Cahoon Elizabeth K, Nadyrov Eldar A, Polyanskaya Olga N, Yauseyenka Vasilina V, Veyalkin Ilya V, Yeudachkova Tamara I, Maskvicheva Tamara I, Minenko Victor F, Liu Wayne, Drozdovitch Vladimir, Mabuchi Kiyohiko, Little Mark P, Zablotska Lydia B, McConnell Robert J, Hatch Maureen, Peters Kamau O, Rozhko Alexander V, Brenner Alina V
Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland 20892-9778.
The Republican Research Center for Radiation Medicine and Human Ecology, Gomel 246040, Belarus.
J Clin Endocrinol Metab. 2017 Jul 1;102(7):2207-2217. doi: 10.1210/jc.2016-3842.
Although radiation exposure is an important predictor of thyroid cancer on diagnosis of a thyroid nodule, the relationship between childhood radiation exposure and thyroid nodules has not been comprehensively evaluated.
To examine the association between internal I-131 thyroid dose and thyroid nodules in young adults exposed during childhood.
DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, we screened residents of Belarus aged ≤18 years at the time of the Chernobyl nuclear accident for thyroid disease (median age, 21 years) with thyroid palpation, ultrasonography, blood/urine analysis, and medical follow-up when appropriate. Eligible participants (N = 11,421) had intact thyroid glands and doses based on direct individual thyroid activity measurements.
Excess odds ratios per Gray (EOR/Gy, scaled at age 5 years at exposure) for any thyroid nodule and for nodules grouped by cytology/histology, diameter size, and singularity.
Risk of any thyroid nodule increased significantly with I-131 dose and, for a given dose, with younger age at exposure. The EOR/Gy (95% confidence intervals) for neoplastic nodules (3.82; 0.87 to 15.52) was significantly higher than for nonneoplastic nodules (0.32; <0.03 to 0.70) and did not vary by size; whereas the EOR/Gy for nonneoplastic nodules did vary by size (P = 0.02) and was 1.55 (0.36 to 5.46) for nodules ≥10 mm and 0.02 (<-0.02 to 0.70) for nodules <10 mm. EORs/Gy for single and multiple nodules were comparable.
Childhood exposure to internal I-131 is associated with increased risk of neoplastic thyroid nodules of any size and nonneoplastic nodules ≥10 mm.
虽然在甲状腺结节诊断时，辐射暴露是甲状腺癌的一个重要预测因素，但儿童期辐射暴露与甲状腺结节之间的关系尚未得到全面评估。
研究儿童期受辐射的年轻成年人中，体内碘-131甲状腺剂量与甲状腺结节之间的关联。
设计、地点和参与者：在这项横断面研究中，我们对切尔诺贝利核事故发生时年龄≤18岁的白俄罗斯居民进行了甲状腺疾病筛查（中位年龄21岁），采用甲状腺触诊、超声检查、血液/尿液分析，并在适当情况下进行医学随访。符合条件的参与者（N = 11421）甲状腺腺体完整，且剂量基于直接的个体甲状腺活性测量。
每格雷的超额比值比（EOR/Gy，按暴露时5岁的年龄进行标化），用于任何甲状腺结节以及按细胞学/组织学、直径大小和单发情况分组的结节。
任何甲状腺结节的风险均随碘-131剂量显著增加，且对于给定剂量，随暴露时年龄越小而增加。肿瘤性结节的EOR/Gy（95%置信区间）为（3.82；0.87至15.52），显著高于非肿瘤性结节（0.32；<0.03至0.70），且不随大小变化；而非肿瘤性结节的EOR/Gy随大小变化（P = 0.02），直径≥10 mm的结节为1.55（0.36至5.46），直径<10 mm的结节为0.02（<-0.02至0.70）。单发和多发结节的EOR/Gy相当。
儿童期暴露于体内碘-131与任何大小的肿瘤性甲状腺结节及直径≥10 mm的非肿瘤性甲状腺结节风险增加相关。
