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Sreekumar A, Jayalekshmi PA, Nandakumar A, Nair RRK, Ahammed R, Sebastian P, Koriyama C, Akiba S, Nakamura S, Konishi J. Thyroid nodule prevalence among women in areas of high natural background radiation, Karunagappally, Kerala, India. Endocrine 2020; 67:124-130. [PMID: 31637657 DOI: 10.1007/s12020-019-02071-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/21/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Radiation exposure has been reported to cause thyroid nodules. The study area was Karunagapally, which has several areas with high natural radiation levels derived from thorium and its decay products. Since thyroid abnormalities are more common in women, the focus was only on women. METHODS The examinations included interview, ultrasonography of the thyroid and serum assays of free thyroxine (FT4), thyrotropin (TSH), and anti-thyroglobulin levels. Cumulative dose during the childhood and lifetime cumulative dose (lagged by 5 years) were estimated. RESULTS We examined 524 female residents aged 17-73 years and found 75 cases of solitary solid thyroid nodules. The prevalence of thyroid nodules were 14.1 % (n = 42) in high dose panchayats and 14.5% (n = 33) in low-dose panchayats. In the logistic regression analysis adjusted for age, the prevalence of solitary thyroid nodule was not linearly related to childhood cumulative dose (P for trend = 0.159) and lifetime cumulative dose (P for trend = 0.333). The prevalence of thyroiditis and hypothyroidism was not related to natural radiation exposure. Serum levels of FT4 or TSH were not related to natural radiation exposure. CONCLUSIONS The results obtained from the present study do not support the increase of solitary thyroid nodule, thyroiditis or hypothyroidism in relation to high-natural-background-radiation exposure.
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Affiliation(s)
| | - Padmavathy Amma Jayalekshmi
- Regional Cancer Center Thiruvananthapuram, Thiruvananthapuram, Kerala, India
- Natural Background Radiation Cancer Registry, Karunagapally, Kerala, India
| | - Athira Nandakumar
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Korimoto, Kagoshima, 890-8580, Japan
| | - Raghu Ram K Nair
- Health Research Foundation, Research Institute for Production Development, Bldg.4F, 15 Shimogamo-morimoto-cho, Sakyo-ku, Kyoto, 606-0805, Japan
| | - Riyaz Ahammed
- Natural Background Radiation Cancer Registry, Karunagapally, Kerala, India
| | - Paul Sebastian
- Regional Cancer Center Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Chihaya Koriyama
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Korimoto, Kagoshima, 890-8580, Japan
| | - Suminori Akiba
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Korimoto, Kagoshima, 890-8580, Japan
- Health Research Foundation, Research Institute for Production Development, Bldg.4F, 15 Shimogamo-morimoto-cho, Sakyo-ku, Kyoto, 606-0805, Japan
| | - Seiichi Nakamura
- Health Research Foundation, Research Institute for Production Development, Bldg.4F, 15 Shimogamo-morimoto-cho, Sakyo-ku, Kyoto, 606-0805, Japan
| | - Junji Konishi
- Health Research Foundation, Research Institute for Production Development, Bldg.4F, 15 Shimogamo-morimoto-cho, Sakyo-ku, Kyoto, 606-0805, Japan
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Raffaelli M, Tempera SE, Sessa L, Lombardi CP, De Crea C, Bellantone R. Total thyroidectomy versus thyroid lobectomy in the treatment of papillary carcinoma. Gland Surg 2020; 9:S18-S27. [PMID: 32055495 DOI: 10.21037/gs.2019.11.09] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Extent of thyroidectomy for papillary thyroid carcinoma is still matter of debate. Indeed, recently, international guidelines endorsed thyroid lobectomy as initial surgical approach for low risk, small medium-sized (T1-T2), N0 papillary thyroid carcinoma in absence of extrathyroidal extension. When dealing with a conservative surgery for oncologic disease is of utmost importance to exclude effectively more advanced disease, which could benefit from a more aggressive initial operation. However, in the setting of surgery for papillary thyroid carcinoma, despite an accurate preoperative work up could led to identify some suspicious characteristics as macroscopic evidence of multifocality or extrathyroidal extension, and/or evidence of lateral neck lymph node metastases, it is difficult to reliably assess the central neck nodal status both pre- and intra-operatively. Frozen section examination of the central neck nodes ipsilateral to the side of the tumor has been proposed in patients scheduled for thyroid lobectomy, in order to modulate the extension of both thyroidectomy and central neck dissection. Future molecular and genetic evidences are needed to establish high-risk patients with small papillary thyroid carcinoma in which thyroid lobectomy could be not and adequate surgical treatment.
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Affiliation(s)
- Marco Raffaelli
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Serena Elisa Tempera
- Division of General Surgery, Ospedale Fatebenefratelli e Oftalmico, Milan, Italy
| | - Luca Sessa
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Celestino Pio Lombardi
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carmela De Crea
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rocco Bellantone
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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53
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Demoury C, De Schutter H, Faes C, Carbonnelle S, Fierens S, Molenberghs G, Van Damme N, Van Bladel L, Van Nieuwenhuyse A, Vleminckx C. Thyroid cancer incidence near nuclear sites in Belgium: An ecological study at small geographical level. Int J Cancer 2019; 146:3034-3043. [PMID: 31745983 PMCID: PMC7187213 DOI: 10.1002/ijc.32796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022]
Abstract
In Belgium, variations in thyroid cancer incidence were observed around the major nuclear sites. The present ecological study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the four nuclear sites at the smallest Belgian geographical level. Rate ratios were obtained from a Bayesian hierarchical model for areas of varying sizes around the nuclear sites. Focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. No evidence was found for more incident cases of thyroid cancer near the two nuclear power plants. Regarding the two industrial and research nuclear sites, no evidence for a higher incidence in the vicinity of Mol‐Dessel was observed, whereas a slightly nonsignificant higher incidence was found in the close vicinity of Fleurus. In addition, significant gradients for thyroid cancer incidence were observed with the different types of surrogate exposure considered in the 20 km area around the site of Fleurus (decreasing distance, increasing wind direction frequency and increasing exposure to estimated hypothetical radioactive discharges of iodine‐131). In the investigation at the smallest Belgian geographical level, variations in thyroid cancer incidence were found around the Belgian nuclear sites. Significant exposure–response relationships were also observed for the site of Fleurus. Further investigations into these findings could be useful to allow inferring causal relationships on the origin of variations in incidence and to provide information at the individual level. What's new? Potential cancer risk associated with living near nuclear installations has long been a public concern. In Belgium, a previous study found a higher incidence around the two nuclear sites with research and industrial activities, but not around the two nuclear power plants. Exposure misclassification due to the large geographical scale could not be excluded, however. The present study, which uses data available at the smallest Belgian geographical level, confirms the previously‐described incidence patterns around the nuclear power plants and for one of the research and industrial sites. There was a significant exposure‐response relationship for the latter. This finding is valuable for thyroid cancer etiology.
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Khosroshahi NS, Pouladi N, Shavali M, Ghafouri F, Abdolahi S, Hossinpour Feizi MA. Association of –634 G > C VEGF-A polymorphism in thyroid cancer patients in North West of Iran. Meta Gene 2019. [DOI: 10.1016/j.mgene.2019.100611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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55
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Kotiaho A, Manninen AL, Nikkinen J, Nieminen MT. COMPARISON OF ORGAN-BASED TUBE CURRENT MODULATION AND BISMUTH SHIELDING IN CHEST CT: EFFECT ON THE IMAGE QUALITY AND THE PATIENT DOSE. RADIATION PROTECTION DOSIMETRY 2019; 185:42-48. [PMID: 30544171 DOI: 10.1093/rpd/ncy242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/10/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
The aim of the study was to compare the absorbed doses and image quality of organ-based tube current modulation (OBTCM) and bismuth shielding of breasts and thyroid against regular tube current modulation in chest CT scan. An anthropomorphic phantom and MOSFET dosemeters were used to evaluate absorbed doses. Image quality was assessed from HU and noise. Relative to the reference scan, the average absorbed dose reduction with OBTCM was 5.2% and with bismuth shields 24.2%. Difference in HU values compared to the reference varied between -4.1 and 4.2 HU in OBTCM scan and between -22.2 and 118.6 HU with bismuth shields. Image noise levels varied between 10.0 to 26.3 HU in the reference scan, from 9.6 to 27.7 HU for the OBTCM scan and from 11.9 to 43.9 HU in the bismuth scan. The use of bismuth shields provided greatest dose reduction compared to the investigated OBTCM.
