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 继续对接受儿童头部手术的患者进行纵向研究， 以及迈克尔·里斯医院的颈部放疗 的 在接受治疗的5，300名患者中，有2，000人在我们的 另有1,400人在其他地方接受了评估。 在这 甲状腺结节的患病率为36%， 在接受手术的人中，36%患有甲状腺癌。 以下是─ 将继续为这些人口中的50%提供以下服务：（1） 确定辐射诱发的甲状腺癌是否继续发生， 如果是，提供其发生率的估计，（2）由于患者在 这些人口正在老龄化，以确定他们的辐射引起的 甲状腺癌具有与年龄相关的恶化预后， 一般人群，和（3）评估治疗方法， 用了 这些将共同提供信息， 有辐射史的人的护理指南。 我们 将继续对其他辐射诱导的肿瘤进行平行研究， 包括唾液、神经和甲状旁腺来源的肿瘤。 将确定与治疗剂量相反的特定器官剂量， 获得更精确的剂量反应曲线和风险评估。 研究来 确定是否存在发展的易感因素 与辐射有关的肿瘤，特别是家族性肿瘤，将扩大。 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 一个患者亚组，其临床 评估，包括甲状腺扫描，是正常的，但谁有升高 血清甲状腺球蛋白水平已经确定。 以下继续- 这些患者和对照组的患者，我们将确定 作为风险因素的异常测定的显著性。 以下是- up也将提供一个比较扫描和超声波的机会 检查甲状腺。 造成不均匀性的因素 甲状腺球蛋白分子与甲状腺肿瘤有关， 研究了

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 approaches to treatment. This will be accomplished by continuing the longitudinal study of patients who received childhood head and neck irradiation for benign conditions at Michael Reese Hospital. Of the 5,300 patients who were so treated, 2,000 have been examined in our program and another 1,400 have been evaluated elsewhere. In this population there is a 36% cumulative prevalence of thyroid nodules and among those who have had surgery, 36% have had thyroid cancer. The follow- up of this population will continue with the following aims: (1) to determine if radiation-induced thyroid cancer is continuing to occur and, if so, to provide an estimate of its incidence, (2) since the patients in this population are growing older, to determine if their radiation-induced thyroid cancers have the same age-dependent worsening prognosis as seen in the general population, and (3) to evaluate the treatment methods that have been used. Together these will provide the information to develop guidelines for the care of persons with a history of radiation. Our parallel studies will continue on other radiation-induced tumors which have been found, including those of salivary, neural, and parathyroid origin. Specific organ doses, as opposed to treatment doses, will be determined to obtain more precise dose-response curves and risk assessments. Studies to determine whether there are susceptibility factors for developing radiation-related neoplasms, especially familial ones, will be extended. Laboratory studies will focus on the role of serum thyroglobulin in the diagnosis of thyroid tumors. A subgroup of patients whose clinical evaluations, including thyroid scans, were normal, bur who had elevated serum thyroglobulin levels has been identified. In continuing the follow- up of these patients and a control group of patients we will determine the significance of the abnormal determination as a risk factor. This follow- up will also provide an opportunity to compare scans with ultrasound examinations of the thyroid. Factors contributing to the heterogeneity of the thyroglobulin molecule, with relation to thyroid neoplasms, will be studied.