Radiation Dose Does Not Affect the Predictive Value of Thyroid Biopsy for Diagnosing Papillary Thyroid Cancer in a Belarusian Cohort Exposed to Chernobyl Fallout.

IF 1.6 4区 医学 Q3 PATHOLOGY Acta Cytologica Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI:10.1159/000536387
Robert J McConnell, Olga Kamysh, Patrick L O'Kane, Ellen Greenebaum, Alexander V Rozhko, Vasilina V Yauseyenka, Victor F Minenko, Vladimir Drozdovitch, Yuliya Yarets, Tatiana Kukhta, Kiyohiko Mabuchi, Mark P Little, Elizabeth K Cahoon, Lydia B Zablotska
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Abstract

Introduction: The Chernobyl nuclear accident exposed residents of contaminated territories to substantial quantities of radioiodines and was followed by an increase in thyroid cancer, primarily papillary thyroid cancer (PTC), among exposed children and adolescents. Although thyroid biopsy is an essential component of screening programs following accidental exposure to radioiodines, it is unknown whether the predictive value of biopsy is affected by different levels of environmental exposure.

Methods: A cohort of 11,732 Belarusians aged ≤18 years at the time of the Chernobyl accident with individual thyroid radiation dose estimates was screened at least once 11-22 years later. Paired cytologic conclusions and histopathologic diagnoses were possible for 258 thyroid nodules from 238 cohort members. Cytologic conclusions were divided into five reporting categories, with all follicular lesion aspirates combined into a single indeterminate category. Standard performance indicators, risk of malignancy (ROM), and odds ratios for a correct cytologic conclusion were calculated, both overall and according to quintile of thyroid radiation dose.

Results: The arithmetic mean thyroid dose estimate for the study group was 1.73 Gy (range: 0.00-23.64 Gy). The final histopathologic diagnosis was cancer for 136 of 258 biopsies (52.7%; 135 papillary and 1 follicular). The overall ROM was 96.7% for cytologies definite for PTC, 83.7% for suspicious for PTC, 33.0% for indeterminate, 8.1% for benign, and 31.0% for non-diagnostic. The ROM showed little change according to level of radiation exposure. Overall, there was no association between thyroid radiation dose and the odds ratio for a correct cytologic conclusion (p = 0.24). When analyzed according to dose quintile, the odds ratio for a correct conclusion increased two-fold at 0.10-0.29 Gy compared to a dose of 0.00-0.09 Gy and decreased at doses of 0.3-24 Gy (p value for linear trend = 0.99).

Conclusions: At radiation doses received by a cohort of young Belarusians exposed to radioiodines by the Chernobyl accident, the predictive value of thyroid biopsy for diagnosing PTC was not significantly affected by level of radiation exposure.

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辐射剂量不会影响甲状腺活检对切尔诺贝利放射性尘埃暴露的白俄罗斯队列中甲状腺乳头状癌诊断的预测价值。
导言:切尔诺贝利核事故使受污染地区的居民暴露于大量放射性碘,随后受污染儿童和青少年的甲状腺癌(主要是甲状腺乳头状癌(PTC))发病率上升。虽然甲状腺活检是意外暴露于放射性碘后筛查项目的重要组成部分,但活检的预测价值是否会受到不同环境暴露水平的影响尚不得而知:对切尔诺贝利事故发生时年龄小于 18 岁的 11,732 名白俄罗斯人进行了队列研究,并在 11-22 年后对他们进行了至少一次甲状腺辐射剂量评估。对 238 名队列成员的 258 个甲状腺结节进行了配对细胞学结论和组织病理学诊断。细胞学结论分为五个报告类别,所有滤泡性病变抽吸物合并为一个不确定类别。计算了标准性能指标、恶性肿瘤风险(ROM)和正确细胞学结论的几率比,既包括总体指标,也包括甲状腺辐射剂量的五分位数:研究组的甲状腺辐射剂量估计值的算术平均值为1.73 Gy(范围:0.00-23.64 Gy)。258 例活检中有 136 例(52.7%;135 例为乳头状,1 例为滤泡状)的最终组织病理学诊断为癌症。细胞学确诊为 PTC 的总 ROM 为 96.7%,怀疑为 PTC 的总 ROM 为 83.7%,不确定的总 ROM 为 33.0%,良性的总 ROM 为 8.1%,未诊断的总 ROM 为 31.0%。ROM随辐射照射水平的变化而变化不大。总体而言,甲状腺辐射剂量与细胞学结论正确的几率之间没有关联(P=0.24)。根据剂量的五分位数进行分析,与0.00-0.09 Gy的剂量相比,0.10-0.29 Gy的剂量下正确结论的几率增加了两倍,而在0.3-24 Gy的剂量下,正确结论的几率有所下降(线性趋势的p值= 0.99):结论:切尔诺贝利核电站事故中受到放射性碘照射的一组白俄罗斯年轻人所接受的辐射剂量对甲状腺活检诊断甲状腺乳头状癌的预测价值影响不大。
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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
审稿时长
4-8 weeks
期刊介绍: With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.
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