Andreassi Maria Grazia, Ait-Ali Lamia, Botto Nicoletta, Manfredi Samantha, Mottola Gaetano, Picano Eugenio
CNR, Institute of Clinical Physiology, Pisa, Italy.
Eur Heart J. 2006 Nov;27(22):2703-8. doi: 10.1093/eurheartj/ehl014. Epub 2006 May 22.
Medical radiological exposure is associated with an additional risk of cancer. Children with repaired congenital heart disease (CHD) are theoretically at a relatively greater cancer risk as the radiological exposure can be intensive in these patients. Chromosomal aberrations test (CA) and micronucleus assay (MN) in peripheral blood lymphocytes are biomarkers of chromosomal damage and intermediate endpoints in carcinogenesis.
The frequency of CA and MN was assessed in three groups of patients: Group I, 32 exposed patients (17 males, age=15.5+/-8.3 years) who underwent cardiac procedures employing ionizing radiation (mostly cardiac catheterization) for CHD between 1965 and 2000; Group II, 32 healthy age- and sex-matched subjects (17 males, age=14.1+/-12.3 years), and Group III, 10 newborn non-exposed patients (7 males) with CHD. Exposed patients of Group I had a mean value of 2.9+/-1.4 cardiac catheterization (range 1-5) procedures per person. The mean frequency of CA was higher in the exposed patients (Group I=2.8+/-1.9% vs. Group II=0.7+/-0.7%; vs. Group III=0.8+/-0.8%; P<0.0001). Similarly, the mean values of MN were higher in the exposed patients (Group I =12.3+/-5.1 per thousand vs. Group II=6.0+/-3.8 per thousand; vs. Group III=4.4+/-1.4 per thousand; P<0.0001).
Cardiac ionizing procedures are associated with a long-lasting mark in the chromosomal damage of exposed children with CHD.
医学放射暴露与额外的癌症风险相关。患有先天性心脏病（CHD）且已接受修复手术的儿童理论上患癌风险相对更高，因为这些患者的放射暴露可能较为密集。外周血淋巴细胞中的染色体畸变试验（CA）和微核试验（MN）是染色体损伤的生物标志物以及致癌过程中的中间终点。
对三组患者的CA和MN频率进行了评估：第一组，32名暴露患者（17名男性，年龄=15.5±8.3岁），他们在1965年至2000年间因CHD接受了使用电离辐射的心脏手术（主要是心脏导管插入术）；第二组，32名年龄和性别匹配的健康受试者（17名男性，年龄=14.1±12.3岁）；第三组，10名未暴露的患有CHD的新生儿患者（7名男性）。第一组的暴露患者每人平均进行2.9±1.4次心脏导管插入术（范围为1 - 5次）。暴露患者的CA平均频率更高（第一组=2.8±1.9%，第二组=0.7±0.7%，第三组=0.8±0.8%；P<0.0001）。同样，暴露患者的MN平均值也更高（第一组 =12.3±5.1‰，第二组=6.0±3.8‰，第三组=4.4±1.4‰；P<0.0001）。
心脏电离手术与患有CHD的暴露儿童的染色体损伤中的长期印记相关。
