Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, 80138 Napoli NA, Italy.
Int J Environ Res Public Health. 2018 Aug 13;15(8):1735. doi: 10.3390/ijerph15081735.
Several epidemiological studies suggest an increased incidence of thyroid carcinoma (TC) in recent years, especially for the papillary histotype (PTC), suggesting that specific carcinogens might promote molecular abnormalities that are typical of PTC. The increased incidence is probably attributed to more intensive and sensitive diagnostic procedures, even if recent data suggest that various toxic elements could explain the phenomenon. Ionizing radiation exposure represents the most accepted risk factor for differentiated thyroid cancer that includes both the follicular and papillary histotypes. In this review, we examined the other environmental carcinogens that play a role in TC, such as eating habits, living in volcanic areas, and xenobiotic elements. Among eating habits, iodine intake represents one of the more discussed elements, because its deficiency is associated with follicular thyroid carcinomas (FTCs), while its progressive increment seems to be responsible for PTC. The gas, ash, and lava emissions of volcanoes are composed of various toxic compounds that pollute ground water, vegetables, and animals, contaminating humans via the food chain. Finally, the risk of developing PTC has also been associated with exposure of the population to xenobiotics in the environment or in the home. Their carcinogenic effects are probably caused by their accumulation, but additional studies are necessary to better understand the mechanisms of action.
几项流行病学研究表明,近年来甲状腺癌(TC)的发病率有所增加,尤其是乳头状组织学类型(PTC),这表明特定的致癌物质可能促进了 PTC 特有的分子异常。发病率的增加可能归因于更密集和敏感的诊断程序,尽管最近的数据表明,各种有毒元素可能解释这一现象。电离辐射暴露是包括滤泡性和乳头状组织学类型在内的分化型甲状腺癌的最被接受的危险因素。在这篇综述中,我们研究了其他在 TC 中起作用的环境致癌物,如饮食习惯、居住在火山地区和外源性元素。在饮食习惯中,碘的摄入是讨论最多的元素之一,因为其缺乏与滤泡性甲状腺癌(FTC)有关,而其逐渐增加似乎是 PTC 的原因。火山的气体、灰烬和熔岩排放物由各种有毒化合物组成,污染地下水、蔬菜和动物,通过食物链污染人类。最后,人群接触环境或家庭中的外源性物质也与 PTC 的发病风险有关。它们的致癌作用可能是由于它们的积累引起的,但需要进一步的研究来更好地理解其作用机制。