Shirahige Y, Ito M, Ashizawa K, Motomura T, Yokoyama N, Namba H, Fukata S, Yokozawa T, Ishikawa N, Mimura T, Yamashita S, Sekine I, Kuma K, Ito K, Nagataki S
First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Endocr J. 1998 Apr;45(2):203-9. doi: 10.1507/endocrj.45.203.
The high incidence of childhood thyroid cancer in Belarus is suspected to be due to radiation exposure after the Chernobyl reactor accident. To clarify the clinical and histological characteristics of childhood thyroid cancer in Belarus, we therefore compared these patients to a radiation non-exposed control series in Japan. In Belarus, 26 thyroid cancers in subjects aged 15 or younger were diagnosed among 25,000 screened between 1991 and 1995 by Chernobyl-Sasakawa Health and Medical Cooperation Project. The clinical and morphologic features of these 26 cases were compared to 37 childhood thyroid cancers in Japan diagnosed between 1962 and 1995. The age distribution at operation in Belarus showed a peak at 10 years old, with a subsequent fall in numbers. In contrast, the age distribution at operation in Japan showed a smooth increase between the ages of 8 and 14. The mean tumor diameter was smaller in Belarus than that in Japan (1.4 +/- 0.7 vs. 4.1 +/- 1.7 cm, P < 0.001). The sex ratio, regional lymph node metastasis, extension to surrounding tissues or lung metastasis did not differ significantly. Histologically, all cases in Belarus were papillary and in Japan 33 cases were papillary and 4 cases were follicular carcinomas. Among papillary carcinomas, the frequency of a solid growth pattern, a criteria for classifying a tumor as poorly differentiated, was higher in Belarus than that in Japan (61.5 vs. 18.2%, P < 0.001). The difference between the features of childhood thyroid cancer in Japan and Belarus may be due to the difference in the process of carcinogenesis, but more direct evidence and further analysis by molecular epidemiology are needed in Belarussian cases.
白俄罗斯儿童甲状腺癌的高发病率被怀疑是切尔诺贝利反应堆事故后辐射暴露所致。为了阐明白俄罗斯儿童甲状腺癌的临床和组织学特征，我们将这些患者与日本未受辐射的对照系列进行了比较。在白俄罗斯，1991年至1995年期间，切尔诺贝利 - 笹川健康与医疗合作项目在25000名接受筛查的对象中诊断出26例15岁及以下的甲状腺癌。将这26例病例的临床和形态学特征与1962年至1995年期间在日本诊断出的37例儿童甲状腺癌进行了比较。白俄罗斯手术时的年龄分布在10岁时出现峰值，随后数量下降。相比之下，日本手术时的年龄分布在8岁至14岁之间呈平稳上升趋势。白俄罗斯的平均肿瘤直径小于日本（1.4±0.7 vs. 4.1±1.7 cm，P < 0.001）。性别比例、区域淋巴结转移、向周围组织的扩展或肺转移没有显著差异。组织学上，白俄罗斯的所有病例均为乳头状癌，日本有33例为乳头状癌，4例为滤泡状癌。在乳头状癌中，实体生长模式（一种将肿瘤分类为低分化的标准）的频率在白俄罗斯高于日本（61.
