Analysis of Thyroid Malignant Pathologic Findings Identified During 3 Rounds of Screening (1997-2008) of a Cohort of Children and Adolescents from Belarus Exposed to Radioiodines After the Chernobyl Accident

作者：Zablotska Lydia B^*; Nadyrov Eldar A; Rozhko Alexander V; Gong Zhihong; Polyanskaya Olga N; McConnell Robert J; O'Kane Patrick; Brenner Alina V; Little Mark P; Ostroumova Evgenia; Bouville Andre; Drozdovitch Vladimir; Minenko Viktor; Demidchik Yuri; Nerovnya Alexander; Yauseyenka Vassilina; Savasteeva Irina; Nikonovich Sergey; Mabuchi Kiyohiko; Hatch Maureen

来源：Cancer, 2015, 121(3): 457-466.

DOI：10.1002/cncr.29073

• thyroid cancer
• pathology
• morphology
• thyroid neoplasms
• Chernobyl nuclear accident
• papillary carcinoma
• radiation
• latency

BACKGROUND: Recent studies of children and adolescents who were exposed to radioactive iodine-131 (I-131) after the 1986 Chernobyl nuclear accident in Ukraine exhibited a significant dose-related increase in the risk of thyroid cancer, but the association of radiation doses with tumor histologic and morphologic features is not clear. METHODS: A cohort of 11,664 individuals in Belarus who were aged <= 18 years at the time of the accident underwent 3 cycles of thyroid screening during 1997 to 2008. I-131 thyroid doses were estimated from individual thyroid activity measurements taken within 2 months after the accident and from dosimetric questionnaire data. Demographic, clinical, and tumor pathologic characteristics of the patients with thyroid cancer were analyzed using 1-way analysis of variance, chi-square tests or Fisher exact tests, and logistic regression. RESULTS: In total, 158 thyroid cancers were identified as a result of screening. The majority of patients had T1a and T1b tumors (93.7%), with many positive regional lymph nodes (N1; 60.6%) but few distant metastases (M1; <1%). Higher I-131 doses were associated with higher frequency of solid and diffuse sclerosing variants of thyroid cancer (P<.01) and histologic features of cancer aggressiveness, such as lymphatic vessel invasion, intrathyroidal infiltration, and multifocality (all P<.03). Latency was not correlated with radiation dose. Fifty-two patients with self-reported thyroid cancers which were diagnosed before 1997 were younger at the time of the accident and had a higher percentage of solid variant cancers compared with patients who had screening-detected thyroid cancers (all P<.0001). CONCLUSIONS: I-131 thyroid radiation doses were associated with a significantly greater frequency of solid and diffuse sclerosing variants of thyroid cancer and various features of tumor aggressiveness.

• 出版日期2015-2-1