Bogdanova T, Zurnadzhy L, Masiuk S, Burko S, Degtyaryova T, Kovalenko A, Bolgov M, Chernyshov S, Gulevatyi S, Thomas G, Tronko M
Laboratory of Morphology of Endocrine System, State Institution "V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv 04114, Ukraine.
Department of Dosimetry, State Institution "National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine", Kyiv 02000, Ukraine.
Exp Oncol. 2019 Sep;41(3):235-241. doi: 10.32471/exp-oncology.2312-8852.vol-41-no-3.13554.
To compare the frequency of main histopathological characteristics, 131І thyroid radiation doses, invasive properties and post-operative follow-up of patients of different age groups with potentially radiogenic papillary thyroid carcinoma (PTC) with the presence and absence of oncocytic changes in tumor cells.
PTC removed in 483 patients from high risk age-group for radiogenic thyroid cancer development (children and adolescents at the time of Chornobyl accident who lived in the northern regions of Ukraine: Kyiv, Zhytomyr, and Chernihiv regions) have been studied microscopically.
The frequency of PTC with the presence of oncocytic changes (OCh) in tumor cells increased significantly with increasing of patients' age at the time of surgery: from 8.3% in children 4-14 years old to 54.3% in adults 39-48 years old (ptrend < 0.0001). The presence of such changes is associated with papillary and solid-trabecular dominant tumor growth pattern in more than 90% of cases in each age group. The mean 131І thyroid dose in the whole series of PTC patients with OCh was significantly lower compared to the same index in PTC patients without OCh (493.7 mGy and 765.8 mGy, respectively, p < 0.0001). In addition, regional metastases recurrences were revealed more frequently in patients with OCh in primary PTC compared with patients without OCh in primary tumor (7.2% vs 1.5%, p = 0.0022).
Significantly increasing age-trend of OCh in PTC of patients affected by the Chornobyl fallout and operated at age from 4 to 48 years, as well as opposite decreasing linear age-trend of 131І thyroid dose may reflect a gradual increase of sporadic PTCs frequency in the potentially radiogenic series with time elapsed since accident. The frequency of oncocytic insensitive to radioiodine therapy of lymph node metastases recurrences also increased with patients age and OCh availability in primary PTC.
比较不同年龄组潜在放射性甲状腺乳头状癌（PTC）患者肿瘤细胞有无嗜酸性变时的主要组织病理学特征频率、¹³¹碘甲状腺辐射剂量、侵袭特性及术后随访情况。
对483例来自放射性甲状腺癌高发年龄组（切尔诺贝利事故发生时居住在乌克兰北部地区：基辅、日托米尔和切尔尼戈夫地区的儿童和青少年）的PTC患者进行显微镜检查。
肿瘤细胞存在嗜酸性变（OCh）的PTC频率随手术时患者年龄增加而显著升高：从4至14岁儿童的8.3%增至39至48岁成年人的54.3%（p趋势<0.0001）。在各年龄组中，超过90%的病例中这种变化与乳头状和实体小梁为主的肿瘤生长模式相关。与无OCh的PTC患者相比，整个系列有OCh的PTC患者的平均¹³¹碘甲状腺剂量显著更低（分别为493.7 mGy和765.8 mGy，p<0.0001）。此外，与原发性肿瘤无OCh的患者相比，原发性PTC有OCh的患者区域转移复发更常见（7.2%对1.5%，p = 0.0022）。
受切尔诺贝利辐射影响且手术年龄在4至48岁的患者，PTC中OCh随年龄显著增加的趋势，以及¹³¹碘甲状腺剂量相反的线性下降趋势，可能反映了自事故发生后，潜在放射性系列中散发性PTC频率随时间逐渐增加。对碘放射性治疗不敏感的淋巴结转移复发频率也随患者年龄及原发性PTC中OCh的存在而增加。