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Affiliation(s)
- Antti Kotiaho
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Department of Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | - Juha Nikkinen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Miika Tapio Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Department of Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
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Antunes L, Bento MJ, Sobrinho-Simões M, Soares P, Boaventura P. Cancer incidence after childhood irradiation for tinea capitis in a Portuguese cohort. Br J Radiol 2019; 93:20180677. [PMID: 31674803 DOI: 10.1259/bjr.20180677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Our aim was to compare cancer incidence in a cohort exposed in childhood (1950-63) to a therapeutic dose of radiation in the North of Portugal and followed-up until the end of 2012, with the incidence rates for the same age and sex in the general population. METHODS A population-based North Region cancer registry (RORENO) was used to assess which members of the cohort developed cancer. The association between radiation exposure and overall and specific cancer sites was evaluated using standardised incidence ratios (SIR). RESULTS Over the full follow-up period, 3357 individuals of the 5356 original tinea capitis (TC) cohort (63%) were retrieved in the RORENO, and 399 new cancer cases were identified, representing an increased risk of 49% when compared with the general population (SIR = 1.49; 95% CI: 1.35-1.64). The risk was slightly higher in males than in females (SIR = 1.65; 95% CI: 1.43-1.89 vs SIR = 1.35; CI = 1.17-1.55). The risk was slightly higher in the individuals exposed to a higher radiation dose (SIR = 1.78; 95% CI: 1.22-2.51 for ≥630 R vs SIR = 1.46; 95% CI: 1.31-1.62 for 325-475 R). In females, there was an excess cancer risk in all cancers with the higher radiation dose (SIR = 2.00; 95% CI: 1.21-3.13 for ≥630 R vs SIR = 1.30; 95% CI: 1.11-1.51 for 325-475 R) which was not observed in males, and for combined dose categories significantly raised SIRs for thyroid and head and neck cancer, suggesting a possible higher radiosensitivity of females. An increased risk was also observed for some cancers located far from the irradiated area. CONCLUSIONS The results suggest an association between radiation exposure and later increased cancer risk for cancers located near the radiation exposed area, mainly thyroid, and head and neck cancers. Further studies are necessary to disentangle possible non-radiation causes for distant cancers increased risk. ADVANCES IN KNOWLEDGE This paper shows a possible association between childhood X-ray epilation and increased risk of cancer which was not previously investigated in the Portuguese TC cohort.
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Affiliation(s)
- Luís Antunes
- North Region Cancer Registry of Portugal, Department of Epidemiology, Portuguese Oncology Institute of Porto (IPO Porto), Rua Dr. António Bernardino de Almeida North Region Cancer Registry of Portugal, 4200-072 Porto, Portugal
| | - Maria José Bento
- North Region Cancer Registry of Portugal, Department of Epidemiology, Portuguese Oncology Institute of Porto (IPO Porto), Rua Dr. António Bernardino de Almeida North Region Cancer Registry of Portugal, 4200-072 Porto, Portugal
| | - Manuel Sobrinho-Simões
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal.,Faculty of Medicine University of Porto, 4200 - 319 Porto, Portugal.,Department of Pathology, Centro Hospitalar de S. João, 4200 - 319 Porto, Portugal
| | - Paula Soares
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal.,Faculty of Medicine University of Porto, 4200 - 319 Porto, Portugal
| | - Paula Boaventura
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal.,Faculty of Medicine University of Porto, 4200 - 319 Porto, Portugal
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Abstract
PURPOSE OF REVIEW Compared with adults, there is a two-fold to three-fold increased risk of malignancy for a pediatric patient undergoing evaluation of a thyroid nodule. In 2015, the American Thyroid Association published guidelines on the evaluation and management of pediatric patients with thyroid nodules and differentiated thyroid cancer. The goal of this clinical update is to review recent additions to the literature and propose opportunities how to best incorporate these findings into clinical practice. RECENT FINDINGS Recent additions to the literature include assessment of ultrasound-based scoring systems to improve selection of patients for fine needle aspiration, defining the pediatric-specific risk of malignancy within The Bethesda System for Reporting Thyroid Cytopathology, and broadening our knowledge of the oncogene landscape that supports incorporation of adjunct oncogene testing to rule-in malignancy of nodules with indeterminate cytology. SUMMARY There have been significant additions to the literature on the evaluation and management of children and adolescents with thyroid nodules since publication of the 2015 American Thyroid Association guidelines. Incorporating these changes into clinical care, within the setting of multidisciplinary, pediatric-specific, regional centers, will maximize ongoing efforts to improve the care of children and adolescents with thyroid nodules.
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Affiliation(s)
- Andrew J Bauer
- Division of Endocrinology and Diabetes, The Thyroid Center, Children's Hospital of Philadelphia, Associate Professor of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Luna-Sánchez S, Del Campo MT, Morán JV, Fernández IM, Checa FJS, de la Hoz RE. Thyroid Function in Health Care Workers Exposed to Ionizing Radiation. HEALTH PHYSICS 2019; 117:403-407. [PMID: 30913057 DOI: 10.1097/hp.0000000000001071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To analyze possible alterations of thyroid function related to dosimetric values in health care workers exposed to ionizing radiation. MATERIALS AND METHODS Forty-six health care workers exposed to ionizing radiation at a tertiary hospital previously exposed to ionizing radiation were included in the study. Age, sex, history of thyroid diseases, thyroid hormones, work post, service, dosimetric values of previous year, and 5 y period were considered. Alterations of thyroid function and other variables were analyzed by exact logistic regression univariate model. RESULTS 7.1% workers showed an increased serum thyroid-stimulating hormone without free T3 or free T4 alteration. A significant relationship between workers with increased thyroid-stimulating hormone and dosimetric values of previous year (odds ratio 6.35, 95% confidence interval 1.20-98.1, p = 0.021) and previous 5 y period of radiation exposure (odds ratio 1.72, 95% confidence interval 1.12-3.34, p = 0.007) was obtained. CONCLUSION An increased risk of subclinical hypothyroidism related to radiation doses was observed in this pilot study on a group of health care workers exposed to ionizing radiation.
