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甲状腺功能亢进症放射性碘治疗后癌症发病率增加。

Increased cancer incidence after radioiodine treatment for hyperthyroidism.

作者信息

Metso Saara, Auvinen Anssi, Huhtala Heini, Salmi Jorma, Oksala Heikki, Jaatinen Pia

机构信息

Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.

出版信息

Cancer. 2007 May 15;109(10):1972-9. doi: 10.1002/cncr.22635.

DOI:10.1002/cncr.22635
PMID:17393376
Abstract

BACKGROUND

Concerns remain about risk of cancer after radioactive iodine (RAI) treatment for hyperthyroidism, especially in organs that concentrate iodine. The objective was to assess the long-term cancer risk from RAI treatment for hyperthyroidism.

METHODS

A total of 2793 hyperthyroid patients treated with RAI at Tampere University Hospital between 1965 and 2002, and 2793 age- and sex-matched reference subjects were followed for an average of 10 years through the Finnish Cancer Registry.

RESULTS

Cancer incidence among hyperthyroid patients treated with RAI was higher than in the population-based control group (118.9 vs 94.9 per 10,000 person-years, rate ratio [RR], 1.25; 95% confidence interval [CI]: 1.08-1.46). Furthermore, incidence of stomach (RR, 1.75, 95% CI: 1.00-3.14), kidney (RR, 2.32; 95% CI: 1.06-5.09), and breast (RR, 1.53; 95% CI: 1.07-2.19) cancer was increased among RAI-treated patients. The relative risk of cancer increased with higher RAI dose administered. The increase in cancer incidence was statistically significant in patients treated at the age of 50-59 (RR, 1.44; 95% CI: 1.05-1.97) or older than 70 years (RR, 1.39; 95% CI: 1.05-1.82). There was a 5-year latent period after the RAI treatment before the cancer incidence began to differ between the RAI-treated hyperthyroid patients and the control group.

CONCLUSIONS

Cancer incidence, especially cancer of the stomach, kidney, and breast, was higher in patients treated with RAI for hyperthyroidism.

摘要

背景

对于放射性碘(RAI)治疗甲亢后癌症风险仍存在担忧,尤其是在摄取碘的器官中。目的是评估RAI治疗甲亢的长期癌症风险。

方法

1965年至2002年间在坦佩雷大学医院接受RAI治疗的2793例甲亢患者,以及2793例年龄和性别匹配的对照受试者通过芬兰癌症登记处平均随访10年。

结果

接受RAI治疗的甲亢患者的癌症发病率高于基于人群的对照组(每10000人年118.9例对94.9例,率比[RR]为1.25;95%置信区间[CI]:1.08 - 1.46)。此外,接受RAI治疗的患者中胃癌(RR为1.75,95%CI:1.00 - 3.14)、肾癌(RR为2.32;95%CI:1.06 - 5.09)和乳腺癌(RR为1.53;95%CI:1.07 - 2.19)的发病率增加。给予的RAI剂量越高,癌症的相对风险增加。在50 - 59岁(RR为1.44;95%CI:1.05 - 1.97)或70岁以上(RR为1.39;95%CI:1.05 - 1.82)接受治疗的患者中,癌症发病率的增加具有统计学意义。RAI治疗后有5年的潜伏期,之后接受RAI治疗的甲亢患者与对照组之间的癌症发病率开始出现差异。

结论

接受RAI治疗甲亢的患者癌症发病率较高,尤其是胃癌、肾癌和乳腺癌。

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