Astakhova L N, Anspaugh L R, Beebe G W, Bouville A, Drozdovitch V V, Garber V, Gavrilin Y I, Khrouch V T, Kuvshinnikov A V, Kuzmenkov Y N, Minenko V P, Moschik K V, Nalivko A S, Robbins J, Shemiakina E V, Shinkarev S, Tochitskaya S I, Waclawiw M A
Research Institute of Radiation Medicine, Ministry of Health, Minsk, Belarus.
Radiat Res. 1998 Sep;150(3):349-56.
The accident at the Chernobyl nuclear power plant on April 26, 1986, released approximately 2 EBq of 131I and other radioiodine isotopes that heavily contaminated southern Belarus. An increase in thyroid cancer reported in 1992 and attributed to the Chernobyl accident was challenged as possibly the result of intensive screening. We began a case-control study to test the hypothesis that the Chernobyl accident caused the increase in thyroid cancer. Records of childhood thyroid cancer in the national therapy centers in Minsk in 1992 yielded 107 individuals with confirmed pathology diagnoses and available for interview. Pathways to diagnosis were (1) routine endocrinological screening in 63, (2) presentation with enlarged or nodular thyroid in 25 and (3) an incidental finding in 19. Two sets of controls were chosen, one matched on pathway to diagnosis, the other representing the area of heavy fallout, both matched on age, sex and rural/urban residence in 1986. The 131I dose to the thyroid was estimated from ground deposition of 137Cs, ground deposition of 131I, a data bank of 1986 thyroid radiation measurements, questionnaires and interviews. Highly significant differences were observed between cases and controls (both sets) with respect to dose. The differences persisted within pathway to diagnosis, gender, age and year of diagnosis, and level of iodine in the soil, and were most marked in the southern portion of the Gomel region. The case-control comparisons indicate a strong relationship between thyroid cancer and estimated radiation dose from the Chernobyl accident.
1986年4月26日，切尔诺贝利核电站事故释放了约2 EBq的131I及其他放射性碘同位素，严重污染了白俄罗斯南部地区。1992年报告的因切尔诺贝利事故导致的甲状腺癌病例增加受到质疑，有人认为这可能是强化筛查的结果。我们开展了一项病例对照研究，以检验切尔诺贝利事故导致甲状腺癌增加这一假设。1992年明斯克国家治疗中心的儿童甲状腺癌记录显示，有107例经病理确诊且可接受访谈。确诊途径为：（1）63例通过常规内分泌筛查；（2）25例因甲状腺肿大或有结节就诊；（3）19例为偶然发现。选取了两组对照，一组在确诊途径上匹配，另一组代表高沉降区域，两组均在年龄、性别和1986年的城乡居住情况方面进行了匹配。通过137Cs的地面沉降、131I的地面沉降、1986年甲状腺辐射测量数据库、问卷调查和访谈来估算甲状腺所接受的131I剂量。在剂量方面，病例组与对照组（两组）之间观察到了高度显著的差异。这些差异在确诊途径、性别、年龄、确诊年份以及土壤碘含量方面均持续存在，在戈梅利地区南部最为明显。病例对照比较表明，甲状腺癌与切尔诺贝利事故估计的辐射剂量之间存在密切关系。
