与辐射相关的甲状腺癌

IF 22 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Endocrine reviews Pub Date : 2024-01-04 DOI:10.1210/endrev/bnad022
Vladimir Saenko, Norisato Mitsutake
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引用次数: 0

摘要

辐射是一种会增加甲状腺癌发病风险的环境因素。外部和内部辐射的实际和可能情况多种多样。本文回顾了甲状腺所受的辐射剂量以及计划中、现有和紧急辐照情况下的相应癌症风险,以及医疗、公共和职业类别的辐照。任何辐照情况都可能对甲状腺造成一定范围的剂量,本文将讨论癌症风险以及影响因素。文章描述了切尔诺贝利核电站事故和福岛核电站事故的后果,总结了甲状腺癌流行病学、治疗和预后、临床病理学特征和基因改变方面的信息。切尔诺贝利事故中的甲状腺癌随着时间的推移发生了演变:侵袭性减弱,驱动因素从融合转变为点突变。对两个地区的甲状腺癌进行比较后发现了许多差异,这些差异累积起来表明,福岛地区甲状腺癌的放射源性质可能性很低。鉴于在各种环境中持续使用不同的辐射源,我们考虑了降低辐照导致甲状腺癌风险的可能方法。对于外部辐照,合理的措施一般符合 "尽可能低 "原则,而对于放射性碘的内部辐照,在预计会发生核反应堆事故的情况下,除其他措施外,可能建议使用稳定碘进行甲状腺阻断。最后,从流行病学、基础科学和临床角度讨论了辐射对甲状腺影响的研究前景。
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Radiation-Related Thyroid Cancer.

Radiation is an environmental factor that elevates the risk of developing thyroid cancer. Actual and possible scenarios of exposures to external and internal radiation are multiple and diverse. This article reviews radiation doses to the thyroid and corresponding cancer risks due to planned, existing, and emergency exposure situations, and medical, public, and occupational categories of exposures. Any exposure scenario may deliver a range of doses to the thyroid, and the risk for cancer is addressed along with modifying factors. The consequences of the Chornobyl and Fukushima nuclear power plant accidents are described, summarizing the information on thyroid cancer epidemiology, treatment, and prognosis, clinicopathological characteristics, and genetic alterations. The Chornobyl thyroid cancers have evolved in time: becoming less aggressive and driver shifting from fusions to point mutations. A comparison of thyroid cancers from the 2 areas reveals numerous differences that cumulatively suggest the low probability of the radiogenic nature of thyroid cancers in Fukushima. In view of continuing usage of different sources of radiation in various settings, the possible ways of reducing thyroid cancer risk from exposures are considered. For external exposures, reasonable measures are generally in line with the As Low As Reasonably Achievable principle, while for internal irradiation from radioactive iodine, thyroid blocking with stable iodine may be recommended in addition to other measures in case of anticipated exposures from a nuclear reactor accident. Finally, the perspectives of studies of radiation effects on the thyroid are discussed from the epidemiological, basic science, and clinical points of view.

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来源期刊
Endocrine reviews
Endocrine reviews 医学-内分泌学与代谢
CiteScore
42.00
自引率
1.00%
发文量
29
期刊介绍: Endocrine Reviews, published bimonthly, features concise timely reviews updating key mechanistic and clinical concepts, alongside comprehensive, authoritative articles covering both experimental and clinical endocrinology themes. The journal considers topics informing clinical practice based on emerging and established evidence from clinical research. It also reviews advances in endocrine science stemming from studies in cell biology, immunology, pharmacology, genetics, molecular biology, neuroscience, reproductive medicine, and pediatric endocrinology.
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