慢性淋巴细胞性甲状腺炎：它是否可能受到石化综合体的影响？来自西西里东南部细胞学研究的数据。
Chronic lymphocytic thyroiditis: could it be influenced by a petrochemical complex? Data from a cytological study in South-Eastern Sicily.
机构信息
A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina
A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina.
出版信息
Eur J Endocrinol. 2015 Apr;172(4):383-9. doi: 10.1530/EJE-14-0864. Epub 2015 Jan 19.
INTRODUCTION
In genetically predisposed individuals, exogenous factors (including pollution) influence the development of Hashimoto's thyroiditis/chronic lymphocytic thyroiditis (CLT). CLT may also be a risk factor for associated thyroid cancer. Few data are available on the role of pollution from petrochemical complexes, one of which is located in the Siracusa province (South-Eastern Sicily), in the pathogenesis of CLT.
AIMS
i) To study the frequency of CLT in fine-needle aspiration cytology (FNAC)-interrogated thyroid nodules from patients who were stably resident in their zones, comparing it in patients living in the petrochemical complex area (zone A) with that of patients from a control area (zone B). ii) To study the frequency of CLT in the FNAC categories of malignancy risk, comparing the two zones.
PATIENTS AND METHODS
We retrospectively evaluated cytologically adequate slides of 1323 nodules in 1013 outpatients who underwent ultrasound-guided FNAC from 2006 to 2012. We stratified by area of residence, gender, and FNAC categories of malignancy risk.
RESULTS
CLT was detected with significantly greater frequency in either patients or nodules from zone A compared with zone B (32.0% vs 23.1%, P=0.002 or 28.2% vs 18.8%, P=0.0001), with a female preponderance (F=35.2% vs M=21.1% or 30.4% vs 20.4%, zone A and F=26.5% vs 12.3% or 21.6% vs 9.5%, zone B). Regardless of zone, CLT was approximately twofold more frequent in the suspiciously malignant+malignant classes (TH4+THY5=47.6%, zone A and 32.4%, zone B) compared with the benign+intermediate classes (THY2+THY3=27.3%, zone A and 18.2%, zone B), but with a clear stepwise THY2 through THY5 increase only in zone A (THY2=25.3%, THY5=66.7%; THY2=18.6%, THY5=28.6% in zone B).
CONCLUSIONS
The petrochemical complex-related pollution is an environmental factor involved in the development of CLT and, likely, in the CLT association with thyroid neoplasms.
简介
在遗传易感性个体中，外源性因素（包括污染）会影响桥本甲状腺炎/慢性淋巴细胞性甲状腺炎（CLT）的发展。CLT 也可能是相关甲状腺癌的一个危险因素。关于石化综合体污染在 CLT 发病机制中的作用，目前仅有少量数据。其中一个石化综合体位于西西里岛东南部的锡拉库萨省。
目的
i）研究稳定居住在各自区域的甲状腺结节细针穿刺细胞学（FNAC）检查患者中 CLT 的频率，并将石化综合体区域（A 区）的患者与对照区域（B 区）的患者进行比较。ii）研究 FNAC 恶性风险分类中 CLT 的频率，并比较两个区域。
患者和方法
我们回顾性评估了 2006 年至 2012 年间 1013 名接受超声引导 FNAC 的门诊患者的 1323 个结节的细胞学充分的切片。我们按居住区域、性别和 FNAC 恶性风险分类进行分层。
结果
与 B 区相比，A 区患者或结节中 CLT 的检出率明显更高（32.0%比 23.1%，P=0.002 或 28.2%比 18.8%，P=0.0001），且女性居多（A 区 F=35.2%比 M=21.1%或 30.4%比 20.4%，B 区 F=26.5%比 12.3%或 21.6%比 9.5%）。无论区域如何，可疑恶性+恶性（TH4+THY5=47.6%，A 区和 32.4%，B 区）与良性+中间（THY2+THY3=27.3%，A 区和 18.2%，B 区）相比，CLT 的发生率均约为两倍，但仅在 A 区存在明显的 THY2 至 THY5 逐渐增加（THY2=25.3%，THY5=66.7%；THY2=18.6%，THY5=28.6%，B 区）。
结论
石化综合体相关污染是 CLT 发展的一个环境因素，可能也是 CLT 与甲状腺肿瘤相关的一个因素。
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