Tronko M, Bogdanova T, Voskoboynyk L, Zurnadzhy L, Shpak V, Gulak L
Institute of Endocrinology and Metabolism of Academy of Medical Sciences of Ukraine, Vyshgorodskaya str 69, Kyiv 04114, Ukraine.
Exp Oncol. 2010 Sep;32(3):200-4.
To describe the epidemiology and pathology of thyroid cancer in Ukraine, and to perform the molecular analysis of genetic alterations more frequently found to be associated to papillary carcinomas (PTC) in a selected group of PTC.
Relationship between the thyroid cancer incidence and gender, age, and place of residence of subjects aged 0-18 years at the time of the Chernobyl accident (5427 subjects of thyroid cancer, among which 3996 (73.6%) were children aged 0 to 14 years at the time of the accident, and 1431 (26.3%) were adolescents aged 15 to 18 years was studied. Pathologically analyzed thyroid carcinomas were obtained from 640 patients (20-40 years old at the time of surgery and born before the Chernobyl accident), and from 90 patients (11-22 years old at the time of surgery and born after the accident). All patients were operated during 2006-2008. RET/PTC rearrangements and BRAF(V600E) mutation were analyzed in 35 cases of PTC.
A comparison between the thyroid cancer incidence rates in the 6 highest contaminated regions of Ukraine and in the other 21 regions shows the most significant difference between the rates for the last three years of follow-up, which confirms that a direct relationship is still present between the rise in thyroid cancer incidence and the post Chernobyl radiation exposure. Much lower incidence of thyroid cancer in subjects, who were born after the accident, additionally confirmed a direct relationship between the Chernobyl accident and thyroid cancer development at least in those who were aged up to 18 years at the time of the nuclear accident. Pathological results showed that with increasing latency the decrease has been noted in the percentage of PTC with solid structure, a decrease in invasive properties of tumors, as well as an increase in the percentage of PTC with papillary-follicular structure, encapsulated forms, and <> carcinomas measuring up to 1 cm. Molecular-biological studies of PTC revealed more common RET/PTC1 and RET/PTC3 rearrangements (34.3% of cases), than BRAFV600E mutation (24%cases).
After 22 years from the Chernobyl nuclear accident the number and incidence of thyroid cancer cases in Ukraine was steadily increased in the cohort of those who were children and adolescents at the time of the accident. Most common thyroid tumors (PTC) were characterized by significant changes in histological structure with increasing latency. PTC with any RET/PTC rearrangements had more aggressive behavior than BRAF(V600E)-positive tumors or PTC without gene alterations.
描述乌克兰甲状腺癌的流行病学和病理学特征，并对一组选定的甲状腺乳头状癌（PTC）中更常见的与PTC相关的基因改变进行分子分析。
研究了切尔诺贝利事故发生时年龄在0至18岁的受试者中甲状腺癌发病率与性别、年龄和居住地之间的关系（5427例甲状腺癌患者，其中3996例（73.6%）在事故发生时为0至14岁的儿童，1431例（26.3%）为15至18岁的青少年）。对640例患者（手术时年龄在20至40岁且出生在切尔诺贝利事故之前）和90例患者（手术时年龄在11至22岁且出生在事故之后）的甲状腺癌进行了病理分析。所有患者均在2006年至2008年期间接受手术。对35例PTC病例分析了RET/PTC重排和BRAF（V600E）突变。
乌克兰6个污染最严重地区与其他21个地区的甲状腺癌发病率比较显示，随访的最后三年发病率差异最为显著，这证实甲状腺癌发病率的上升与切尔诺贝利事故后的辐射暴露之间仍存在直接关系。事故后出生的受试者甲状腺癌发病率低得多，这进一步证实了切尔诺贝利事故与甲状腺癌发生之间至少在核事故发生时年龄在18岁以下的人群中存在直接关系。病理结果显示，随着潜伏期的增加，实体结构的PTC百分比下降，肿瘤的侵袭性降低，乳头状-滤泡结构、包膜型以及直径达1cm的“小”癌的PTC百分比增加。PTC的分子生物学研究显示，RET/PTC1和RET/PTC3重排比BRAFV600E突变更常见（分别为34.3%和24%）。
切尔诺贝利核事故22年后，乌克兰事故发生时为儿童和青少年的人群中甲状腺癌病例数和发病率稳步上升。大多数常见的甲状腺肿瘤（PTC）随着潜伏期的增加在组织结构上有显著变化。任何RET/PTC重排的PTC比BRAF（V600E）阳性肿瘤或无基因改变的PTC具有更具侵袭性的行为。
