Huszno B, Szybiński Z, Przybylik-Mazurek E, Stachura J, Trofimiuk M, Buziak-Bereza M, Gołkowski F, Pantoflinski J
Department of Endocrinology, Jagiellonian University, Collegium Medicum, Krakow, Poland.
J Endocrinol Invest. 2003;26(2 Suppl):71-6.
The aim of the study was to evaluate the correlation between thyroid cancer histotype and incidence rate (IR) and iodine nutrition level in two endemic goiter areas: the districts of Krakow and Nowy Sacz. The suspension of iodine prophylaxis in Poland in 1980 resulted in increased goiter prevalence in schoolchildren and adults and elevated TSH levels in newborns in the early 1990s. Since 1992 a rise in thyroid cancer IR was observed. Thyroid cancer IR in the Krakow population was 2.22 in 1986; 3.62 in 1995 and 6.02 in 2001; in Nowy Sacz: 1.52; 2.59 and 3.88 respectively. In 1986 papillary/follicular cancer ratio in both areas was about 1.0--the value typical of iodine deficient areas. After restoring the obligatory iodine prophylaxis in 1997, a significant decrease in elevated TSH concentration in newborns and urinary iodine concentration increase in schoolchildren were observed. A relative rise in the incidence of papillary thyroid cancer and decrease in follicular cancer, resulting in rise in papillary/follicular thyroid cancer ratio up to 5.9 in 2001 was also observed. Since 1999 no further thyroid cancer IR increase was noted. In conclusion, a significant increase in differentiated thyroid cancer IR was observed in association with the iodine prophylaxis suspension. Changes in thyroid cancer histotypes in 1986-2001 and a significant decrease in incremental rate of differentiated thyroid cancer probably reflect the influence of effective iodine prophylaxis. The significant difference between IR of thyroid cancer incidence in the districts of Krakow and Nowy Sacz may be related to differences in the exposure to radiation after the Chernobyl accident.
本研究旨在评估两个地方性甲状腺肿地区（克拉科夫和新松奇区）甲状腺癌组织类型与发病率（IR）以及碘营养水平之间的相关性。1980年波兰停止碘预防措施，导致20世纪90年代初学龄儿童和成年人甲状腺肿患病率上升，新生儿促甲状腺激素（TSH）水平升高。自1992年以来，观察到甲状腺癌发病率上升。克拉科夫人群的甲状腺癌发病率在1986年为2.22；1995年为3.62，2001年为6.02；新松奇区分别为1.52、2.59和3.88。1986年，两个地区的乳头状/滤泡状癌比例约为1.0，这是碘缺乏地区的典型值。1997年恢复强制性碘预防措施后，观察到新生儿TSH浓度显著下降，学龄儿童尿碘浓度增加。还观察到乳头状甲状腺癌发病率相对上升，滤泡状癌发病率下降，导致乳头状/滤泡状甲状腺癌比例在2001年升至5.9。自1999年以来，未观察到甲状腺癌发病率进一步上升。总之，观察到分化型甲状腺癌发病率显著上升与碘预防措施暂停有关。1986 - 2001年甲状腺癌组织类型的变化以及分化型甲状腺癌增长率的显著下降可能反映了有效碘预防的影响。克拉科夫区和新松奇区甲状腺癌发病率的显著差异可能与切尔诺贝利事故后辐射暴露的差异有关。
