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Individual Dose Response and Radiation Origin of Childhood and Adolescent Thyroid Cancer in Fukushima II: Possibility of High I-131 Exposure as in Chernobyl 福岛儿童和青少年甲状腺癌的个体剂量反应和辐射来源:与切尔诺贝利一样高剂量暴露的可能性
Pub Date : 2022-10-21 DOI: 10.31487/j.cor.2022.04.02
T. Katō, Kosaku Yamada
Background: Thyroid cancer incidence of individual dose groups in Fukushima residents exposed at ≤18 years of age demonstrated a linear response to thyroid dose estimated in the United Nations Scientific Committee on the effects of Atomic Radiation (UNSCEAR) 2020/2021. Increased childhood thyroid cancer in Fukushima was found to come dominantly from radiation exposure from the nuclear accident. The UNSCEAR 2020/2021 concluded that the apparent excess of thyroid cancers would not be expected at thyroid doses estimated by the UNSCEAR. The purpose of this paper is to solve the puzzle of the high childhood thyroid cancer incidence in Fukushima despite the estimated low thyroid dose.Methods: The conversion coefficient k connecting thyroid doses estimated in UNSCEAR 2020/2021 and doses based on direct thyroid dose measurements in Chernobyl: 1 GyUN2021 = k × 1 Gy (gray), was estimated by comparing incidences and dose dependences of thyroid cancers in Fukushima and Chernobyl after nuclear disasters. Results: The ratio of the observed cases /expected cases from cancer registry: of about 60 in Fukushima prefecture, was higher than the ratios observed after the Chernobyl accident. The thyroid doses estimated by UNSCEAR were corrected by adding a baseline dose to recover the severely underestimated ingestion dose. The conversion coefficients were: k =60~70 from the comparison of the excess absolute risks (EAR) and their dose dependences in Fukushima and in Chernobyl, and k =10~180 from the comparison of excess relative risk per gray (ERR/Gy) in Fukushima with those in Chernobyl. The thyroid doses might have been underestimated by about 1/50~1/100 in UNSCEAR 2020/2021.Conclusion: The dozens-fold increase of childhood thyroid cancer cases after the Fukushima nuclear accident was found to arise from radioactive iodine exposure comparable to that in Chernobyl.
背景:≤18岁的福岛居民个体剂量组的甲状腺癌发病率与联合国原子辐射影响科学委员会(UNSCEAR) 2020/2021年估计的甲状腺剂量呈线性反应。福岛儿童甲状腺癌的增加主要来自核事故的辐射暴露。2020/2021年科委会的结论是,按照科委会估计的甲状腺剂量,预计不会出现明显的甲状腺癌过量。本文的目的是解决福岛儿童甲状腺癌发病率高的难题,尽管估计甲状腺剂量低。方法:通过比较福岛和切尔诺贝利核灾后甲状腺癌发病率和剂量依赖性,估算UNSCEAR 2020/2021估算的甲状腺剂量与基于切尔诺贝利直接甲状腺剂量测量的剂量之间的换算系数k: 1 GyUN2021 = k × 1 Gy(灰色)。结果:福岛县约60例癌症登记中观察病例/预期病例的比率高于切尔诺贝利事故后观察到的比率。通过增加基线剂量以恢复严重低估的摄入剂量,纠正了科委会估计的甲状腺剂量。换算系数为:福岛和切尔诺贝利的超绝对危险度(EAR)及其剂量依赖性比较k =60~70,福岛和切尔诺贝利的超每灰色相对危险度(ERR/Gy)比较k =10~180。在联合国科委2020/2021年期间,甲状腺剂量可能被低估了约1/50~1/100。结论:福岛核事故发生后,儿童甲状腺癌病例数增加了数十倍,与切尔诺贝利的放射性碘暴露相当。
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引用次数: 2
Clinical Heterogenicity in Children with Ovotesticular Disorder of Sex Development: Experience at Children’s Hospital of Mexico Federico Gomez 儿童性发育卵睾丸障碍的临床异质性:墨西哥儿童医院的经验
Pub Date : 2022-10-01 DOI: 10.31487/j.cor.2022.04.01
Jorge Mario Molina Díaz, Luis Guillermo Martínez Domínguez, Karla Eugenia Hernández Trejo
