The thyroid disease study in the Republic of the Marshall Islands

1994年和1996年在马歇尔群岛夸贾林和马朱罗进行的甲状腺结节检查结果表明：1.甲状腺结节的检出率与比基尼角呈负相关。2.甲减患病率和甲状腺自身抗体阳性率明显低于日本成年人和长崎原子弹爆炸受害者。3.根据世界卫生组织关于碘缺乏的标准，估计三分之一的马朱罗居民为中度碘缺乏。4.马歇尔人在原子弹试验时期（1949-58）的辐射剂量测量无法完成。5. 70例细针穿刺活检标本中未检测到K-ras癌基因第61位密码子突变。6.1994年在马朱罗进行的11例甲状腺手术中，病理诊断为乳头状癌7例，癌3例。4例p53蛋白免疫化学染色阳性，由于没有剂量学资料，我们不能对该对象作出明确的结论。但根据以上结果提出了一些建议。1.从甲状腺结节患病率的地理分布来看，存在着原子弹试验低剂量辐射效应的可能性。2.碘摄入不足可能影响甲状腺结节的患病率。3.滤泡癌的高比例与马歇尔群岛诱发甲状腺癌的其他报道相矛盾。马歇尔群岛甲状腺肿瘤的病因可能与切尔诺贝利地区不同。

The results from the examination in 1994 and 1996 at Kwajalein and Majuro in Marshall Islands were as follows ;1.The prevalence of palpable thyroid nodules had reverse correlation to the angle rhetafrom Bikini. 2.The prevalence of hypothyroidism and the ratio of positive auto-antibody to thyroid were quite lower than Japanese adults and Nagasaki atomic bomb victims. 3.On the basis of WHO criteria on iodine deficiency, one third of Majuro residents were estimated as moderate iodine deficiency. 4.The radiation dosimetry for the Marshall people during atomic bomb testing era (1949-58) could not be completed. 5.The mutation of codon 61, K-ras oncogene was not detected in 70 fine needle aspiration biopsy specimens. 6.In eleven operated thyroid in 1994 at Majuro, seven papillary carcinomas and three carcinomas were pathologicaly diagnosed. The p53 protein was immunohistochemically positive in four cases.Since no dosimetry data was available for this time, we could not have definite conclusions on the object. But some suggestion were given from the above results. 1.From the geographical distribution of the prevalence of thyroid nodule, there was possibility of low dose radiation effect of atomic bomb testing. 2.Rather poor iodine intake might affect the thyroid nodule prevalence. 3.The high ratio of follicular carcinoma was contradictory to other reports on the thyroid cancer induced by Marshall Islands. The cause of the thyroid tumors in Marshall Islands might be different from that in the Chernobyl area.