性核種および体の残りの部分において放出されたガンマ線は、首に押し付けられた放射線検出器によって記録される。こうした測定が1986年6月にベラルーシにおいて多数行われた。ヨウ素131の短い半減期とセシウム放射性同位元素（主にセシウム134と137）の摂取と蓄積により、1986年6月初旬以降に行われた甲状腺測定による甲状腺線量はこれまで信頼性がないと主に考えられてきた。甲状腺におけるヨウ素131の放射能測定を行う機器によって記録されたシグナルに対するセシウムの放射性同位体の影響を評価するために、モンテカルロ法が機器の較正係数を計算するのに使われた。それらの計算は6つの年齢基準（新生児、1歳、5歳、10歳、15歳、成人）の男性について行われた。較正係数はヨウ素131とセシウム放射性同位元素の時間依存的摂取関数の見積もりと合致した。甲状腺におけるヨウ素131による器具指標の分画は、測定された被験者の年齢および事故から経過した時間の関数としてこうして算出された。1986年5月に行われた甲状腺測定値を処理する際にこの情報を使用することで、甲状腺線量推定値の精度が改善され、1986年6月に行われた甲状腺測定の大部分を活用することが可能になると考えられる。
URL:http://www.ncbi.nlm.nih.gov/pubmed/15494363
タイトル：ポスト・チェルノブイリ甲状腺腫瘍の染色体不均衡
著者：リヒターH., ブラセルマンH., ヒーバーL., トマスG., ボグダノヴァT.
典拠：甲状腺 14、1061-1064頁、2004年。
キーワード：幼年期の甲状腺腫瘍
概要：60のポスト・チェルノブイリ幼少期甲状腺腫瘍からの組織サンプルを調べた。腫瘍DNA内の染色体損益を検出するのに比較ゲノムハイブリダイゼーション（CGH）を使用した。これは幼年期の甲状腺腫瘍における初のCGH研究である。ポスト・チェルノブイリ腫瘍は腫瘍の30％において染色体不均衡を示した。ポスト・チェルノブイリ腫瘍における最も頻度の高いDNAのコピー数の変化は染色体2、7q11.2-21、13q21-22、21（DNA増加）、染色体16p/q, 20q, 22q (DNA喪失)を含んでいる。ポスト・チェルノブイリ甲状腺腫瘍で検出されたこれらの具体的な変化（染色体16p/qおよび22q上の欠損）は甲状腺腫瘍における攻撃的な生物学的行動に関連するものとして以前に報告されており、したがってポスト・チェルノブイリ腫瘍における甲状腺乳頭癌（PTC）のより攻撃的な表現型を説明できる可能性がある。RET再配列を示すポスト・チェルノブイリPTCの18％もまた、追加の遺伝的事象が腫瘍のこのサブセットに関与している、もしくは腫瘍内の遺伝的異質性がそれらの腫瘍に存在することを示す染色体不均衡を見せており、腫瘍の発生にたいするオリゴクローナルのパターンを示唆している。
URL:http://www.ncbi.nlm.nih.gov/pubmed/15650359
タイトル：チェルノブイリ・フォールアウトに中程度影響を受けた国々の成人における甲状腺がんの増加
著者：マーベスSt., ロウサロヴァM., シェルブH., レングフェルダーE.
典拠：医科学モニター、10、300-306頁、2004年。
キーワード：チェコ共和国
概要：甲状腺癌の発生率がチェルノブイリの放射性降下物の影響を受けた子供たちの間で増加した。青年および成人における同様の影響についての証拠は比較的少ない。チェコ共和国のがん登録は、甲状腺癌の発生の様々な決定要因を研究する機会を提供してくれる。
URL:http://www.ncbi.nlm.nih.gov/pubmed/15295858