Introduction: DSD are congenital alterations in which either sexual chromosomes, gonadal or anatomical development are atypical. It is estimated that about 1 in every 4500 live births has some type of DSD, ovotesticular DSD representing around 3-10% of the cases. Given the rarity of DSD, it is an underexplored area, and little is known of ovotesticular DSD.Materials and Methods: A retrospective study on patients diagnosed with Ovotesticular DSD in a tertiary medical center from 2009 to 2018. The clinical presentation, phenotype, gonadal features, gender assignment and medical management were evaluated.Results: A total of 184 cases matched the initial search criteria. Only 9 patients with confirmed histopathological diagnosis were selected. Eight out of the nine cases evaluated presented ambiguous genitalia at birth, and only one was detected until pubertal age with presence of bilateral gynecomastia. A female 46 XX karyotype was reported in six patients, whereas the remaining three patients had mosaicism. Four patients were at pubertal age at the time of the study, and three of them required induction of puberty due to lack of sexual steroid production due to loss of gonadal organs. Discussion: Ovotesticular DSD is a rare finding with a heterogeneous spectrum concerning its genetic etiology, clinical presentation, and surgical findings. Most patients are diagnosed during infancy or childhood; few are diagnosed at pubertal age.Conclusion: Actual management and decision on gender assigning and treatment is challenging and debatable; therefore, a scrupulous clinical examination, as well as hormonal, imaging, genetic and molecular investigation is needed for a correct diagnosis. Further investigation is required to fully understand the disease.
简介:DSD是先天性的改变,其中性染色体,性腺或解剖发育是非典型的。据估计,每4500名活产婴儿中约有1人患有某种类型的DSD,其中卵睾丸DSD约占3-10%。鉴于DSD的罕见性,这是一个未被充分探索的领域,对卵睾丸DSD知之甚少。材料与方法:对2009 - 2018年某三级医疗中心诊断为卵睾丸DSD的患者进行回顾性研究。评估临床表现、表型、性腺特征、性别分配和医疗管理。结果:184例符合初始检索标准。只选择9例经组织病理学确诊的患者。9例中有8例在出生时表现出生殖器模糊,只有1例在青春期前被发现存在双侧男性乳房。6例患者报告为女性46 XX核型,而其余3例患者有嵌合体。4名患者在研究时处于青春期,其中3名患者由于性器官丧失导致性类固醇分泌不足而需要诱导青春期。讨论:卵睾丸DSD是一种罕见的发现,其遗传病因,临床表现和手术结果具有异质性。大多数患者在婴儿期或儿童期被诊断出来;很少在青春期被诊断出来。结论:性别分配和治疗的实际管理和决策具有挑战性和争议性;因此,严谨的临床检查,以及激素、影像学、遗传和分子调查是正确诊断的必要条件。需要进一步调查以充分了解这种疾病。
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引用次数: 0
Characteristics and Outcomes of Adult Patients with Secondary Hemophagocytic Lymphohistiocytosis Depending on Malignancy Etiology 成年患者继发性噬血细胞性淋巴组织细胞病的特点和预后与恶性病因的关系
Pub Date : 2022-08-12 DOI: 10.31487/j.cor.2022.03.04
N. Magy-Bertrand, A. Pastissier, J. Razanamahery, S. Humbert, T. Soumagne, É. Daguindau, C. Chirouze, G. Piton
Hemophagocytic lymphohistiocytosis (HLH) may be secondary to cancer or other conditions in adults. We aimed to compare characteristics and outcomes of secondary HLH depending on cancer status among adults. Weight loss over 10 %, headache and enlarged lymph nodes were more frequent in malignant- HLH (M-HLH). Higher phosphatase alkaline level and CRP level were present in M-HLH. Mortality rate tended to be higher in M-HLH group in the first month and during the two years follow-up. Some clinical features and biological abnormalities are associated with an increased probability of malignancy in secondary HLH among adults.
