A Screening Study of Thyroid Cancer and Other Thyroid Diseases among Individuals Exposed in Utero to Iodine-131 from Chernobyl Fallout
A Screening Study of Thyroid Cancer and Other Thyroid Diseases among Individuals Exposed in Utero to Iodine-131 from Chernobyl Fallout
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DOI：
10.1210/jc.2008-2049
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发表时间：
2009-03-01
影响因子：
5.8
通讯作者：
Tronko, M.
中科院分区：
文献类型：
--
作者：
Hatch, M.;Brenner, A.;Tronko, M.
背景：与稳定碘一样，放射性碘集中在甲状腺中，增加暴露儿童患甲状腺癌的风险。关于胚胎/胎儿甲状腺暴露的数据很少，这引发了关于孕妇使用碘 131 (I-131) 的问题。我们在此介绍了因在子宫内暴露于切尔诺贝利核事故的 I-131 放射性尘埃而导致甲状腺疾病的估计风险。方法：我们从 2003 年到 2006 年进行了一项横断面甲状腺筛查研究（触诊、超声、甲状腺激素，以及细针抽吸（如果有指示的话））。参与者是来自乌克兰的 2582 对母子，其中母亲在 4 月 26 日事故发生时已怀孕， 1986 年，即 I-131 沉降物仍然存在的 2 个月后（1494 颗来自污染区，1088 颗来自对照组）。个体子宫内甲状腺累积剂量估计值来自于母亲甲状腺中估计的 I-131 活性（平均 72 mGy；范围 0-3230 mGy）。 结果：筛查结果确定了 7 例甲状腺癌和 1 例 Hurthle 细胞肿瘤。尽管甲状腺癌每格雷的估计超额比值有所升高（每格雷的超额比值比为 11.66），但没有统计学意义（P = 0.12）。未发现其他甲状腺疾病的辐射风险。结论：我们的结果表明，在切尔诺贝利事故发生后约 20 年，子宫内接触放射性碘可能会增加患甲状腺癌的风险，这支持在怀孕期间对 I-131 进行保守的医疗用途。 (临床内分泌代谢杂志 94: 899-906, 2009)
Background: Like stable iodine, radioiodines concentrate in the thyroid gland, increasing thyroid cancer risk in exposed children. Data on exposure to the embryonic/fetal thyroid are rare, raising questions about use of iodine 131 (I-131) in pregnant women. We present here estimated risks of thyroid disease from exposure in utero to I-131 fallout from the Chernobyl nuclear accident.Methods: We conducted a cross-sectional thyroid screening study (palpation, ultrasound, thyroid hormones, and, if indicated, fine needle aspiration) from 2003 to 2006. Participants were 2582 mother-child pairs from Ukraine in which the mother had been pregnant at the time of the accident on April 26, 1986, or 2 months after the time during which I-131 fallout was still present (1494 from contaminated areas, 1088 in the comparison group). Individual cumulative in utero thyroid dose estimates were derived from estimated I-131 activity in the mother's thyroid (mean 72 mGy; range 0-3230 mGy).Results: There were seven cases of thyroid carcinoma and one case of Hurthle cell neoplasm identified as a result of the screening. Whereas the estimated excess odds ratio per gray for thyroid carcinoma was elevated (excess odds ratio per gray 11.66), it was not statistically significant (P = 0.12). No radiation risks were identified for other thyroid diseases.Conclusion: Our results suggest that in utero exposure to radioiodines may have increased the risk of thyroid carcinoma approximately 20 yr after the Chernobyl accident, supporting a conservative approach to medical uses of I-131 during pregnancy. (J Clin Endocrinol Metab 94: 899-906, 2009)