Exposure to flame retardant chemicals and occurrence and severity of papillary thyroid cancer: A case-control study
Exposure to flame retardant chemicals and occurrence and severity of papillary thyroid cancer: A case-control study
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DOI：
10.1016/j.envint.2017.06.021
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发表时间：
2017-10-01
影响因子：
11.8
通讯作者：
Sosa, Julie Ann
中科院分区：
文献类型：
--
作者：
Hoffman, Kate;Lorenzo, Amelia;Sosa, Julie Ann
背景：甲状腺癌是美国增长最快的癌症，乳头状甲状腺癌(PTC)占发病病例的80%。越来越多的人暴露在阻燃化学品(FRS)中，这引发了人们对它们在这一“流行病”中可能扮演的角色的担忧。目前的研究旨在检验这一假设，即暴露于FRS的较高水平与PTC发病几率增加相关。方法：联系并邀请杜克癌症研究所的PTC患者参加。年龄和性别匹配的对照组是从杜克卫生系统和周围社区招募的。由于许多常见的FRS不存在适合长期接触的生物标志物，而粉尘中的FRS水平与暴露显著相关，因此除了现有的生物标志物外，还评估了家庭粉尘中的FRS与PTC之间的关系。结果：某些FR，特别是粉尘中十溴二苯醚(BDE-209)和三(2-氯乙基)磷酸的水平升高，与PTC的发病几率增加相关。粉尘BDE-209浓度高于中位数水平的参与者患PTC的可能性是那些BDE-209浓度较低的参与者的2.29倍[95%可信区间：1.03，5.08]。根据肿瘤侵袭性和突变状态的不同，相关性有所不同；TCEP与更大、更具侵袭性的肿瘤更密切相关，而BDE-209与更小、更不侵袭性的肿瘤更相关。结论：综上所述，这些结果提示家庭暴露于FRS，特别是BDE-209和TCEP，可能与PTC的发生和严重程度有关，值得进一步研究。
Background: Thyroid cancer is the fastest increasing cancer in the U.S., and papillary thyroid cancer (PTC) accounts for > 80% of incident cases. Increasing exposure to flame retardant chemicals (FRs) has raised concerns about their possible role in this 'epidemic'. The current study was designed to test the hypothesis that higher exposure to FRs is associated with increased odds of PTC.Methods: PTC patients at the Duke Cancer Institute were approached and invited to participate. Age- and gender-matched controls were recruited from the Duke Health System and surrounding communities. Because suitable biomarkers of long-term exposure do not exist for many common FRs, and levels of FRs in dust are significantly correlated with exposure, relationships between FRs in household dust and PTC were evaluated in addition to available biomarkers. PTC status, measures of aggressiveness (e.g. tumor size) and BRAF V600E mutation were included as outcomes.Results: Higher levels of some FRs, particularly decabromodiphenyl ether (BDE-209) and tris(2-chloroethyl) phosphate in dust, were associated with increased odds of PTC. Participants with dust BDE-209 concentrations above the median level were 2.29 times as likely to have PTC [95% confidence interval: 1.03, 5.08] compared to those with low BDE-209 concentrations. Associations varied based on tumor aggressiveness and mutation status; TCEP was more strongly associated with larger, more aggressive tumors and BDE-209 was associated with smaller, less aggressive tumors.Conclusions: Taken together, these results suggest exposure to FRs in the home, particularly BDE-209 and TCEP, may be associated with PTC occurrence and severity, and warrant further study.