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Affiliation(s)
- Shirley Luna-Sánchez
- Occupational Health and Prevention Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - M T Del Campo
- Occupational Health and Prevention Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Julio Valverde Morán
- Radiological Protection Service, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Ignacio Mahillo Fernández
- Epidemiology and Biostatistics Unit, Research Institute of Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Fernando José Sancho Checa
- Occupational Health and Prevention Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Rafael E de la Hoz
- Occupational Medicine and Medicine Divisions, Icahn School of Medicine at Mount Sinai, NY
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Carr FE. THYROID CANCER. Cancer 2019. [DOI: 10.1002/9781119645214.ch23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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60
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Aguet J, Becce F, Dunet V, Vlassenbroek A, Coche EE, Omoumi P. Optimizing radiation dose parameters in MDCT arthrography of the shoulder: illustration of basic concepts in a cadaveric study. Skeletal Radiol 2019; 48:1261-1268. [PMID: 30725159 DOI: 10.1007/s00256-019-3150-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/11/2018] [Accepted: 01/07/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine in a cadaveric study the lowest achievable radiation dose and optimal tube potential generating diagnostic image quality in multidetector computed tomography (MDCT) arthrography of the shoulder. MATERIALS AND METHODS Six shoulders from three human cadavers were scanned using a 256-MDCT system after intra-articular injection of diluted iodinated contrast material. Using six decreasing radiation dose levels (CTDIvol: 20, 15, 10, 8, 6, and 4 mGy) and for each dose level, four decreasing tube potentials (140, 120, 100, and 80 kVp), image noise and contrast-to-noise ratio (CNR) were measured. Two independent and blinded observers assessed the overall diagnostic image quality, subjective amount of noise, and severity of artifacts according to a four-point scale. Influence of those MDCT data acquisition parameters on objective and subjective image quality was analyzed using the Kruskal-Wallis and Wilcoxon signed-rank tests, and pairwise comparisons were performed. RESULTS Multidetector CT protocols with radiation doses of 15 mGy or higher, combined with tube potentials of 100 kVp or higher, were equivalent in CNR to the reference 20 mGy-140 kVp protocol (all p ≥ 0.054). Above a CTDIvol of 10 mGy and a tube potential of 120 kVp, all protocols generated diagnostic image quality and subjective noise equivalent to the 20 mGy-140 kVp protocol (all p ≥ 0.22). CONCLUSIONS Diagnostic image quality in MDCT arthrography of the shoulder can be obtained with a radiation dose of 10 mGy at an optimal tube potential of 120 kVp, corresponding to a reduction of up to 50% compared with standard-dose protocols, and as high as 500% compared with reported protocols in the literature.
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Affiliation(s)
- Julien Aguet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | | | - Emmanuel E Coche
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Bruxelles, Belgium
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
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Ameziane El Hassani R, Buffet C, Leboulleux S, Dupuy C. Oxidative stress in thyroid carcinomas: biological and clinical significance. Endocr Relat Cancer 2019; 26:R131-R143. [PMID: 30615595 DOI: 10.1530/erc-18-0476] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 01/07/2019] [Indexed: 12/16/2022]
Abstract
At physiological concentrations, reactive oxygen species (ROS), including superoxide anions and H2O2, are considered as second messengers that play key roles in cellular functions, such as proliferation, gene expression, host defence and hormone synthesis. However, when they are at supraphysiological levels, ROS are considered potent DNA-damaging agents. Their increase induces oxidative stress, which can initiate and maintain genomic instability. The thyroid gland represents a good model for studying the impact of oxidative stress on genomic instability. Indeed, one particularity of this organ is that follicular thyroid cells synthesise thyroid hormones through a complex mechanism that requires H2O2. Because of their detection in thyroid adenomas and in early cell transformation, both oxidative stress and DNA damage are believed to be neoplasia-preceding events in thyroid cells. Oxidative DNA damage is, in addition, detected in the advanced stages of thyroid cancer, suggesting that oxidative lesions of DNA also contribute to the maintenance of genomic instability during the subsequent phases of tumourigenesis. Finally, ionizing radiation and the mutation of oncogenes, such as RAS and BRAF, play a key role in thyroid carcinogenesis through separate and unique mechanisms: they upregulate the expression of two distinct 'professional' ROS-generating systems, the NADPH oxidases DUOX1 and NOX4, which cause DNA damage that may promote chromosomal instability, tumourigenesis and dedifferentiation.
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Affiliation(s)
- Rabii Ameziane El Hassani
- Laboratory of Biology of Human Pathologies 'BioPatH', Faculty of Sciences, Mohammed V University of Rabat, Rabat, Morocco
| | - Camille Buffet
- UMR 8200 CNRS, Gustave Roussy and Paris Sud University, Villejuif, France
| | - Sophie Leboulleux
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Sud University, Villejuif, France
| | - Corinne Dupuy
- UMR 8200 CNRS, Gustave Roussy and Paris Sud University, Villejuif, France
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Hu MJ, Zhang C, Liang L, Wang SY, Zheng XC, Zhang Q, Jiang CX, Zhong Q, Huang F. Fasting serum glucose, thyroid-stimulating hormone, and thyroid hormones and risk of papillary thyroid cancer: A case-control study. Head Neck 2019; 41:2277-2284. [PMID: 30759328 DOI: 10.1002/hed.25691] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 12/31/2018] [Accepted: 01/16/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This study was to investigate the association of fasting serum glucose (FSG), thyroid-stimulating hormone (TSH), and thyroid hormones with papillary thyroid cancer (PTC). METHODS A total of 649 participants were included in this case-control study. The associations of FSG, TSH, free triiodothyronine (FT3) and free thyroxine (FT4) with PTC were estimated using an unconditional logistic regression. RESULTS Compared with the lowest quintile of TSH levels, odds ratios (ORs) and 95% confidence intervals (CIs) for association between PTC risk and highest quintile of TSH levels were 1.67 (95% CI, 0.99-2.83). However, this risk correlation was more significant in PTC cases with ≤1.0 cm tumor size (adjusted OR, 1.95; 95% CI, 1.08-3.54; adjusted P-trend, 0.05). The PTC risk was also inversely associated with the serum FT3 level in all participants (adjusted P-trend, 0.001), but positively associated with the serum FT4 (adjusted P-trend, 0.001) and FSG (adjusted P-trend, 0.01) levels. Among the participants without diabetes, the individuals with high FSG levels and abnormal TSH concentration had an increased PTC risk (adjusted OR, 3.38; 95% CI, 1.78-6.42). CONCLUSION The current study provides evidence for the association of FSG, TSH, and thyroid hormones (FT3 and FT4) with PTC risk. However, larger relative studies are needed.
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Affiliation(s)
- Ming-Jun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Ling Liang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Sheng-Ying Wang
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, West Branch of Anhui Provincial Hospital, First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Xu-Cai Zheng
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, West Branch of Anhui Provincial Hospital, First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Qian Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Chun-Xiao Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qi Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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Ramos MS, Echegaray JJ, Kuhn-Asif S, Wilkinson A, Yuan A, Singh AD, Browne AW. Animal models of radiation retinopathy - From teletherapy to brachytherapy. Exp Eye Res 2019; 181:240-251. [PMID: 30716328 DOI: 10.1016/j.exer.2019.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/09/2019] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
Radiation retinopathy is a serious vision-impairing complication of radiation therapy used to treat ocular tumors. Characterized by retinal vasculopathy and subsequent retinal damage, the first sign of radiation retinopathy is the preferential loss of vascular endothelial cells. Ensuing ischemia leads to retinal degradation and late stage neovascularization. Despite the established disease progression, the pathophysiology and cellular mechanisms contributing to radiation retinopathy remain unclear. Clinical experience and basic research for other retinal vasculopathies, such as diabetic retinopathy and retinopathy of prematurity, can inform our understanding of radiation retinopathy; however, the literature investigating the fundamental mechanisms in radiation retinopathy is limited. Treatment trials have shown modest success but, ultimately, fail to address the cellular events that initiate radiation retinopathy. Animal models of radiation retinopathy could provide means to identify effective therapies. Here, we review the literature for all animal models of radiation retinopathy, summarize anatomical highlights pertaining to animal models, identify additional physiological factors to consider when investigating radiation retinopathy, and explore the use of clinically relevant tests for studying in vivo models of radiation retinopathy. We encourage further investigation into the mechanistic characterization of radiation retinopathy in the hope of discovering novel treatments.
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Affiliation(s)
- Michael S Ramos
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Jose J Echegaray
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Sonia Kuhn-Asif
- Animal Eye Center, 2864 Acton Road, Birmingham, AL, 35243, UK
| | - Allan Wilkinson
- Taussig Cancer Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Alex Yuan
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Arun D Singh
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Andrew W Browne
- Gavin Herbert Eye Institute, 850 Health Sciences Road, Irvine, CA, 92697, USA.
