切尔诺贝利清理工人造血和淋巴组织恶性疾病。

Daniel Gluzman, Nobutaka Imamura, Lylia Sklyarenko, Valentina Nadgornaya, Michael Zavelevich, Vasily Machilo
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引用次数: 25

摘要

在灾难发生后的18年里,清理工人中白血病和恶性淋巴瘤的发病率是否增加,这个问题仍然是一个有争议的问题。准确诊断主要形式的造血恶性肿瘤,并将这些数据与一般人群的数据进行比较,将有助于估计辐射因素对此类病理总体发病率的相对贡献。材料和方法:1996-2003年,乌克兰参考实验室对切尔诺贝利清理工人连续发生的187例造血和淋巴组织恶性疾病进行了分析。对照组为参考文献实验室同期诊断的以基辅市和区居民为主的普通人群连续患者1942例。观察小鼠骨髓和外周血细胞的形态和细胞化学。采用免疫细胞化学技术(PAP、apap、ABC)和白细胞分化抗原单克隆抗体对白血病细胞进行免疫表型分析。结果:在研究的切尔诺贝利清理工人中登记了各种类型的造血和淋巴组织恶性疾病,包括骨髓增生异常综合征(9例),急性淋巴细胞白血病(8例)和急性髓母细胞白血病(31例),慢性髓性白血病(17例),多发性骨髓瘤(17例)以及其他形式的慢性骨髓增生性和淋巴增生性疾病,包括b细胞慢性淋巴细胞白血病(49例)。结论:根据现代分类(EGIL、WHO)对造血恶性肿瘤的确诊,为进一步开展可能与切尔诺贝利事故有关的白血病的分析流行病学研究奠定了基础。
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Malignant diseases of hematopoietic and lymphoid tissues in Chernobyl clean-up workers.

Introduction: The question as to whether the incidence of leukemias and malignant lymphomas among the clean-up workers increased in 18 years after the catastrophe is still a point of much controversy. Precise diagnosis of the main forms of hematopoietic malignancies and comparison of these data with those in the general population will be helpful in estimating thr relative contribution of the radiation factor to the overall incidence of such pathologies.

Materials and methods: In all, 187 consecutive cases of malignant diseases of hematopoietic and lymphoid tissues in Chernobyl clean-up workers were analyzed in Ukrainian Reference Laboratory in 1996-2003. A total of 1942 consecutive patients of general population, mainly the residents of Kyiv city and district, diagnosed in References Laboratory at the same period comprised the group of comparison. The morphology and cytochemistry of bone marrow and peripheral blood cells were studied. Immunocytochemical techniques (PAP, APAAP, ABC) and the panel of monoclonal antibodies to differentiation antigens of leukocytes were employed for immunophenotyping leukemic cells.

Results: Various types of malignant disease of hematopoietic and lymphoid tissues were registered in Chernobyl clean-up workers under study including myelodysplastic syndromes (nine patients), acute lymphoblastic leukemia (eight) and acute myeloblastic leukemia (31), chromic myeloid leukemia (17), multiple myeloma (17) and other forms of chromic myeloproliferative and lymphoproliferative disease including B-cell chromic lymphocytic leukemia (49 patients).

Conclusion: The verified diagnosis of tumors of hematopoietic malignancies according to modern classification (EGIL, WHO) could be the prerequisite for further analytical epidemiology study of leukemias that may be related to the Chernobyl accident.

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