成人嗜血球性淋巴组织细胞增多症(HLH)可能继发于癌症或其他疾病。我们的目的是比较成人中继发性HLH的特征和结果,这取决于癌症状态。体重减轻超过10%,头痛和淋巴结肿大在恶性HLH (M-HLH)中更为常见。M-HLH患者存在较高的磷酸酶碱性水平和CRP水平。M-HLH组在第一个月和2年随访期间死亡率有较高的趋势。一些临床特征和生物学异常与成人继发性HLH中恶性肿瘤的可能性增加有关。
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引用次数: 0
Comparison Between CT Volumetric Measurement and RECIST 1.1 Criteria to Assess the Tumoral Response in Advanced Renal Cell Carcinoma Treated by Immunotherapy CT体积测量与RECIST 1.1标准评价免疫治疗晚期肾癌肿瘤反应的比较
Pub Date : 2022-08-05 DOI: 10.31487/j.cor.2022.03.03
C. Roy, M. Quentin, P. Barthélémy, M. Mielcarek, P. Leyendecker, M. Ohana
Objective: Assessment of a volumetric method versus gold standard unidimensional measurement based on RECIST 1.1 in advanced renal clear cell carcinoma (RCC) treated by immunotherapy.Materials and Methods: We retrospectively recorded the CT data of 14 adult patients treated with immunotherapy for metastatic RCC from February 2016 to January 2018. Follow-up CT scanners were independently reviewed by two radiologists. Unidimensional RECIST 1.1 and volumetric measurements were compared at each time point, with a total of 810 measurements performed for statistical analysis. The main criterion was the inter-observer agreement for each method. The secondary criterion was the tumoral response assessment based on three different items: RECIST 1.1, spherical volumetric method, ellipsoidal volumetric method.Results: Intraclass coefficient correlation in volumetric method (0.986 [95% CI: 0.980, 0.990]) was higher than in RECIST (0.903 [95% CI: 0.861, 0.928]). Relative measurement differences with Bland and Altman plot were lower in the volumetric method with shorter limits of agreement (0.8%; upper LOA95%: 36.5; lower LOA95%: −35), versus those in RECIST (-5.1 % (upper LOA95%: 46; lower LOA95%: −57). The volumetric method (especially the ellipsoidal one) assesses the progression disease earlier than RECIST for 57% of patients, but there is no formal difference for partial response assessment.Conclusion: Volumetric assessment for tumoral response in metastatic RCC compared to unidimensional measurements had a higher inter-observer agreement and might predict disease progression earlier.
目的:评估基于RECIST 1.1的体积法与金标准单维测量法在免疫治疗晚期肾透明细胞癌(RCC)中的应用。材料与方法:回顾性记录2016年2月至2018年1月接受转移性RCC免疫治疗的14例成人患者的CT资料。后续的CT扫描仪由两名放射科医生独立审查。在每个时间点比较一维RECIST 1.1和体积测量,共进行810次测量进行统计分析。主要标准是每种方法的观察者之间的一致。次要标准是基于三个不同项目的肿瘤反应评估:RECIST 1.1、球形容积法、椭球容积法。结果:容积法的类内相关系数(0.986 [95% CI: 0.980, 0.990])高于RECIST法(0.903 [95% CI: 0.861, 0.928])。体积法与Bland和Altman图的相对测量差异较小,一致性限较短(0.8%;上loab 95%: 36.5;低loab 95%:−35),而RECIST组为- 5.1%(上loab 95%: 46;下loo95 %:−57)。57%的患者采用容积法(尤其是椭球法)比RECIST更早评估疾病进展,但在部分缓解评估方面没有正式差异。结论:与单维测量相比,体积评估转移性RCC的肿瘤反应具有更高的观察者间一致性,并且可能更早地预测疾病进展。
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引用次数: 0
Diluted Lycopodium Induced Cell Death and Clinical Improvement in Hepatocellular Carcinoma 稀释石蒜素诱导肝癌细胞死亡及临床改善
Pub Date : 2022-07-08 DOI: 10.31487/j.cor.2022.03.02
Satadal Das, D. Chatterjee, Banhishikha Singh, Ashoke Kumar Pradhan, Krishnendu Paira