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Alqahtani SJM, Welbourn R, Meakin JR, Palfrey RM, Rimes SJ, Thomson K, Knapp KM. Increased radiation dose and projected radiation-related lifetime cancer risk in patients with obesity due to projection radiography. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:38-53. [PMID: 30569898 DOI: 10.1088/1361-6498/aaf1dd] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Primarily to evaluate the radiation dose delivered to patients with obesity in projection radiography and its relationship to the patient's size. A secondary purpose is to estimate the subsequent projected radiation-related lifetime cancer risk to patients with obesity compared to normal-weight patients. METHOD AND MATERIAL Data from 1964 patients from a bariatric clinic in the UK were reviewed with the relevant permission. 630 patients were identified to have a projection radiography history and were included in the study. Patients' dose area product (DAP) data were collected for all projection radiography. Multiple exams in one day including a single DAP reading and exams with no records of DAP and exposure factors were excluded. Correlations were calculated and data analysed to yield the third quartile for each examination using STATA 14. Absorbed doses were generated from PCXMC simulation, utilising DAP data from this study and the UK national diagnostic reference level (NDRL), to calculate the effective risk for patients with obesity compared to patients with normal-weight. RESULTS Patients with obesity received higher DAPs for all examinations included in this study compared to NDRL. Abdominal and lumbar spine radiographs DAPs were the highest (17.6 and 30.31 Gy cm2) compared to the NDRL (2.5 and 4 Gy cm2). Only moderate to low correlations were found between patient's size and DAPs in the abdomen and chest radiographs. The projected radiation-related lifetime cancer risk for patients with obesity is up to 153% higher than for adult patients with normal weight. CONCLUSION Patients with obesity receive higher DAPs than normal-weight adults which may be in excess of that expected due to their size. Therefore, radiation-related lifetime cancer risk is increased in patients with obesity as a result of medical radiation exposures. This indicates more dose optimisation research is needed in this group of patients to reduce dose rate and variation.
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Affiliation(s)
- Saeed J M Alqahtani
- Medical Imaging Department, University of Exeter, Exeter EX1 2LU, United Kingdom. Diagnostic Radiology Department, Najran University, Najran, 61441, Kingdom of Saudi Arabia
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Li P, Zhang A, Liu Y, Xu C, Tang L, Yuan H, Liu Q, Wang X, Feng D, Wang L, Huang G, Song S. Radioactive Iodine Therapy in Patients with Differentiated Thyroid Cancer: Study of External Dose Rate Attenuation Law and Individualized Patient Management. Thyroid 2019; 29:93-100. [PMID: 30351248 DOI: 10.1089/thy.2017.0570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Therapy with radioactive iodine (131I) is a well established treatment method for postsurgical differentiated thyroid carcinoma (DTC). A fixed discharge time is generally set, regardless of individual differences in residual body radioactivity (RBA). This study aimed to investigate the RBA of each patient to find the attenuation law and to identify underlying factors in order to predict the time point for a safe, scientifically sound discharge plan. METHODS A total of 231 DTC patients undergoing 131I treatment were all treated with 3.7 GBq (100 mCi) of 131I. RBA was estimated by measuring the external body dose rate (EDR) at a distance of 1 m from the body surface between 0 and 72 hours after oral administration of 131I. Data from each patient were used to establish a time-EDR value (h-μSv/h) curve. Software was developed to predict the time when a patient's dose equivalent meets the national safety standard by including six time points between 40 and 60 hours. Several factors that might affect that time were analyzed. RESULTS The EDR attenuation law in patients could be described with a double exponential decay model, and the cutoff value was set as 23.3 μSv/h, upon which the predictive software was developed. Student's t-test showed there was no statistical difference between predicted values and the actual measured values (p > 0.05). Correlation analysis found that serum thyroglobulin, total triiodothyronine, total thyroxine, free triiodothyronine, free thyroxine, thyrotropin, 2- and 24-hour iodine uptake rate of the thyroid, scores of 99mTc-pertechnetate thyroid scan, scores of 131I whole-body scan, scores of ultrasound scan, and gastrointestinal residues were associated with attenuation speed. A further multiple linear regression analysis found that 24-hour iodine uptake (X1), residual thyroid grading by 131I whole-body scan (X2), blood free triiodothyronine (X3) and free thyroxine (X4) predominantly influenced the decline of the EDR. The regression equation was Ŷ = 2.091X1 + 6.370X2 + 4.529X3 + 2.466X4 - 8.614 (F = 44.03, p < 0.01). CONCLUSIONS An effective and convenient method was created to measure and predict the individual safety time for discharge. This could play a significant role not only for scientific hospital discharge planning, rational use of medical resources, and better individualized management, but also in public radiation protection.
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Affiliation(s)
- Panli Li
- 1 Department of Nuclear Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 2 Institute of Clinical Nuclear Medicine; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 3 SJTU-USYD Joint Research Alliance for Translational Medicine; Shanghai, P.R. China
| | - Aimi Zhang
- 1 Department of Nuclear Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 2 Institute of Clinical Nuclear Medicine; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Ye Liu
- 4 Department of Automation; Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Chunyuan Xu
- 4 Department of Automation; Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Linglin Tang
- 1 Department of Nuclear Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 2 Institute of Clinical Nuclear Medicine; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Hong Yuan
- 1 Department of Nuclear Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 2 Institute of Clinical Nuclear Medicine; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Qiufang Liu
- 1 Department of Nuclear Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 2 Institute of Clinical Nuclear Medicine; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 3 SJTU-USYD Joint Research Alliance for Translational Medicine; Shanghai, P.R. China
| | - Xiuying Wang
- 3 SJTU-USYD Joint Research Alliance for Translational Medicine; Shanghai, P.R. China
- 5 Biomedical and Multimedia Information Technology Research Group, School of Information Technologies, University of Sydney, Sydney, Australia
| | - Dagan Feng
- 3 SJTU-USYD Joint Research Alliance for Translational Medicine; Shanghai, P.R. China
- 5 Biomedical and Multimedia Information Technology Research Group, School of Information Technologies, University of Sydney, Sydney, Australia
| | - Lisheng Wang
- 3 SJTU-USYD Joint Research Alliance for Translational Medicine; Shanghai, P.R. China
- 4 Department of Automation; Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Gang Huang
- 1 Department of Nuclear Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 2 Institute of Clinical Nuclear Medicine; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 3 SJTU-USYD Joint Research Alliance for Translational Medicine; Shanghai, P.R. China
- 6 Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, P.R. China
| | - Shaoli Song
- 1 Department of Nuclear Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 2 Institute of Clinical Nuclear Medicine; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
- 3 SJTU-USYD Joint Research Alliance for Translational Medicine; Shanghai, P.R. China
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Bolf EL, Sprague BL, Carr FE. A Linkage Between Thyroid and Breast Cancer: A Common Etiology? Cancer Epidemiol Biomarkers Prev 2018; 28:643-649. [PMID: 30541751 DOI: 10.1158/1055-9965.epi-18-0877] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/11/2018] [Accepted: 12/07/2018] [Indexed: 01/06/2023] Open
Abstract
Breast and thyroid cancers are two malignancies with highest incidence in women. These cancers often occur metachronously. Women with thyroid cancer are at increased risk for subsequent breast cancer; women with breast cancer have an increased incidence of later development of thyroid cancer, suggesting a common etiology. This bidirectional relationship is reported worldwide; however, the underlying reasons for this co-occurrence are unknown. In this review, we summarize the current epidemiologic evidence and putative mechanisms of these metachronous or synchronous cancers. Key potential causative factors are chemotherapy and radiotherapy of the primary tumor, genetic variants linking the two diseases, hormonal signaling both from the thyroid gland and from estrogens, and lifestyle and environmental factors. There is a critical need for additional epidemiologic studies focused on gender and regional incidence together with molecular investigations on common tumorigenic pathways in these endocrine cancers. Understanding the putative mechanisms will aid in the diagnosis and clinical management of both diseases.
