Teikyo University Graduate School of Public Health, Tokyo, Japan.
The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
Clin Lymphoma Myeloma Leuk. 2014 Feb;14(1):18-20. doi: 10.1016/j.clml.2013.12.010. Epub 2013 Dec 19.
Exposure to ionizing radiation is a known environmental risk factor for a variety of cancers including hematological malignancies, such as leukemia, myelodysplastic syndromes, and multiple myeloma. Therefore, for Hiroshima and Nagasaki atomic bomb survivors (surviving victims who were exposed to ionizing radiation emitted from the nuclear weapons), several cancer-screening tests have been provided annually, with government support, to detect the early stage of malignancies. An M-protein screening test has been used to detect multiple myeloma at an early stage among atomic bomb survivors. In the screening process, a number of patients with monoclonal gammopathy of undetermined significance (MGUS), in addition to multiple myeloma, have been identified. In 2009 and 2011, we reported the age- and sex-specific prevalence of MGUS between 1988 and 2004 and the possible role of radiation exposure in the development of MGUS using the screening data of more than 1000 patients with MGUS among approximately 52,000 Nagasaki atomic bomb survivors. The findings included: (1) a significant lower overall prevalence (2.1%) than that observed in Caucasian or African-origin populations; (2) a significantly higher prevalence in men than in women; (3) an age-related increase in the prevalence; (4) a significantly higher prevalence in people exposed to higher radiation doses only among those exposed at age 20 years or younger; and (5) a lower frequency of immunoglobulin M MGUS in Japanese patients than in patients in Western countries. The large study of MGUS among Nagasaki atomic bomb survivors has provided important findings for the etiology of MGUS, including a possible role of radiation exposure on the cause of MGUS and an ethnicity-related difference in the characteristics of MGUS.
接触电离辐射是包括血液系统恶性肿瘤（如白血病、骨髓增生异常综合征和多发性骨髓瘤）在内的多种癌症的已知环境风险因素。因此，对于广岛和长崎原子弹幸存者（暴露于核武器释放的电离辐射的幸存受害者），政府每年都提供一些癌症筛查测试，以检测恶性肿瘤的早期阶段。M 蛋白筛查测试已用于在原子弹幸存者中早期检测多发性骨髓瘤。在筛查过程中，除了多发性骨髓瘤外，还发现了许多具有意义未明的单克隆丙种球蛋白血症（MGUS）的患者。2009 年和 2011 年，我们根据 1988 年至 2004 年的筛查数据报告了年龄和性别特异性 MGUS 患病率，以及辐射暴露在 MGUS 发展中的可能作用，该数据来自大约 52000 名长崎原子弹幸存者中的 1000 多名 MGUS 患者。研究结果包括：（1）总体患病率（2.1%）明显低于白种人或非洲裔人群；（2）男性患病率明显高于女性；（3）患病率随年龄增长而增加；（4）仅在 20 岁或以下暴露于更高辐射剂量的人群中，暴露人群的患病率显著更高；（5）日本患者的免疫球蛋白 M MGUS 频率低于西方国家患者。这项对长崎原子弹幸存者中 MGUS 的大型研究为 MGUS 的病因学提供了重要发现，包括辐射暴露对 MGUS 病因的可能作用以及 MGUS 特征的种族相关差异。