Hepatocellular carcinoma (HCC) is a common cancer with high incidence rate, and 5-year survival rate in HCC is less than 20%. Thus, in search of newer anticancer agents effective in HCC, we have explored possible usefulness of an alternative medicine Lycopodium against the human liver cancer cell line, HepG2 along with its clinical efficacy. The HepG2 cell line was challenged with Lycopodium 6C (diluted Lycopodium <1pg /mL available as alternative medicine) along with vehicle alcohol control in 24 hours. The cytopathic effect and viability test with methylene blue stain were observed. The cells were harvested for total RNA extraction, and gene expression levels of targeted cytokines -Interferon gamma (IFN γ); Interleukins - IL-6, IL-8, IL-10, IL-1β, Transforming Growth Factor- TGF-β1, TGF-β3 and Tumor Necrosis Factor alpha (TNF-α) by RT-PCR were studied. DNA fragmentation assay and cell viability assay by MTT method were also tested. After ethical permission we applied this medicine as adjunct therapy to observe any beneficial role of the medicine. Statistically significant changes of IL-10, IL-1β and TGF-β3 were observed after challenge with Lycopodium 6C. The IL-10 gene expression in malignant cells was significantly reduced with Lycopodium 6C; however, the expression is more with vehicle alcohol compared to normal control set. Thus, the medicine could decrease the excessive IL-10 gene expression to a moderate level. IL-1β and TGF-β3 gene up-regulation by the vehicle alcohol were also mitigated by the medicine Lycopodium 6C. Mild DNA fragmentation was also seen in cancer cells after challenge with the medicine. Two cases suffering from hepatocellular carcinoma showed much clinical improvement after therapy with this medicine. Lycopodium 6C may act as a supporting alternative medication for treating HCC.
肝细胞癌(HCC)是一种常见的高发癌症,HCC的5年生存率不足20%。因此,为了寻找对HCC有效的新型抗癌药物,我们探索了替代药物石松对人肝癌细胞系HepG2的可能有效性及其临床疗效。在HepG2细胞系24小时内,用石松6C(稀释后的石松<1pg /mL可作为替代药物)和酒精对照刺激HepG2细胞系。观察亚甲蓝染色对细胞病变的影响及细胞活力测定。收集细胞进行总RNA提取,检测目标细胞因子-干扰素γ (IFN γ)的基因表达水平;采用RT-PCR方法研究白细胞介素- IL-6、IL-8、IL-10、IL-1β、转化生长因子- TGF-β1、TGF-β3和肿瘤坏死因子α (TNF-α)的表达。采用MTT法进行DNA片段化试验和细胞活力试验。在获得伦理许可后,我们将该药作为辅助治疗来观察该药的任何有益作用。经石蒜6C攻毒后,IL-10、IL-1β、TGF-β3含量变化有统计学意义。石蒜6C可显著降低恶性细胞中IL-10基因的表达;但与正常对照组相比,载药酒精组表达更多。因此,该药物可以将过量的IL-10基因表达降低到中等水平。药石蒜6C也能减轻载体酒精对IL-1β和TGF-β3基因的上调。在接受药物攻击后,癌细胞也出现了轻微的DNA断裂。2例肝癌患者经该药治疗后临床有明显改善。石蒜6C可作为治疗HCC的辅助替代药物。
{"title":"Diluted Lycopodium Induced Cell Death and Clinical Improvement in Hepatocellular Carcinoma","authors":"Satadal Das, D. Chatterjee, Banhishikha Singh, Ashoke Kumar Pradhan, Krishnendu Paira","doi":"10.31487/j.cor.2022.03.02","DOIUrl":"https://doi.org/10.31487/j.cor.2022.03.02","url":null,"abstract":"Hepatocellular carcinoma (HCC) is a common cancer with high incidence rate, and 5-year survival rate in HCC is less than 20%. Thus, in search of newer anticancer agents effective in HCC, we have explored possible usefulness of an alternative medicine Lycopodium against the human liver cancer cell line, HepG2 along with its clinical efficacy. The HepG2 cell line was challenged with Lycopodium 6C (diluted Lycopodium <1pg /mL available as alternative medicine) along with vehicle alcohol