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Affiliation(s)
- Eric L Bolf
- Department of Pharmacology, Larner College of Medicine, University of Vermont, Burlington, Vermont.,University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Brian L Sprague
- University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, Vermont.,Department of Biochemistry, Larner College of Medicine, University of Vermont, Burlington, Vermont.,Department of Surgery, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Frances E Carr
- Department of Pharmacology, Larner College of Medicine, University of Vermont, Burlington, Vermont. .,University of Vermont Cancer Center, Larner College of Medicine, University of Vermont, Burlington, Vermont
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Standardization of Radiologic Procedures for Pediatric Videofluoroscopic Swallow Studies: A Service-based Quality Improvement Initiative. Pediatr Qual Saf 2018; 3:e123. [PMID: 31334455 PMCID: PMC6581479 DOI: 10.1097/pq9.0000000000000123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/11/2018] [Indexed: 01/29/2023] Open
Abstract
Introduction The videofluoroscopic swallow study (VFSS) remains the primary method to evaluate swallowing function in infants and children. However, limited standards exist to guide the image acquisition during pediatric VFSSs, leading to inadequate images, variable assessment quality, and potential for suboptimal diagnostic accuracy. The goal of this quality improvement project was to standardize the radiological procedure for radiologists at our institution. Methods A multidisciplinary team of project leaders established 3 imaging standards to target (magnification, the field of view, and pulse repetition rate), based on the best available evidence. The team used the Institute for Healthcare Improvement's Model for Improvement to guide the project, identified key drivers, and implemented specific interventions. Project leaders observed a total of 170 VFSS examinations, performed by radiology faculty, fellows, and residents over 24 months. The primary outcome for this project was physician compliance with 3 established imaging standards: field of view, magnification, and pulse repetition rate. Project leaders collected data without the radiologists' knowledge, and also recorded average radiation exposure as a balancing measure during this process. Results At baseline, compliance with all 3 criteria was 20%. Following interventions designed to improve radiologist performance with the 3 identified standards, the compliance rate reached 100% for the last 50 recorded VFSSs. During this same time, there was no meaningful increase in average radiation exposure compared with the 6 months before the implementation of this project. Conclusions Compliance with standardized image acquisition of VFSSs can be accomplished using a systematic quality improvement protocol targeting simple, inexpensive interventions.
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Luo J, Deziel NC, Huang H, Chen Y, Ni X, Ma S, Udelsman R, Zhang Y. Cell phone use and risk of thyroid cancer: a population-based case-control study in Connecticut. Ann Epidemiol 2018; 29:39-45. [PMID: 30446214 DOI: 10.1016/j.annepidem.2018.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/11/2018] [Accepted: 10/20/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE This study aims to investigate the association between cell phone use and thyroid cancer. METHODS A population-based case-control study was conducted in Connecticut between 2010 and 2011 including 462 histologically confirmed thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between cell phone use and thyroid cancer. RESULTS Cell phone use was not associated with thyroid cancer (OR: 1.05, 95% CI: 0.74-1.48). A suggestive increase in risk of thyroid microcarcinoma (tumor size ≤10 mm) was observed for long-term and more frequent users. Compared with cell phone nonusers, several groups had nonstatistically significantly increased risk of thyroid microcarcinoma: individuals who had used a cell phone >15 years (OR: 1.29, 95% CI: 0.83-2.00), who had used a cell phone >2 hours per day (OR: 1.40, 95% CI: 0.83-2.35), who had the most cumulative use hours (OR: 1.58, 95% CI: 0.98-2.54), and who had the most cumulative calls (OR: 1.20, 95% CI: 0.78-1.84). CONCLUSIONS This study found no significant association between cell phone use and thyroid cancer. A suggestive elevated risk of thyroid microcarcinoma associated with long-term and more frequent uses warrants further investigation.
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Affiliation(s)
- Jiajun Luo
- Department of Surgery, Yale School of Medicine, New Haven, CT
| | - Nicole C Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT
| | - Huang Huang
- Department of Surgery, Yale School of Medicine, New Haven, CT
| | - Yingtai Chen
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Ni
- Department of Otorhinolaryngology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, CT
| | - Robert Udelsman
- Endocrine Neoplasm Institute, Miami Cancer Institute, Miami, FL
| | - Yawei Zhang
- Department of Surgery, Yale School of Medicine, New Haven, CT; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT.
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ZNF703 is Overexpressed in Papillary Thyroid Carcinoma Tissues and Mediates K1 Cell Proliferation. Pathol Oncol Res 2018; 26:355-364. [DOI: 10.1007/s12253-018-0494-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 10/10/2018] [Indexed: 12/11/2022]
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70
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Aravindan KP. Papillary thyroid cancer: Why the increase and what can be done? Indian J Cancer 2018; 54:491-492. [PMID: 29798944 DOI: 10.4103/ijc.ijc_221_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- K P Aravindan
- Professor (Retired), Government Medical College, Kozhikode, Kerala, India
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71
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Hu MJ, Zhang Q, Liang L, Wang SY, Zheng XC, Zhou MM, Yang YW, Zhong Q, Huang F. Association between vitamin D deficiency and risk of thyroid cancer: a case-control study and a meta-analysis. J Endocrinol Invest 2018; 41:1199-1210. [PMID: 29464660 DOI: 10.1007/s40618-018-0853-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 02/13/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Although vitamin D is reportedly associated with various cancers, the association between vitamin D and thyroid cancer is indefinite. We aimed to investigate whether this association applies to thyroid cancer (TC). METHODS A total of 276 Chinese Han people were recruited in a current matched case-control study. Multivariable conditional logistic regression was computed to estimate the association between plasma 25(OH)D and papillary thyroid cancer (PTC). In addition, we searched relevant studies in PubMed and Web of Science databases before December 2017 to conduct a meta-analysis. RESULTS In our case-control study, plasma 25(OH)D concentration was inversely associated with PTC risk (highest tertile vs lowest tertile: adjusted OR = 0.25; 95% CI 0.10, 0.61; Ptrend = 0.003). This association was independent of body mass index and physical activity (all adjusted Pinteraction > 0.05). A total of 11 studies were included in the meta-analysis, among which ten studies have been published and one was our case-control study. Compared with 25(OH)D non-deficient group, the pooled OR of TC was 1.42 (95% CI 1.17, 1.73) in the deficient group. Similarly, blood 25(OH)D levels in patients with TC were tend to be lower than those in the controls (SMD = - 0.20, 95% CI - 0.36, - 0.03). CONCLUSIONS A high level of circulating 25(OH)D was associated with a decreased TC risk. This association has important significance in public health and should, therefore, be further studied.
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Affiliation(s)
- M-J Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Q Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - L Liang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - S-Y Wang
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, No. 107 East Lake Road, Hefei, 230032, Anhui, People's Republic of China
| | - X-C Zheng
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, No. 107 East Lake Road, Hefei, 230032, Anhui, People's Republic of China
| | - M-M Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Y-W Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Q Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - F Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China.
