Land C E, Saku T, Hayashi Y, Takahara O, Matsuura H, Tokuoka S, Tokunaga M, Mabuchi K
Radiation Epidemiology Branch, National Cancer Institute, Rockville, Maryland 20892, USA.
Radiat Res. 1996 Jul;146(1):28-36.
A wide-ranging search for benign and malignant tumors of the major and minor salivary glands among members of the Life Span Study sample of the Radiation Effects Research Foundation identified 41 malignant and 94 benign incident tumors, including 14 malignant and 12 benign tumors of the minor salivary gland, plus 10 major gland tumors of unknown behavior. Dose-response analyses found statistically significant increases in risk with increasing A-bomb dose for both cancer and benign tumors. Estimated relative risks at 1 Sv weighted tissue kerma (RR1Sv, with 90% confidence interval in parentheses) were 4.5 (2.5-8.5) for cancer and 1.7 (1.1-2.7) for benign tumors. When analyzed by histological subtype within these two broad groups, it appeared that most of the dose response for malignant tumors was provided by an exceptionally strong dose response for mucoepidermoid carcinoma [11 exposed cases with dose estimates, RR1Sv = 9.3 (3.5-30.6)], and most or all of that for benign tumors corresponded to Warthin's tumor [12 cases, RR1Sv = 4.1 (1.6-11.3)]. There was a marginal dose response for malignant tumors other than mucoepidermoid carcinoma [RR1Sv = 2.4 (0.99-5.7)] but no significant trend for benign tumors other than Warthin's tumor [RR1Sv = 1.3 (0.9-2.2)]. Re-examination of the original data from published studies of other irradiated populations may shed new light on the remarkable type specificity of the salivary tumor dose response observed in the present study.
辐射效应研究基金会寿命研究样本成员中对大、小唾液腺良恶性肿瘤进行的广泛搜索，发现了41例恶性和94例良性新发肿瘤，其中包括14例小唾液腺恶性肿瘤和12例良性肿瘤，外加10例行为不明的大唾液腺肿瘤。剂量反应分析发现，癌症和良性肿瘤的风险均随原子弹剂量增加而有统计学显著增加。在1 Sv加权组织比释动能时的估计相对风险（RR1Sv，括号内为90%置信区间），癌症为4.5（2.5 - 8.5），良性肿瘤为1.7（1.1 - 2.7）。在这两个大类中按组织学亚型分析时，似乎恶性肿瘤的大部分剂量反应是由黏液表皮样癌异常强烈的剂量反应提供的[11例暴露病例有剂量估计，RR1Sv = 9.3（3.5 - 30.6）]，而良性肿瘤的大部分或全部剂量反应对应于沃辛瘤[12例，RR1Sv = 4.1（1.6 - 11.3）]。黏液表皮样癌以外的恶性肿瘤有边缘剂量反应[RR1Sv = 2.4（0.99 - 5.7）]，但沃辛瘤以外的良性肿瘤无显著趋势[RR1Sv = 1.3（0.9 - 2.2）]。对其他受照人群已发表研究的原始数据进行重新审查，可能会为本研究中观察到的唾液腺肿瘤剂量反应显著的类型特异性提供新的线索。