control in 24 hours. The cytopathic effect and viability test with methylene blue stain were observed. The cells were harvested for total RNA extraction, and gene expression levels of targeted cytokines -Interferon gamma (IFN γ); Interleukins - IL-6, IL-8, IL-10, IL-1β, Transforming Growth Factor- TGF-β1, TGF-β3 and Tumor Necrosis Factor alpha (TNF-α) by RT-PCR were studied. DNA fragmentation assay and cell viability assay by MTT method were also tested. After ethical permission we applied this medicine as adjunct therapy to observe any beneficial role of the medicine. Statistically significant changes of IL-10, IL-1β and TGF-β3 were observed after challenge with Lycopodium 6C. The IL-10 gene expression in malignant cells was significantly reduced with Lycopodium 6C; however, the expression is more with vehicle alcohol compared to normal control set. Thus, the medicine could decrease the excessive IL-10 gene expression to a moderate level. IL-1β and TGF-β3 gene up-regulation by the vehicle alcohol were also mitigated by the medicine Lycopodium 6C. Mild DNA fragmentation was also seen in cancer cells after challenge with the medicine. Two cases suffering from hepatocellular carcinoma showed much clinical improvement after therapy with this medicine. Lycopodium 6C may act as a supporting alternative medication for treating HCC.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88196572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 Vaccine Acceptance Among Cancer Patients at Sindh Institute of Urology and Transplantation 信德省泌尿外科和移植研究所癌症患者COVID-19疫苗接受情况
Pub Date : 2022-06-22 DOI: 10.31487/j.cor.2022.03.01
Anita Vallacha, Afshan Asghar Rasheed, Narjis Muzaffar, Najeeb Niamatullah, B. Malik, Chandu Mal, Lubna Gul
Background: Coronavirus disease (COVID-19) was declared as pandemic by World Health Organization (WHO) on 30th January 2020. Cancer patients are a vulnerable population with increased risk for mortality associated with COVID-19 infection. In this study, we report the impact of education for acceptance of COVID-19 vaccination in our cancer patients.Methods: This was a cross-sectional study between 1st August 2021 and 31st October 2021. All patients with diagnosis of cancer who presented to the oncology clinic were asked whether they received COVID-19 vaccine or planning to get vaccinated. Patients, who had refused the vaccine, were educated to get vaccinated. Post counseling, they were again asked if they would agree to get vaccinated.Results: Out of 512 cancer patients, 274 (53.5%) were male. Of total, 456 (89.1%) were diagnosed cases of solid malignancy. Patients who were on active oncological treatment were 406 (79.3%). Of total 512, 396 (77.3%) patients agreed for the COVID-19 vaccine while 116 (22.7%) had refused to get vaccinated. Of those 116, 75 (64.7%) patients accepted to get vaccinated post counseling.Conclusion: COVID-19 vaccine acceptance is higher among cancer patients at our institute compared to reported data. Oncologists should play a key role in encouraging their patients to get vaccine in order to reduce COVID-19 related mortality.
