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非霍奇金淋巴瘤与电离辐射:病例报告及文献复习。

Non-Hodgkin lymphomas and ionizing radiation: case report and review of the literature.

机构信息

University of Bremen, Bibliotheksstraße 1, 28359, Bremen, Germany.

Society for Radiation Protection, Grenzstraße 20, 30627, Hannover, Germany.

出版信息

Ann Hematol. 2022 Feb;101(2):243-250. doi: 10.1007/s00277-021-04729-z. Epub 2021 Dec 8.

Abstract

Non-Hodgkin lymphoma (NHL) increased continuously since the last century in developed countries. While they are considered as disease in elder ages, a remarkable increasing incidence is also observed in German children and juveniles. The higher rates are interpreted by the changes in classification because diseases such as chronic lymphocytic leukaemia were also identified as NHL. Considerable rates of NHL were found in nuclear workers and liquidators of Chernobyl, i.e. in cases of low-dose chronical exposures. In Germany, we noticed three workers who developed NHL after decontamination of nuclear facilities. The bone marrow is generally considered as target organ for ionizing radiation, but NHL is obviously induced in the whole pool of lymphocytes. Therefore, the dosimetry in cases of typical occupational external and internal exposure must be revised. A high radiation sensitivity for NHL is a possible suspect and likely reason which may partly explain the continuous rise of the diseases in populations underlying the current increases of medical diagnostic exposure. NHL is also induced in children and juveniles with a history of diagnostic X-rays.

摘要

自上个世纪以来,发达国家的非霍奇金淋巴瘤(NHL)发病率持续上升。虽然 NHL 被认为是老年疾病,但德国儿童和青少年的发病率也显著上升。由于慢性淋巴细胞白血病等疾病也被归类为 NHL,因此分类的变化可以解释发病率的上升。在核工作者和切尔诺贝利的清理人员中也发现了相当比例的 NHL,即低剂量慢性暴露的情况下。在德国,我们注意到有三名工人在核设施去污后患上 NHL。骨髓通常被认为是电离辐射的靶器官,但 NHL 显然是在整个淋巴细胞池中诱导的。因此,必须对典型职业外部和内部暴露的剂量进行修正。NHL 的高辐射敏感性可能是一个可能的嫌疑人,也是疾病在当前医疗诊断辐射暴露增加的人群中持续上升的部分原因。有诊断性 X 射线照射史的儿童和青少年也会患上 NHL。

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