Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD 20892-9778, USA.
Republican Research Center for Radiation Medicine and Human Ecology, 290 Ilyicha Street, Gomel, 246040, Belarus.
Probl Radiac Med Radiobiol. 2021 Dec;26:188-198. doi: 10.33145/2304-8336-2021-26-188-198.
To describe the status and results of thyroid disease screening and assessment of reliability of radiationthyroid doses in the Belarusian in utero cohort of 2,965 individuals exposed to Chernobyl (Chornobyl) fallout.
Thyroid screening examinations are currently underway including thyroid palpation by anendocrinologist, ultrasonographic examination by an ultrasonographer and analysis of blood samples for diagnosisof hypo- and hyperthyroidism, autoimmune thyroiditis, thyroid function tests (thyroid-stimulating hormone [TSH],thyroxine [T4], thyroid peroxidase antibody [anti-TPO], and thyroglobulin antibodies [anti-TG]). Reliability of (i)information from 780 pairs of questionnaires obtained during the first and second interviews of the mothers and (ii)thyroid doses, which were calculated for the cohort members using this information, is evaluated.
As of 15 August 2021, 1,267 in utero exposed study subjects had been screened. A single thyroid nodule wasdiagnosed in 167 persons (13.2 % of the total) and multiple thyroid nodules in 101 persons (8.0 %): 189 (14.9 %)persons had nodules detected for the first time at the screening while 79 (6.2 %) persons had nodules detected pre-viously (pre-screening nodules). Fifty-nine out of 268 subjects (22.0 %) with a suspicious thyroid nodule werereferred to fine needle aspiration biopsy, and among them 33 (55.9 %) were biopsied. Reasonable agreement wasobserved for modelqbased doses calculated for the Belarusian in utero cohort members using data from the two inter-views (Spearman's rank-correlation coefficient rs = 0.74, p < 0.001), while measurementqbased doses yielded almost per-fect agreement (rs = 0.99, p < 0.001).
During the thyroid screening, at least one thyroid nodule was identified in 268 of 1,267 (21.2 %) inutero exposed cohort members. Seven thyroid cancer cases were identified in the cohort, including 5 pre-screeningcases and 2 cases detected during the screening. Ongoing research on this unique cohort will provide importantinformation on adverse health effects following prenatal and postnatal exposure to radioiodine and radiocesium iso-topes, for which available epidemiological data are scant.
描述白俄罗斯 2965 名切尔诺贝利(Chornobyl)落下物宫内暴露个体的甲状腺疾病筛查状况和可靠性评估结果。
目前正在进行甲状腺筛查检查,包括内分泌学家进行甲状腺触诊、超声医师进行超声检查以及分析血液样本以诊断甲状腺功能减退症、甲状腺功能亢进症、自身免疫性甲状腺炎、甲状腺功能检查(促甲状腺激素 [TSH]、甲状腺素 [T4]、甲状腺过氧化物酶抗体 [抗-TPO]和甲状腺球蛋白抗体 [抗-TG])。评估了(i)母亲在第一次和第二次访谈中获得的 780 对问卷中的信息的可靠性,以及(ii)使用该信息为队列成员计算的甲状腺剂量的可靠性。
截至 2021 年 8 月 15 日,已有 1267 名宫内暴露的研究对象接受了筛查。在 167 名患者(总人数的 13.2%)中诊断出单个甲状腺结节,在 101 名患者(8.0%)中诊断出多个甲状腺结节:189 名(14.9%)患者在筛查中首次发现结节,而 79 名(6.2%)患者在筛查前(筛查前结节)发现结节。268 名可疑甲状腺结节患者中有 59 名被转诊进行细针抽吸活检,其中 33 名(55.9%)接受了活检。使用来自两次访谈的数据计算白俄罗斯宫内队列成员的基于模型 q 的剂量时,观察到合理的一致性(Spearman 等级相关系数 rs = 0.74,p < 0.001),而基于测量 q 的剂量则几乎完全一致(rs = 0.99,p < 0.001)。
在甲状腺筛查中,1267 名宫内暴露队列成员中有 268 名(21.2%)至少发现一个甲状腺结节。该队列中发现了 7 例甲状腺癌病例,包括 5 例筛查前病例和 2 例筛查中发现的病例。对这一独特队列的持续研究将提供有关产前和产后暴露于放射性碘和放射性铯同位素后不良健康影响的重要信息,而这方面的流行病学数据很少。