背景:世界卫生组织(世卫组织)于2020年1月30日宣布冠状病毒病(COVID-19)为大流行。癌症患者是易受感染人群,与COVID-19感染相关的死亡风险增加。在本研究中,我们报告了教育对癌症患者接受COVID-19疫苗接种的影响。方法:这是2021年8月1日至2021年10月31日的横断面研究。所有到肿瘤诊所就诊的癌症诊断患者都被问及是否接种了COVID-19疫苗或计划接种疫苗。那些拒绝接种疫苗的病人接受了接种疫苗的教育。咨询后,他们再次被问及是否同意接种疫苗。结果:512例肿瘤患者中,男性274例(53.5%)。其中456例(89.1%)被诊断为实体恶性肿瘤。积极接受肿瘤治疗的患者406例(79.3%)。在512名患者中,同意接种疫苗的有396名(77.3%),拒绝接种疫苗的有116名(22.7%)。在116例患者中,75例(64.7%)患者接受咨询后接种疫苗。结论:我院肿瘤患者COVID-19疫苗接受度高于报道数据。肿瘤学家应该在鼓励患者接种疫苗以降低COVID-19相关死亡率方面发挥关键作用。
{"title":"COVID-19 Vaccine Acceptance Among Cancer Patients at Sindh Institute of Urology and Transplantation","authors":"Anita Vallacha, Afshan Asghar Rasheed, Narjis Muzaffar, Najeeb Niamatullah, B. Malik, Chandu Mal, Lubna Gul","doi":"10.31487/j.cor.2022.03.01","DOIUrl":"https://doi.org/10.31487/j.cor.2022.03.01","url":null,"abstract":"Background: Coronavirus disease (COVID-19) was declared as pandemic by World Health Organization (WHO) on 30th January 2020. Cancer patients are a vulnerable population with increased risk for mortality associated with COVID-19 infection. In this study, we report the impact of education for acceptance of COVID-19 vaccination in our cancer patients.\u0000Methods: This was a cross-sectional study between 1st August 2021 and 31st October 2021. All patients with diagnosis of cancer who presented to the oncology clinic were asked whether they received COVID-19 vaccine or planning to get vaccinated. Patients, who had refused the vaccine, were educated to get vaccinated. Post counseling, they were again asked if they would agree to get vaccinated.\u0000Results: Out of 512 cancer patients, 274 (53.5%) were male. Of total, 456 (89.1%) were diagnosed cases of solid malignancy. Patients who were on active oncological treatment were 406 (79.3%). Of total 512, 396 (77.3%) patients agreed for the COVID-19 vaccine while 116 (22.7%) had refused to get vaccinated. Of those 116, 75 (64.7%) patients accepted to get vaccinated post counseling.\u0000Conclusion: COVID-19 vaccine acceptance is higher among cancer patients at our institute compared to reported data. Oncologists should play a key role in encouraging their patients to get vaccine in order to reduce COVID-19 related mortality.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87982953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Individual Dose Response and Radiation Origin of Childhood and Adolescent Thyroid Cancer in Fukushima, Japan 日本福岛儿童和青少年甲状腺癌的个体剂量反应和辐射来源
Pub Date : 2022-05-04 DOI: 10.31487/j.cor.2022.02.02
T. Kato, Kosaku Yamada
Background: After the Fukushima Nuclear Power Plant accident in 2011, thyroid ultrasound screening was carried out as part of the Fukushima health management survey (FHMS) on all residents of ages≤18 years at the accident. The results of the 1st (2011-2013) and 2nd (2014-2015) round screening showed dozens of times excess thyroid cancer detection compared to the expected from the cancer registry. Both FHMS and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) summarized that thyroid cancer cases detected in Fukushima were unlikely to be attributed to radiation exposure from the absence of dose-response relation. We elucidated the response of thyroid cancer incidence to individual external doses and found the dominant radiation effect on the increased thyroid cancer incidence after the accident.Method: Association between average individual external dose based on FHMS basic survey and thyroid cancer incidence rate of dose groups was analysed by the linear regression analysis. Thyroid dose estimated in UNSCEAR 2020/2021 for 10-year-old children was used for comparison. Results: Incidence proportions of dose groups in the 2nd round showed a linear response to mean individual external dose under 2.5 mSv range. A rough estimate of the excess relative risk per gray (Gy) was ERR/Gy =213 (95%CI: 129, 297) (p=0.02).Conclusion: Childhood and adolescent thyroid cancer in Fukushima was associated with individual external dose estimated in FHMS basic survey. Increased childhood and adolescent thyroid cancer in Fukushima could most probably be attributed to radiation exposure from the nuclear accident.
