Struttura Complessa Chirurgia Oncologica della Tiroide, ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G.PASCALE, NAPOLI, Italy.
Endocrinology, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95122, Catania, Italy.
Crit Rev Oncol Hematol. 2020 Jun;150:102950. doi: 10.1016/j.critrevonc.2020.102950. Epub 2020 Apr 10.
Incidence and mortality of thyroid cancer are increasing, thus making mandatory to improve the knowledge of disease etiology. The hypothesis of a role for anthropogenic chemicals is raising wide consideration. A series of occupational studies revealed that job exposures with high risk of chemical contamination were usually more prone to thyroid cancer development. These include shoe manufacture, preserving industry, building activities, pulp/papermaker industry and the wood processing, agricultural activities, and other work categories characterized by contact with chemicals, such as chemists and pharmacists. However, such epidemiological analyses cannot define a causal relationship. Thyroid-disrupting activity has emerged for a broad set of anthropogenic chemicals, with the best evidence being gained for polychlorinated biphenyls, polybrominated diphenyl ethers, dioxins, bisphenols, phthalates, pesticides, and heavy metals. A series of case-control studies, assessing exposure to thyroid-disrupting agents, as measured on biological matrices, have been recently performed providing the following insights: a) positive relationship with thyroid cancer was found for phthalates, bisphenols, the heavy metals cadmium, copper, and lead; b) polybrominated diphenyl ethers exposure showed no relationship with thyroid cancer c) controversial results were reported for polychlorinated biphenyls and pesticides. However, such studies cannot demonstrate the causal link with disease occurrence, as exposure is assessed after tumour development. Studies with different methodological approach are therefore required for defining the role of anthropogenic environmental chemicals in thyroid carcinogenesis.
甲状腺癌的发病率和死亡率正在上升,因此必须提高对疾病病因的认识。人为化学物质起作用的假设引起了广泛的关注。一系列职业研究表明,工作中接触高风险化学污染物通常更容易导致甲状腺癌的发生。这些职业包括制鞋、食品保存、建筑活动、纸浆/造纸业以及木材加工、农业活动以及其他接触化学品的工作类别,如化学家和药剂师。然而,此类流行病学分析无法确定因果关系。一系列人为化学物质具有甲状腺干扰活性,其中多氯联苯、多溴联苯醚、二恶英、双酚、邻苯二甲酸盐、农药和重金属的证据最为充分。最近进行了一系列病例对照研究,评估了生物基质中测量的甲状腺干扰剂暴露情况,得出以下结论:a)邻苯二甲酸盐、双酚、重金属镉、铜和铅与甲状腺癌呈正相关;b)多溴联苯醚暴露与甲状腺癌无关联;c)多氯联苯和农药的结果存在争议。然而,这些研究不能证明与疾病发生的因果关系,因为暴露是在肿瘤发生后进行评估的。因此,需要采用不同方法学方法的研究来确定人为环境化学物质在甲状腺癌发生中的作用。