Antonelli A, Miccoli P, Derzhitski V E, Panasiuk G, Solovieva N, Baschieri L
Institute of Clinical Medicine II, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
World J Surg. 1996 Sep;20(7):867-71. doi: 10.1007/s002689900132.
This study reviews the epidemiology of thyroid cancer during childhood from the environs of Gomel in Belarus and the clinical data of 64 children aged 4 to 16 years from this area who had been diagnosed with differentiated thyroid carcinoma following the nuclear accident of Chernobyl. One case of thyroid cancer in children (aged < 15 years at diagnosis) was observed during the period 1981-1985 (rate = 0.5; expressed as annual averages per million children under age 15 years in the region of Gomel and period identified) before the Chernobyl accident. Twenty-one cases of thyroid cancer in children were observed during 1986-1990 (rate = 10.5) and 143 (rate 97) during 1991-1994 after the Chernobyl accident. During the first 7 months of 1995, there were 33 more cases of thyroid cancer observed in children. Three children with thyroid cancer were born since 1986 in the Gomel region. A total of 64 children aged 4 to 16 years from this area who had been diagnosed with differentiated thyroid carcinoma had been reviewed by us during the period May to November 1994. The female/male ratio was 1.4:1.0. At the time of the first diagnosis the mean age of the children was 9.4 +/- 2.8 years, and at the time of the accident their mean age was 3.8 +/- 2.4 years. More than 90% of the patients were less than 6 years of age and 3 were still in utero at the time of the accident. The period of latency between the accident and the first diagnosis was 5.6 +/- 1.5 years. Their ages at the time of the first diagnosis and their ages at the time of the accident were significantly correlated (p = 0.001); there was no significant correlation between the age of each child at the time of the accident and the latent period before the onset of carcinoma. The aggressiveness of the tumor, evaluated on the basis of T stage, lymph node status, and lung metastases, did not correlate with age at the time of the first diagnosis or with the age at the time of the accident. The susceptibility of the thyroid to the carcinogenetic effects of radiation, particularly during the first years of life (< 5 years) has clearly been demonstrated. However, there appears to be no correlation between the aggressiveness of the tumor and the age of the patients.
本研究回顾了白俄罗斯戈梅利周边地区儿童甲状腺癌的流行病学情况，以及该地区64名年龄在4至16岁之间、在切尔诺贝利核事故后被诊断为分化型甲状腺癌的儿童的临床数据。在切尔诺贝利事故之前的1981 - 1985年期间，观察到1例儿童甲状腺癌（诊断时年龄<15岁）（发病率 = 0.5；以戈梅利地区每百万15岁以下儿童每年的平均发病率表示）。在切尔诺贝利事故后的1986 - 1990年期间，观察到21例儿童甲状腺癌（发病率 = 10.5），1991 - 1994年期间观察到143例（发病率97）。在1995年的前7个月，又观察到33例儿童甲状腺癌病例。自1986年以来，戈梅利地区有3名患甲状腺癌的儿童出生。1994年5月至11月期间，我们对该地区64名年龄在4至16岁之间、被诊断为分化型甲状腺癌的儿童进行了回顾。男女比例为1.4:1.0。首次诊断时儿童的平均年龄为9.4±2.8岁，事故发生时他们的平均年龄为3.8±2.4岁。超过90%的患者年龄小于6岁，3名患者在事故发生时还在子宫内。事故与首次诊断之间的潜伏期为5.6±1.5年。他们首次诊断时的年龄与事故发生时的年龄显著相关（p = 0.001）；每个儿童事故发生时的年龄与癌症发病前的潜伏期之间没有显著相关性。根据T分期、淋巴结状况和肺转移情况评估的肿瘤侵袭性，与首次诊断时的年龄或事故发生时的年龄均无相关性。甲状腺对辐射致癌作用的易感性，特别是在生命的最初几年（<5岁）已得到明确证实。然而，肿瘤的侵袭性与患者年龄之间似乎没有相关性。