背景:2011年福岛核电站事故发生后,作为福岛健康管理调查(FHMS)的一部分,对事故现场所有年龄≤18岁的居民进行了甲状腺超声筛查。第1轮(2011-2013年)和第2轮(2014-2015年)筛查的结果显示,甲状腺癌的检出率比癌症登记处的预期高出数十倍。FHMS和联合国原子辐射影响科学委员会(UNSCEAR)都总结说,由于没有剂量-反应关系,在福岛发现的甲状腺癌病例不太可能归因于辐射照射。我们阐明了个体外照射剂量对甲状腺癌发病率的影响,发现事故发生后甲状腺癌发病率增加的主要影响因素是辐射。方法:采用线性回归分析FHMS基础调查所得个体平均外剂量与剂量组甲状腺癌发病率的关系。使用联合国科委会2020/2021年对10岁儿童估计的甲状腺剂量进行比较。结果:第二轮剂量组的发病率与2.5 mSv范围内的个体平均外剂量呈线性关系。每灰色(Gy)的超额相对风险的粗略估计是ERR/Gy =213 (95%CI: 129,297) (p=0.02)。结论:福岛儿童和青少年甲状腺癌与FHMS基础调查估计的个体外照射剂量有关。福岛儿童和青少年甲状腺癌的增加很可能归因于核事故的辐射暴露。
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引用次数: 2
Biliary Tract Rhabdomyosarcoma: A Challenging Diagnosis 胆道横纹肌肉瘤:一个具有挑战性的诊断
Pub Date : 2022-04-21 DOI: 10.31487/j.cor.2022.02.01
Fernanda de Oliveira Mota, N. Dassi, Ioná Grossman, Flávio Augusto Vercillo Luisi, Ricardo Antônio Bertacchi Uvo, E. M. Monteiro Caran
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. It is located mainly in the head and neck, extremities and trunk, rarely achieving the biliary tract (1%). The clinical presentation is characterized by obstructive jaundice, abdominal pain and palpable mass. The prognosis is favourable when being early diagnosed. The main differential diagnosis is the choledochal cyst. We bring a case report about a patient with biliary tract rhabdomyosarcoma, diagnosed and treated for 1 year as choledochal cyst, presenting obstructive jaundice for one year. A hepatic biopsy was done, showing hepatic fibrosis. He presented clinical worsening and was referred for liver transplant. An exploratory laparotomy was done before planning the transplant, which showed a biliary tract mass, followed by a biopsy. The anatomopathological result was RMS. Biliary tract RMS is a rare entity that should be included in the differential diagnosis of obstructive jaundice in children. Because of its similarity with choledochal cyst, pediatricians and surgeons should consider this hypothesis, for adequate investigation and treatment.
横纹肌肉瘤(Rhabdomyosarcoma, RMS)是儿童最常见的软组织肉瘤。主要发生在头颈、四肢和躯干,很少发生在胆道(1%)。临床表现为梗阻性黄疸、腹痛及可触及肿块。早期诊断预后良好。主要鉴别诊断为胆总管囊肿。我们报告一例胆道横纹肌肉瘤患者,诊断为胆总管囊肿并治疗1年,表现为梗阻性黄疸1年。肝活检显示肝纤维化。他表现出临床恶化并被转介肝移植。在计划移植前进行了探查性剖腹手术,发现胆道肿块,随后进行了活检。解剖病理结果均为RMS。胆道RMS是一个罕见的实体,应包括在鉴别诊断梗阻性黄疸在儿童。由于其与胆总管囊肿相似,儿科医生和外科医生应考虑这一假设,以便进行充分的调查和治疗。
{"title":"Biliary Tract Rhabdomyosarcoma: A Challenging Diagnosis","authors":"Fernanda de Oliveira Mota, N. Dassi, Ioná Grossman, Flávio Augusto Vercillo Luisi, Ricardo Antônio Bertacchi Uvo, E. M. Monteiro Caran","doi":"10.31487/j.cor.2022.02.01","DOIUrl":"https://doi.org/10.31487/j.cor.2022.02.01","url":null,"abstract":"Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. It is located mainly in the head and neck, extremities and trunk, rarely achieving the biliary tract (1%). The clinical presentation is characterized by obstructive jaundice, abdominal pain and palpable mass. The prognosis is favourable when being early diagnosed. The main differential diagnosis is the choledochal cyst. We bring a case report about a patient with biliary tract rhabdomyosarcoma, diagnosed and treated for 1 year as choledochal cyst, presenting obstructive jaundice for one year. A hepatic biopsy was done, showing hepatic fibrosis. He presented clinical worsening and was referred for liver transplant. An exploratory laparotomy was done before planning the transplant, which showed a biliary tract mass, followed by a biopsy. The anatomopathological result was RMS. Biliary tract RMS is a rare entity that should be included in the differential diagnosis of obstructive jaundice in children. Because of its similarity with choledochal cyst, pediatricians and surgeons should consider this hypothesis, for adequate investigation and treatment.