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Polednik KM, Simpson MC, Adjei Boakye E, Mohammed KA, J Dombrowski J, Varvares MA, Osazuwa-Peters N. Radiation and Second Primary Thyroid Cancer Following Index Head and Neck Cancer. Laryngoscope 2018; 129:1014-1020. [PMID: 30208210 DOI: 10.1002/lary.27467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES/HYPOTHESIS Radiation is thought to increase risk of developing second primary thyroid cancer (SPTC). This study estimated the rate of SPTC following index head and neck cancer (HNC) and determined whether radiation treatment among HNC survivors increased SPTC risk. STUDY DESIGN Retrospective data analysis. METHOD The Surveillance, Epidemiology, and End Results database (1975-2014) was queried for cases of index HNC (N = 127,563) that developed SPTC. Adjusted multivariable competing risk proportional hazards model tested risk of developing a SPTC following index HNC. Sensitivity analyses using proportional hazards models were also performed restricting data to patients who 1) received both radiation and chemotherapy and 2) radiation alone. RESULTS Only 0.2% of index HNC survivors (n = 229) developed SPTC, yielding a rate of 26.1 per 100,000 person-years. For every increasing year of age at diagnosis, patients were 3% less likely to develop an SPTC (adjusted hazard ratio [aHR] = 0.97, 95% CI: 0.96-0.98). Males were also less likely to develop an SPTC (aHR = 0.73, 95% CI: 0.55-0.96). Radiation (aHR = 0.92, 95% CI: 0.68-1.25), surgery (aHR = 0.79, 95% CI: 0.56-1.11), and chemotherapy (aHR = 1.13, 95% CI: 0.76-1.69) were not significantly associated with developing SPTC. The sensitivity models also did not find an association between treatment and risk of SPTC. CONCLUSIONS Rate of developing SPTC following index HNC was very low, and previous exposure to radiation did not significantly increase risk in our study population. More studies are needed to understand the increasing incidence of thyroid cancer across the United States. LEVEL OF EVIDENCE NA Laryngoscope, 129:1014-1020, 2019.
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Affiliation(s)
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Eric Adjei Boakye
- Center for Health Outcomes Research, Saint Louis University, St. Louis, Missouri
| | - Kahee A Mohammed
- Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri.,Center for Health Outcomes Research, Saint Louis University, St. Louis, Missouri
| | - John J Dombrowski
- Department of Radiation Oncology, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Mark A Varvares
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Nosayaba Osazuwa-Peters
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri.,Saint Louis University Cancer Center, St. Louis, Missouri.,Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, U.S.A
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Pyka M, Eschle P, Sommer C, Weyland MS, Kubik R, Scheidegger S. Effect of thyroid shielding during mammography: measurements on phantom and patient as well as estimation with Monte Carlo simulation. Eur Radiol Exp 2018; 2:14. [PMID: 29984353 PMCID: PMC6022527 DOI: 10.1186/s41747-018-0042-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/19/2018] [Indexed: 11/15/2022] Open
Abstract
Background During mammography, the thyroid is exposed to scattered radiation from breast tissue and the device. This may increase the risk of radiation induced thyroid cancer. Methods We investigated the scatter radiation exposition of the thyroid and the effect of a tailored thyroid protection in phantom and patient as well as by using Monte Carlo simulation (MCS). The protective effect of a modified thyroid protection, the relevance of the protective effect and acceptance by patients have been investigated. Results Phantom and patient measurements provided higher values for the surface dose at thyroid position than expected from MCS (phantom 0.32 mGy; patients 0.38 mGy; MCS 0.16 mGy). Phantom measurements indicated scatter contributions from both breast tissue and collimator/tube system. The value found in our patient study is within the range of the literature (0.22–0.39 mGy). The thyroid protection significantly reduced the surface dose but the dose (0.016 mGy) was higher than that expected from the lead equivalent value. However, the impact of the collar to the effective dose was small (< 4%). The collar was not visible on mammograms. Conclusions Scatter from the collimator/tube system contributed with 50% to the thyroid dose. Due to the relative small fraction of dose deposited in the thyroid when compared to the mean glandular dose to the breast, a collar is not mandatory in general. Not being associated with the risk of obscuring parts of mammograms, such a collar may be used for young women considering their higher radio sensitivity.
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Affiliation(s)
- Miriam Pyka
- 1Department of Medical Services, Institute of Radiology, Kantonsspital Baden, Baden, Switzerland
| | - Patrik Eschle
- 2Zurich University of Applied Science, ZHAW School of Engineering, Winterthur, Switzerland
| | - Christian Sommer
- 2Zurich University of Applied Science, ZHAW School of Engineering, Winterthur, Switzerland
| | - Mathias S Weyland
- 2Zurich University of Applied Science, ZHAW School of Engineering, Winterthur, Switzerland
| | - Rahel Kubik
- 1Department of Medical Services, Institute of Radiology, Kantonsspital Baden, Baden, Switzerland
| | - Stephan Scheidegger
- 2Zurich University of Applied Science, ZHAW School of Engineering, Winterthur, Switzerland
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Jang JH, Park SH, Cho KS, Cho WK, Suh YJ, Suh BK, Koh DK. Cancer in thyroid nodules with fine-needle aspiration in Korean pediatric populations. Ann Pediatr Endocrinol Metab 2018; 23:94-98. [PMID: 29969881 PMCID: PMC6057015 DOI: 10.6065/apem.2018.23.2.94] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/15/2017] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To determine the prevalence and clinical findings of benign thyroid nodules and cancer in Korean pediatric patients with thyroid nodules. METHODS We investigated the medical records of 134 patients aged younger than 18 years who had a goiter, thyroid nodule, thyroid mass, or thyroid cancer who underwent fine needle aspiration biopsy (FNAB). RESULTS The study population included 113 females (84.3%) and 21 males (13.7%); the mean patient age was 16.1±2.3 years (range, 8-18 years). Of the 134 patients, 24 (18.0%) were finally diagnosed with thyroid cancer, of which 20 (83.3%) were papillary cancer and 4 (16.7%) were follicular cancer. No patient was exposed to radiation. FNAB revealed malignant cancer in 21 of the patients; 3 were initially reported as having benign tumors by FNAB, but were later diagnosed with follicular cancer. An additional 13 patients were suspected to have malignant tumors by FNAB, with a final diagnosis of nodular hyperplasia. Cystic nodules were more common in the benign group. The percentages of cervical lymphadenopathy and irregular nodular margins were higher in the malignant group compared to the benign group. Cervical lymphadenopathy and FNAB malignant findings were highly suggestive of malignant nodules. CONCLUSION Thyroid cancer prevalence in a Korean pediatric population is comparable to reported estimates of worldwide thyroid cancer prevalence. In this population, cancer predominates on the right thyroid lobe. Papillary thyroid cancers are dominant in the Korean pediatric population but are less prevalent than in Korean adults. As expected, FNAB was highly accurate in predicting malignant nodules.
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Affiliation(s)
- Joon Ho Jang
- Department of Pediatrics, St. Vincent’s Hospital, The Catholic University of Korea, Korea
| | - So Hyun Park
- Central Children’s Hospital, Hwasung, Korea,Address for correspondence: So Hyun Park, MD Central Children’s Hospital, 17 Dongtan-jisung-ro, Hwasung 18454, Korea Tel: +82-31-249-8220 Fax: +82-31-8060-5044 E-mail:
| | - Kyung soon Cho
- Department of Pediatrics, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Bucheon, Korea
| | - Won Kyung Cho
- Department of Pediatrics, St. Vincent’s Hospital, The Catholic University of Korea, Korea
| | - Young Jin Suh
- Department of Surgery, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
| | - Byung Kyu Suh
- Department of Pediatrics, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Dae Kyun Koh
- Department of Pediatrics, St. Vincent’s Hospital, The Catholic University of Korea, Korea
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75
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Marcu M, Hedesiu M, Salmon B, Pauwels R, Stratis A, Oenning ACC, Cohen ME, Jacobs R, Baciut M, Roman R, Dinu C, Rotaru H, Barbur I. Estimation of the radiation dose for pediatric CBCT indications: a prospective study on ProMax3D. Int J Paediatr Dent 2018; 28:300-309. [PMID: 29356184 DOI: 10.1111/ipd.12355] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND An increasing number of CBCT units and a wide variability of radiation doses have been reported in dentistry lately. AIM To estimate the effective, cumulative, and organ absorbed doses in children exposed to CBCT over 2 years. DESIGN A prospective study was conducted in children who underwent CBCT diagnostic imaging with the ProMax3D machine. Organ and effective doses were calculated by Monte Carlo simulation using 5- and 8-year-old pediatric voxel phantoms. Extrapolation procedures were applied to estimate doses for other ages and CBCT protocols used in clinical conditions. RESULTS The median effective dose was 137.9 μSv, and the median cumulative dose was 231.4 μSv. Statistically significant differences in the effective doses and cumulative doses were found for various indications of CBCT in children (P < 0.001). The median absorbed organ dose for brain and thyroid was significantly higher for the clinical condition that required large FOVs (2.5 mGy and 1.05 mGy, respectively) compared to medium (0.19 and 0.51 mGy) and small FOVs (0.07 and 0.24 mGy; P < 0.05). The radiation dose of salivary glands did not vary significantly with FOV. CONCLUSION The results revealed the variation of CBCT doses and the influence of FOV size in pediatric exposure.
