白俄罗斯子宫内队列的甲状腺筛查和甲状腺辐射剂量的可靠性。

V Drozdovitch, V V Yauseyenka, V F Minenko, I V Veyalkin, T S Kukhta, R I Grakovitch, S Trofimik, O N Polyanskaya, L Starastsenka, E K Cahoon, M Hatch, M P Little, A V Brenner, E Ostroumova, K Mabuchi, A V Rozhko
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引用次数: 0

摘要

目的描述甲状腺疾病筛查的现状和结果,以及对切尔诺贝利(切尔诺贝利核电站)放射性尘埃暴露的 2965 名白俄罗斯子宫内人群中甲状腺辐射剂量可靠性的评估:目前正在进行甲状腺筛查,包括由内分泌科医生进行甲状腺触诊、由超声波技师进行超声波检查、分析血液样本以诊断甲状腺功能减退症和甲状腺功能亢进症、自身免疫性甲状腺炎、甲状腺功能检测(促甲状腺激素[TSH]、甲状腺素[T4]、甲状腺过氧化物酶抗体[抗-TPO]和甲状腺球蛋白抗体[抗-TG])。对(i)母亲第一次和第二次面谈时获得的 780 对问卷中的信息和(ii)根据这些信息计算出的队列成员甲状腺剂量的可靠性进行了评估:截至 2021 年 8 月 15 日,共筛查出 1267 名子宫内暴露的研究对象。有 167 人(占总人数的 13.2%)被确诊为单发甲状腺结节,101 人(占总人数的 8.0%)被确诊为多发甲状腺结节:189人(14.9%)在筛查中首次发现结节,79人(6.2%)在筛查前发现结节(筛查前结节)。在 268 名有可疑甲状腺结节的受试者中,59 人(22.0%)被推荐进行细针穿刺活检,其中 33 人(55.9%)进行了活检。利用两次互查数据计算出的白俄罗斯子宫内队列成员的模型q基剂量显示出合理的一致性(斯皮尔曼秩相关系数rs = 0.74,p < 0.001),而测量q基剂量几乎完全一致(rs = 0.99,p < 0.001):结论:在甲状腺筛查中,1267 名胎儿暴露队列成员中有 268 人(21.2%)至少发现了一个甲状腺结节。队列中发现了 7 例甲状腺癌病例,包括 5 例筛查前病例和 2 例筛查中发现的病例。对这一独特队列的持续研究将为产前和产后接触放射性碘和铯同位素对健康的不利影响提供重要信息,而现有的流行病学数据却很少。
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THYROID SCREENING AND RELIABILITY OF RADIATION THYROID DOSES FOR THE BELARUSIAN IN UTERO COHORT.

Objective: To describe the status and results of thyroid disease screening and assessment of reliability of radiationthyroid doses in the Belarusian in utero cohort of 2,965 individuals exposed to Chernobyl (Chornobyl) fallout.

Materials and methods: Thyroid screening examinations are currently underway including thyroid palpation by anendocrinologist, ultrasonographic examination by an ultrasonographer and analysis of blood samples for diagnosisof hypo- and hyperthyroidism, autoimmune thyroiditis, thyroid function tests (thyroid-stimulating hormone [TSH],thyroxine [T4], thyroid peroxidase antibody [anti-TPO], and thyroglobulin antibodies [anti-TG]). Reliability of (i)information from 780 pairs of questionnaires obtained during the first and second interviews of the mothers and (ii)thyroid doses, which were calculated for the cohort members using this information, is evaluated.

Results: As of 15 August 2021, 1,267 in utero exposed study subjects had been screened. A single thyroid nodule wasdiagnosed in 167 persons (13.2 % of the total) and multiple thyroid nodules in 101 persons (8.0 %): 189 (14.9 %)persons had nodules detected for the first time at the screening while 79 (6.2 %) persons had nodules detected pre-viously (pre-screening nodules). Fifty-nine out of 268 subjects (22.0 %) with a suspicious thyroid nodule werereferred to fine needle aspiration biopsy, and among them 33 (55.9 %) were biopsied. Reasonable agreement wasobserved for modelqbased doses calculated for the Belarusian in utero cohort members using data from the two inter-views (Spearman's rank-correlation coefficient rs = 0.74, p < 0.001), while measurementqbased doses yielded almost per-fect agreement (rs = 0.99, p < 0.001).

Conclusions: During the thyroid screening, at least one thyroid nodule was identified in 268 of 1,267 (21.2 %) inutero exposed cohort members. Seven thyroid cancer cases were identified in the cohort, including 5 pre-screeningcases and 2 cases detected during the screening. Ongoing research on this unique cohort will provide importantinformation on adverse health effects following prenatal and postnatal exposure to radioiodine and radiocesium iso-topes, for which available epidemiological data are scant.

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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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