Gluzman Daniel, Imamura Nobutaka, Sklyarenko Lylia, Nadgornaya Valentina, Zavelevich Michael, Machilo Vasily
RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, National Academy of Sciences of Ukraine, Kyiv, Ukraine.
Hematol J. 2005;5(7):565-71. doi: 10.1038/sj.thj.6200568.
The question as to whether the incidence of leukemias and malignant lymphomas among the clean-up workers increased in 18 years after the catastrophe is still a point of much controversy. Precise diagnosis of the main forms of hematopoietic malignancies and comparison of these data with those in the general population will be helpful in estimating thr relative contribution of the radiation factor to the overall incidence of such pathologies.
In all, 187 consecutive cases of malignant diseases of hematopoietic and lymphoid tissues in Chernobyl clean-up workers were analyzed in Ukrainian Reference Laboratory in 1996-2003. A total of 1942 consecutive patients of general population, mainly the residents of Kyiv city and district, diagnosed in References Laboratory at the same period comprised the group of comparison. The morphology and cytochemistry of bone marrow and peripheral blood cells were studied. Immunocytochemical techniques (PAP, APAAP, ABC) and the panel of monoclonal antibodies to differentiation antigens of leukocytes were employed for immunophenotyping leukemic cells.
Various types of malignant disease of hematopoietic and lymphoid tissues were registered in Chernobyl clean-up workers under study including myelodysplastic syndromes (nine patients), acute lymphoblastic leukemia (eight) and acute myeloblastic leukemia (31), chromic myeloid leukemia (17), multiple myeloma (17) and other forms of chromic myeloproliferative and lymphoproliferative disease including B-cell chromic lymphocytic leukemia (49 patients).
The verified diagnosis of tumors of hematopoietic malignancies according to modern classification (EGIL, WHO) could be the prerequisite for further analytical epidemiology study of leukemias that may be related to the Chernobyl accident.
灾难发生18年后,清理工作人员中白血病和恶性淋巴瘤的发病率是否上升这一问题仍存在诸多争议。准确诊断造血系统恶性肿瘤的主要类型,并将这些数据与普通人群的数据进行比较,将有助于评估辐射因素对这类疾病总体发病率的相对影响。
1996年至2003年期间,乌克兰参考实验室对切尔诺贝利清理工作人员中187例连续的造血和淋巴组织恶性疾病病例进行了分析。同期在参考实验室诊断的总共1942例连续的普通人群患者,主要是基辅市及周边地区的居民,组成了对照组。对骨髓和外周血细胞的形态学和细胞化学进行了研究。采用免疫细胞化学技术(PAP、APAAP、ABC)和针对白细胞分化抗原的单克隆抗体组合对白血病细胞进行免疫表型分析。
在所研究的切尔诺贝利清理工作人员中登记了各种类型的造血和淋巴组织恶性疾病,包括骨髓增生异常综合征(9例患者)、急性淋巴细胞白血病(8例)和急性髓细胞白血病(31例)、慢性髓细胞白血病(17例)、多发性骨髓瘤(17例)以及其他形式的慢性骨髓增殖性和淋巴增殖性疾病,包括B细胞慢性淋巴细胞白血病(49例患者)。
根据现代分类(EGIL、WHO)对造血系统恶性肿瘤进行确诊,可能是进一步分析可能与切尔诺贝利事故相关的白血病流行病学研究的前提条件。