Neriishi K, Yoshimoto Y, Carter R L, Matsuo T, Ichimaru M, Mikami M, Abe T, Fujimura K, Kuramoto A
Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan.
Radiat Res. 1993 Mar;133(3):351-9.
An analysis of monoclonal gammopathy in relation to radiation exposure was conducted on atomic bomb survivors examined between October 1979 and September 1981 and between June 1985 and May 1987. There was no overall increase in the relative risk of monoclonal gammopathy and only a suggestive increase in benign monoclonal gammopathy in the second survey which did not achieve statistical significance (P = 0.17). Thirty-one cases were detected among 8796 individuals studied in the first survey, whereas 68 cases were found among 7350 people in the second survey. Among the 31 cases found in the first survey, 9 individuals (29%) died before the second survey: 4 of cancer, 4 of vascular disease, and 1 of infection. Among the 8 individuals with benign monoclonal gammopathy examined in both surveys, 4 developed suppression of residual immunoglobulin(s), suggesting the progression of monoclonal gammopathy. The overall relative risks of monoclonal gammopathy in atomic bomb survivors in the two surveys were not significantly increased with increasing radiation dose. Only benign monoclonal gammopathy in 1985-1987 showed a suggestive increase with radiation exposure. The relative risk of benign monoclonal gammopathy in 1985-1987 was 2.64 in the group exposed to 0.01-0.49 Gy and 2.14 in the > or = 0.50-Gy group (95% confidence intervals = 0.90-8.82 and 0.69-7.31, respectively).
对1979年10月至1981年9月以及1985年6月至1987年5月期间接受检查的原子弹爆炸幸存者进行了与辐射暴露相关的单克隆丙种球蛋白病分析。单克隆丙种球蛋白病的相对风险总体上没有增加,在第二次调查中,良性单克隆丙种球蛋白病仅呈现出有提示性的增加,但未达到统计学显著性(P = 0.17)。在第一次调查的8796名研究对象中检测到31例病例,而在第二次调查的7350人中发现了68例病例。在第一次调查中发现的31例病例中,9人(29%)在第二次调查前死亡:4人死于癌症,4人死于血管疾病,1人死于感染。在两次调查中均接受检查的8例良性单克隆丙种球蛋白病患者中,4人出现残余免疫球蛋白抑制,提示单克隆丙种球蛋白病进展。两次调查中原子弹爆炸幸存者单克隆丙种球蛋白病的总体相对风险并未随辐射剂量增加而显著升高。仅1985 - 1987年的良性单克隆丙种球蛋白病随辐射暴露呈现出有提示性的增加。1985 - 1987年,暴露于0.01 - 0.49 Gy组的良性单克隆丙种球蛋白病相对风险为2.64,暴露于≥0.50 Gy组的相对风险为2.14(95%置信区间分别为0.90 - 8.82和0.69 - 7.31)。