Iglesias Maria Laura, Schmidt Angelica, Ghuzlan Abir Al, Lacroix Ludovic, Vathaire Florent de, Chevillard Sylvie, Schlumberger Martin
Institut Gustave Roussy, Université Paris-Sud, Villejuif, France.
Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires. Buenos Aires, Argentina.
Arch Endocrinol Metab. 2017 Mar-Apr;61(2):180-187. doi: 10.1590/2359-3997000000257. Epub 2017 Feb 16.
The association between radiation exposure and the occurrence of thyroid cancer has been well documented, and the two main risk factors for the development of a thyroid cancer are the radiation dose delivered to the thyroid gland and the age at exposure. The risk increases after exposure to a mean dose of more than 0.05-0.1 Gy (50-100mGy). The risk is more important during childhood and decreases with increased age at exposure, being low in adults. After exposure, the minimum latency period before the appearance of thyroid cancers is 5 to 10 years. Papillary carcinoma (PTC) is the most frequent form of thyroid carcinoma diagnosed after radiation exposure, with a higher prevalence of the solid subtype in young children with a short latency period and of the classical subtype in cases with a longer latency period after exposure. Molecular alterations, including intra-chromosomal rearrangements, are frequently found. Among them, RET/PTC rearrangements are the most frequent. Current research is directed on the mechanism of genetic alterations induced by radiation and on a molecular signature that can identify the origin of thyroid carcinoma after a known or suspected exposure to radiation.
辐射暴露与甲状腺癌发生之间的关联已有充分记录，甲状腺癌发生的两个主要风险因素是甲状腺所接受的辐射剂量以及暴露时的年龄。暴露于平均剂量超过0.05 - 0.1 Gy（50 - 100 mGy）后，风险会增加。在儿童期风险更为显著，且随着暴露年龄的增加而降低，在成年人中风险较低。暴露后，甲状腺癌出现前的最短潜伏期为5至10年。乳头状癌（PTC）是辐射暴露后诊断出的最常见的甲状腺癌形式，在潜伏期短的幼儿中实体亚型患病率较高，而在暴露后潜伏期较长的病例中经典亚型患病率较高。经常发现包括染色体内重排在内的分子改变。其中，RET/PTC重排最为常见。当前的研究方向是辐射诱导的基因改变机制以及能够在已知或疑似辐射暴露后识别甲状腺癌起源的分子特征。
