Iwanaga Masako, Tagawa Masuko, Tsukasaki Kunihiro, Matsuo Tatsuki, Yokota Ken-ichi, Miyazaki Yasushi, Fukushima Takuya, Hata Tomoko, Imaizumi Yoshitaka, Imanishi Daisuke, Taguchi Jun, Momita Sabro, Kamihira Shimeru, Tomonaga Masao
Department of Hematology and Molecular Medicine, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Blood. 2009 Feb 19;113(8):1639-50. doi: 10.1182/blood-2008-05-159665. Epub 2008 Oct 10.
Radiation exposure is a possible predisposing factor for monoclonal gammopathy of undetermined significance (MGUS), but the association has been uncertain. We investigated the relationship between radiation exposure and MGUS prevalence by using data from the M-protein screening for Nagasaki atomic bomb survivors between 1988 and 2004. Radiation exposure was assessed by exposure distance from the hypocenter and exposure radiation dose. We computed prevalence ratios (PRs) and the 95% confidence intervals (CIs) adjusting for exposure age and sex. A total of 1082 cases of MGUS were identified from 52 525 participants. MGUS prevalence was significantly higher in people exposed at distance within 1.5 km than beyond 3.0 km (PR, 1.4; 95% CI, 1.1-1.9) among those exposed at age 20 years or younger, but it was not found among those exposed at age 20 years or older. MGUS prevalence was also significantly higher in people exposed to more than 0.1 Gy than those exposed to less than 0.01 Gy (PR, 1.7; 95% CI, 1.0-2.8) among those exposed at age 20 years or younger. Thus, people exposed at younger age exhibited a significantly high risk of MGUS when exposed to a high radiation dose. There was no clear association between radiation exposure and the malignant progression of MGUS. Further detailed analysis is needed.
辐射暴露是意义未明的单克隆丙种球蛋白病（MGUS）的一个可能的诱发因素，但这种关联一直不明确。我们利用1988年至2004年期间长崎原子弹幸存者M蛋白筛查的数据，研究了辐射暴露与MGUS患病率之间的关系。通过与爆心的暴露距离和暴露辐射剂量来评估辐射暴露情况。我们计算了患病率比（PRs）和95%置信区间（CIs），并对暴露年龄和性别进行了校正。在52525名参与者中，共识别出1082例MGUS病例。在20岁及以下暴露人群中，距离爆心1.5公里以内暴露的人群MGUS患病率显著高于距离爆心3.0公里以外暴露的人群（PR，1.4；95%CI，1.1 - 1.9），但在20岁及以上暴露人群中未发现这种情况。在20岁及以下暴露人群中，暴露于超过0.1 Gy的人群MGUS患病率也显著高于暴露于低于0.01 Gy的人群（PR，1.7；95%CI，1.0 - 2.8）。因此，年轻时暴露于高辐射剂量的人群MGUS风险显著较高。辐射暴露与MGUS的恶性进展之间没有明确的关联。需要进一步进行详细分析。
