Leenhardt L, Aurengo A
Service Central de Médecine Nucléaire, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Bd de l'Hôpital, Paris, 75013, France.
Baillieres Best Pract Res Clin Endocrinol Metab. 2000 Dec;14(4):667-77. doi: 10.1053/beem.2000.0109.
The dramatic increase in childhood thyroid carcinoma observed in Belarus and Ukraine as early as 4 years after the Chernobyl nuclear accident, is well recognized as being a consequence of exposure to radioactive iodine fallout. Uncertainties persist concerning the contamination and the dosimetric data. Thyroid nodule, cervical lymph nodes or systematic ultrasound thyroid screening in exposed children led to the diagnosis. The carcinomas affected younger subjects, were less influenced by gender, and were more aggressive at clinical and histological presentation than in the case with naturally occurring carcinoma. Total thyroidectomy and radioiodine treatment remain the treatment of choice. The prognosis is good but further studies are needed to evaluate the prognosis of children presenting with pulmonary metastasis. The project of the Newly Independent States Chernobyl Tissue Bank will facilitate molecular genetic research into this important public health issue. Nevertheless, clinicians must keep in mind the simplicity and the effectiveness of iodine prophylaxis.
早在切尔诺贝利核事故发生4年后，白俄罗斯和乌克兰儿童甲状腺癌就出现了显著增加，这被公认为是放射性碘沉降物暴露的结果。关于污染情况和剂量测定数据仍存在不确定性。对受辐射儿童进行甲状腺结节、颈部淋巴结或系统性甲状腺超声筛查可作出诊断。这些癌症影响的是较年轻的人群，受性别的影响较小，在临床和组织学表现上比自然发生的癌症更具侵袭性。全甲状腺切除术和放射性碘治疗仍然是首选治疗方法。预后良好，但需要进一步研究来评估出现肺转移的儿童的预后。新独立国家切尔诺贝利组织库项目将促进对这一重要公共卫生问题的分子遗传学研究。尽管如此，临床医生必须牢记碘预防措施的简易性和有效性。
