RADIATION INDUCED THYROID CANCER

这项研究的主要目的是研究辐射引起的 甲状腺癌通过协调的临床和实验室调查。 的 临床研究的目的是确定持续的发病率 辐射诱发的甲状腺癌，并评估诊断方法， 内科和外科治疗方法。 这将通过 继续对已接受评估的患者进行纵向研究， 迈克尔·里斯因童年头颈部病史住院 辐照 在接受这种治疗的5，300名患者中， 已与另外1，600人取得联系。 在这个群体中 结节的患病率为37%，在接受过手术的患者中， 得了甲状腺癌 后续行动将继续提供 辐射引起的甲状腺癌的发病率，现在估计至少 每年有1.5%的人口处于危险之中。 随访接受过治疗的患者 结节将提供一个治疗方法的评价， 采用 所有这些将为制定指导方针提供信息 用于照顾有辐射史的人。 类似研究 将继续研究其他已发现的辐射诱发肿瘤， 包括唾液源、神经源和甲状旁腺源。 实验室研究将集中在血清甲状腺球蛋白在甲状腺疾病中的作用。 甲状腺肿瘤的诊断 血浆甲状腺球蛋白升高， 大多数甲状腺结节患者和12%的 有辐射史，但其他方面看起来完全正常。 一个 最初甲状腺球蛋白水平升高表明形成高风险 甲状腺结节 在患者接受随访期间， 确定血清甲状腺球蛋白的变化是否也有临床意义 与受辐射人群的相关性。 甲状腺癌患者 将获得连续的甲状腺球蛋白测定，以评估 这些测量应在临床上使用。 影响因素 对甲状腺球蛋白的放射免疫测定进行了研究。

The major objective of this research proposal is to study radiation-induced thyroid cancer by coordinated clinical and laboratory investigations. The clinical studies are designed to determine the continuing incidence of radiation-induced thyroid cancer and to evaluate methods of diagnosis and medical and surgical approach to treatment. This will be accomplished by continuing the longitudinal study of patients who have been evaluated at Michael Reese Hospital because of a history of childhood head and neck irradiation. Of 5,300 patients who were so treated, 1,900 have been examined and another 1,600 have been contacted. In this population there is a 37% prevalence of nodules and among those who have had surgery 35% have had thyroid cancer. Follow-up will continue to provide an estimate of the incidence of radiation-induced thyroid cancer, now estimated at least 1.5% of the population at risk per year. Follow-up of patients who had nodules will provide an evaluation of the treatment methods which have been used. Together these will provide the information to develop guidelines for the care of persons with a history of irradiation. Similar studies will continue on the other radiation-induced tumors which have been found, including those of salivary, neural, and parathyroid origin. Laboratory studies will focus on the role of serum thyroglobulin in the diagnosis of thyroid tumors. Plasma thyroglobulin is elevated in a majority of patients with thyroid nodules and in 12% of patients with a history of irradiation but who otherwise appear completely normal. An initially elevated thyroglobulin level indicates a higher risk of forming thyroid nodules. While patients are being followed, it will be possible to determine whether changes in serum thyroglobulin also have clinical relevance in an irradiated population. In patients with thyroid cancer sequential thyroglobulin determinations will be obtained to assess how these measurements should be used clinically. Factors influencing the radioimmunoassay determination of thyroglobulin will be studied.