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Affiliation(s)
- Maria Marcu
- Department of Oral Radiology, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Oral Radiology, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Benjamin Salmon
- EA 2496-Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris Descartes University - Sorbonne Paris Cité, Paris, France
| | - Ruben Pauwels
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Andreas Stratis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anne Caroline Costa Oenning
- EA 2496-Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris Descartes University - Sorbonne Paris Cité, Paris, France.,Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (Unicamp), Piracicaba, Sao Paulo, Brazil
| | - Mike E Cohen
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mihaela Baciut
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Roman
- Department of Oral Radiology, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotaru
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Barbur
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
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76
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Shulan JM, Vydro L, Schneider AB, Mihailescu DV. Role of biomarkers in predicting the occurrence of thyroid neoplasms in radiation-exposed children. Endocr Relat Cancer 2018; 25:481-491. [PMID: 29453230 DOI: 10.1530/erc-17-0408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/14/2018] [Indexed: 01/08/2023]
Abstract
With increasing numbers of childhood cancer survivors who were treated with radiation, there is a need to evaluate potential biomarkers that could signal an increased risk of developing thyroid cancer. We aimed to examine the relationships between thyrotropin and thyroglobulin levels and the risk of developing thyroid nodules and cancer in a cohort of radiation-exposed children. 764 subjects who were irradiated in the neck area as children were examined and followed for up to 25 years. All subjects underwent a clinical examination, measurements of thyrotropin, thyroglobulin levels and thyroid imaging. At baseline, 216 subjects had thyroid nodules and 548 did not. Of those with nodules, 176 underwent surgery with 55 confirmed thyroid cancers. During the follow-up, 147 subjects developed thyroid nodules including 22 with thyroid cancer. Thyroglobulin levels were higher in subjects with prevalent thyroid nodules (26.1 ng/mL vs 9.37 ng/mL; P < 0.001) and in those who had an initial normal examination but later developed thyroid nodules (11.2 ng/mL vs 8.87 ng/mL; P = 0.017). There was no relationship between baseline thyrotropin levels and the prevalent presence or absence of thyroid nodules, whether a prevalent neoplasm was benign or malignant, subsequent development of thyroid nodules during follow-up or whether an incident nodule was benign or malignant. In conclusion, in radiation-exposed children, higher thyroglobulin levels indicated an increased risk of developing thyroid nodules but did not differentiate between benign and malignant neoplasms. There was no association between the baseline TSH level and the risk of developing thyroid nodules or cancer.
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Affiliation(s)
| | | | | | - Dan V Mihailescu
- Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, Illinois, USA
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77
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Dossus L, Franceschi S, Biessy C, Navionis AS, Travis RC, Weiderpass E, Scalbert A, Romieu I, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Bonnet F, Fournier A, Fortner RT, Kaaks R, Aleksandrova K, Trichopoulou A, La Vecchia C, Peppa E, Tumino R, Panico S, Palli D, Agnoli C, Vineis P, Bueno-de-Mesquita HBA, Peeters PH, Skeie G, Zamora-Ros R, Chirlaque MD, Ardanaz E, Sánchez MJ, Ramón Quirós J, Dorronsoro M, Sandström M, Nilsson LM, Schmidt JA, Khaw KT, Tsilidis KK, Aune D, Riboli E, Rinaldi S. Adipokines and inflammation markers and risk of differentiated thyroid carcinoma: The EPIC study. Int J Cancer 2018; 142:1332-1342. [PMID: 29168186 DOI: 10.1002/ijc.31172] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/23/2017] [Accepted: 11/03/2017] [Indexed: 01/13/2023]
Abstract
Other than the influence of ionizing radiation and benign thyroid disease, little is known about the risk factors for differentiated thyroid cancer (TC) which is an increasing common cancer worldwide. Consistent evidence shows that body mass is positively associated with TC risk. As excess weight is a state of chronic inflammation, we investigated the relationship between concentrations of leptin, adiponectin, C-reactive protein, interleukin (IL)-6, IL-10 and tumor necrosis factor (TNF)-α and the risk of TC. A case-control study was nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study and included 475 first primary incident TC cases (399 women and 76 men) and 1,016 matched cancer-free cohort participants. Biomarkers were measured in serum samples using validated and highly sensitive commercially available immunoassays. Odds ratios (ORs) of TC by levels of each biomarker were estimated using conditional logistic regression models, adjusting for BMI and alcohol consumption. Adiponectin was inversely associated with TC risk among women (ORT3vs.T1 = 0.69, 95% CI: 0.49-0.98, Ptrend = 0.04) but not among men (ORT3vs.T1 = 1.36, 95% CI: 0.67-2.76, Ptrend = 0.37). Increasing levels of IL-10 were positively associated with TC risk in both genders and significantly so in women (ORT3vs.T1 = 1.59, 95% CI: 1.13-2.25, Ptrend = 0.01) but not in men (ORT3vs.T1 = 1.78, 95% CI: 0.80-3.98, Ptrend = 0.17). Leptin, CRP, IL-6 and TNF-α were not associated with TC risk in either gender. These results indicate a positive association of TC risk with IL-10 and a negative association with adiponectin that is probably restricted to women. Inflammation may play a role in TC in combination with or independently of excess weight.
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Affiliation(s)
- Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Silvia Franceschi
- Infections Section, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Anne-Sophie Navionis
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Augustin Scalbert
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Hubert Department of Global Health, Emory University, Atlanta, GA
| | | | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Marie-Christine Boutron-Ruault
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, France
- Gustave Roussy, Villejuif, France
| | - Fabrice Bonnet
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, France
- Gustave Roussy, Villejuif, France
- Department of Endocrinology, Rennes University Hospital (CHU), Rennes, France
- Rennes 1 University, Rennes, France
| | - Agnès Fournier
- CESP, INSERM U1018, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif Cedex, France
- Gustave Roussy, Villejuif, France
| | - Renee T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | | | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | | | - Rosario Tumino
- Cancer Registry and Histopathology Department, "Civic-M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Italian Institute for Genomic Medicine (IIGM), Torino, Italy
| | - H B As Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia
| | - Petra H Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Maria-Jose Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria (ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | | | - Miren Dorronsoro
- Basque Regional Health Department, Public Health Direction and Biodonostia Research Institute CIBERESP, San Sebastian, Spain
| | - Maria Sandström
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Lena Maria Nilsson
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Kay-Tee Khaw
- Cancer Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Bjørknes University College, Oslo, Norway
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Sabina Rinaldi
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
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78
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Britel M, Bourguignon M, Foray N. The use of the term 'radiosensitivity' through history of radiation: from clarity to confusion. Int J Radiat Biol 2018. [PMID: 29533136 DOI: 10.1080/09553002.2018.1450535] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSES The term 'radiosensitivity' appeared for the first time at the beginning of the 20th century, few years after the discovery of X-rays. Initially used by French and German radiologists, it illustrated the risk of radiation-induced (RI) skin reactions. From the 1950s, 'radiosensitivity' was progressively found to describe other features of RI response such as RI cancers or cataracts. To date, such confusion may raise legal issues and complexify the message addressed to general public. Here, through an historical review, we aimed to better understand how this confusion appeared. METHODS To support our historical review, a quantitative and qualitative wording analysis of the 'radiosensitivity' occurrences and its derived terms was performed with Google books, Pubmed, Web of Science™ databases, and in all the ICRP publications. CONCLUSIONS While 'radiosensitivity' was historically related to RI adverse tissue events attributable to cell death, the first efforts to quantify the RI risk specific to each organ/tissue revealed some different semantic fields that are not necessarily compatible together (e.g. adverse tissue events for skin, cataracts for eyes, RI cancer for breast or thyroid). To avoid such confusion, we propose to keep the historical definition of 'radiosensitivity' to any clinical and cellular consequences of radiation attributable to cell death and to introduce the term 'radiosusceptibility' to describe the RI cancers or any feature that is attributable to cell transformation.