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82503890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Outcomes of Endoscopic Submucosal Dissection for Early Gastric Cancer in Different Indications 内镜下粘膜下剥离治疗早期胃癌不同适应症的临床效果
Pub Date : 2022-02-09 DOI: 10.31487/j.cor.2022.01.03
Ruihua Shi, Z. Duan, Qingxia Wang
Gastric cancer still threatens the health of people, which is the fifth most common cancer and the fourth leading cancer-related death worldwide. The stage of the disease is critical for the 5-year survival of gastric cancer; the 5-year survival rates could reach 90% for gastric cancer detected at early stages. At present, endoscopic submucosal dissection (ESD) is the main treatment for early gastric cancer. Referring to the treatment guideline of the Japan Gastric Cancer Association, the indications for ESD mainly include absolute indications, expanded indications, and relative indications. Many studies have reported favourable long-term outcomes after undergoing ESD, and compared with surgery, ESD preserves the entire stomach and improves the quality of life of patients. However, it has also been reported that the recurrence rate of gastric cancer after ESD is high, so regular follow-up and careful examination are needed, even for patients with early gastric cancer who met absolute indications.
胃癌仍然威胁着人们的健康,它是世界上第五大常见癌症和第四大癌症相关死亡。胃癌的分期对其5年生存至关重要;早期发现的胃癌5年生存率可达90%。目前,内镜下粘膜剥离术(ESD)是早期胃癌的主要治疗方法。参照日本胃癌协会的治疗指南,ESD的适应证主要包括绝对适应证、扩展适应证和相对适应证。许多研究报道了ESD术后良好的长期预后,与手术相比,ESD保护了整个胃,提高了患者的生活质量。但也有报道称,ESD术后胃癌复发率高,即使是符合绝对指征的早期胃癌患者,也需要定期随访,仔细检查。
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引用次数: 0
The Value of Radiation Therapy for the Treatment of Diffuse Large B-Cell Lymphoma in a New Era 新时期放射治疗弥漫性大b细胞淋巴瘤的价值
Pub Date : 2022-01-31 DOI: 10.31487/j.cor.2022.01.02
Bao‐an Chen, Zhongshu Yuan, Jing Zhang, Xue Wu, L. Yin
As a highly heterogeneous disease, diffuse large B-cell lymphoma shows different clinical presentations, molecular and immunophenotypic characteristics, International Prognostic Index (IPI score) and response to therapy, which consequently brings about different prognoses and survival results. In addition to surgery and chemotherapy, radiation is also one important modality to treat diffuse large B-cell lymphoma. Over the past few decades, radiation therapy has stepped forward because of technological revolutions. The role of radiation in treating diffuse large B-cell lymphoma is discussed, including: i) advances in modern-day radiation technology ii) potential toxicity from radiation, iii) indications for radiation, and iv) available studies about the efficacy of radiation.
弥漫性大b细胞淋巴瘤是一种高度异质性的疾病,其临床表现、分子和免疫表型特征、国际预后指数(IPI)评分和对治疗的反应不同,从而导致预后和生存结果不同。除手术和化疗外,放疗也是治疗弥漫性大b细胞淋巴瘤的一种重要方式。在过去的几十年里,由于技术革命,放射治疗取得了进步。本文讨论了放射治疗弥漫性大b细胞淋巴瘤的作用,包括:i)现代放射技术的进展;ii)放射的潜在毒性;iii)放射的适应症;iv)有关放射疗效的现有研究。
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Clinical Oncology and Research
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