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Affiliation(s)
- Manon Britel
- a Institut National de la Santé et de la Recherche Médicale (INSERM), UMR1052, Centre de Recherches en Cancérologie de Lyon , Lyon , France
| | - Michel Bourguignon
- b Institut de Radioprotection et Sûreté Nucléaire (IRSN) , Fontenay aux Roses , France
| | - Nicolas Foray
- a Institut National de la Santé et de la Recherche Médicale (INSERM), UMR1052, Centre de Recherches en Cancérologie de Lyon , Lyon , France
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79
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Yahyapour R, Amini P, Rezapour S, Cheki M, Rezaeyan A, Farhood B, Shabeeb D, Musa AE, Fallah H, Najafi M. Radiation-induced inflammation and autoimmune diseases. Mil Med Res 2018; 5:9. [PMID: 29554942 PMCID: PMC5859747 DOI: 10.1186/s40779-018-0156-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 03/02/2018] [Indexed: 12/22/2022] Open
Abstract
Currently, ionizing radiation (IR) plays a key role in the agricultural and medical industry, while accidental exposure resulting from leakage of radioactive sources or radiological terrorism is a serious concern. Exposure to IR has various detrimental effects on normal tissues. Although an increased risk of carcinogenesis is the best-known long-term consequence of IR, evidence has shown that other diseases, particularly diseases related to inflammation, are common disorders among irradiated people. Autoimmune disorders are among the various types of immune diseases that have been investigated among exposed people. Thyroid diseases and diabetes are two autoimmune diseases potentially induced by IR. However, the precise mechanisms of IR-induced thyroid diseases and diabetes remain to be elucidated, and several studies have shown that chronic increased levels of inflammatory cytokines after exposure play a pivotal role. Thus, cytokines, including interleukin-1(IL-1), tumor necrosis factor (TNF-α) and interferon gamma (IFN-γ), play a key role in chronic oxidative damage following exposure to IR. Additionally, these cytokines change the secretion of insulin and thyroid-stimulating hormone(TSH). It is likely that the management of inflammation and oxidative damage is one of the best strategies for the amelioration of these diseases after a radiological or nuclear disaster. In the present study, we reviewed the evidence of radiation-induced diabetes and thyroid diseases, as well as the potential roles of inflammatory responses. In addition, we proposed that the mitigation of inflammatory and oxidative damage markers after exposure to IR may reduce the incidence of these diseases among individuals exposed to radiation.
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Affiliation(s)
- Rasoul Yahyapour
- School of Medicine, Jiroft University of Medical Sciences, Jiroft, Zip code: 8813833435, Iran
| | - Peyman Amini
- Department of Radiology, Faculty of Paramedical, Tehran University of Medical Sciences, Tehran, Zip code: 1417613151, Iran
| | - Saeed Rezapour
- Department of Radiology, Faculty of Paramedical, Tehran University of Medical Sciences, Tehran, Zip code: 1417613151, Iran
| | - Mohsen Cheki
- Department of Radiologic Technology, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Zip code: 6135715794, Iran
| | - Abolhasan Rezaeyan
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Zip code: 1449614535, Iran
| | - Bagher Farhood
- Departments of Medical Physics and Radiology, Faculty of Paramedical Sciences, Kashan University of Medical Sciences, Kashan, Zip code: 3715835155, Iran
| | - Dheyauldeen Shabeeb
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences (International Campus), Tehran, Zip code: 1417613151, Iran.,Department of Physiology, College of Medicine, University of Misan, Misan, Iraq
| | - Ahmed Eleojo Musa
- Research center for molecular and cellular imaging, Tehran University of Medical Sciences, Tehran, Zip code: 1417613151, Iran
| | - Hengameh Fallah
- Department of Chemistry, Faculty of Science, Islamic Azad University, Arak, Zip code: 3836119131, Iran
| | - Masoud Najafi
- Radiology and Nuclear Medicine Department, School of Paramedical Sciences, Kermanshah University of Medical Science, Kermanshah, Zip code: 6714869914, Iran.
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80
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Chen F, Jin Y, Feng L, Zhang J, Tai J, Shi J, Yu Y, Lu J, Wang S, Li X, Chu P, Han S, Cheng S, Guo Y, Ni X. RRS1 gene expression involved in the progression of papillary thyroid carcinoma. Cancer Cell Int 2018; 18:20. [PMID: 29449788 PMCID: PMC5812111 DOI: 10.1186/s12935-018-0519-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/03/2018] [Indexed: 11/15/2022] Open
Abstract
Background Papillary thyroid carcinoma (PTC) is one of the most frequent malignancies of the endocrine system, whose mechanisms of pathogenesis, progression and prognosis are still far from being clearly elucidated. Despite an increasing body of evidences highlights ribosome biogenesis regulator homolog (RRS1) as a ribosome biogenesis protein in yeast and plants, little is known about human RRS1 function. Methods Proliferation, cell cycle and apoptosis of PTC cells were assessed following the knockdown of RRS1 expression though MTT, colony formation assay, and flow cytometry. Then, transcriptome profiling was conducted to explore pathway changes after RRS1 silencing in PTC cells. Receiver operating characteristic curve and Youden’s index were performed in twenty-four thyroid carcinoma samples to assess their potential clinical diagnostic value. Results Firstly, we found that silencing RRS1 significantly reduced cell proliferation, inhibited cell cycle, and promoted apoptosis in PTC cell line. The result also showed that knock-down of RRS1 could up-regulate genes involving apoptosis and metabolism, while, down-regulate genes relative to cell proliferation and blood vessel development. Notably, the present study confirmed the diagnostic value of RRS1 for thyroid carcinoma in both children and adults. Conclusions In conclusion, these data afford a comprehensive view of a novel function of human RRS1 by promoting cell proliferation and could be a potential indicator for papillary thyroid carcinoma. Electronic supplementary material The online version of this article (10.1186/s12935-018-0519-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Feng Chen
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,2Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Rd., Beijing, 100045 China
| | - Yaqiong Jin
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,3Biobank for Clinical Data and Samples in Pediatric, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lin Feng
- 4State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, Peking Union Medical College and Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, China
| | - Jie Zhang
- 2Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Rd., Beijing, 100045 China
| | - Jun Tai
- 2Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Rd., Beijing, 100045 China
| | - Jin Shi
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,2Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Rd., Beijing, 100045 China
| | - Yongbo Yu
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,3Biobank for Clinical Data and Samples in Pediatric, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jie Lu
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,3Biobank for Clinical Data and Samples in Pediatric, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shengcai Wang
- 2Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Rd., Beijing, 100045 China
| | - Xin Li
- 5Department of Biochemistry and Molecular Biology, Peking University Health Science Center, Beijing, China
| | - Ping Chu
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,3Biobank for Clinical Data and Samples in Pediatric, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shujing Han
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,3Biobank for Clinical Data and Samples in Pediatric, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shujun Cheng
- 4State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, Peking Union Medical College and Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, China
| | - Yongli Guo
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,3Biobank for Clinical Data and Samples in Pediatric, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Ni
- 1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.,2Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Rd., Beijing, 100045 China.,3Biobank for Clinical Data and Samples in Pediatric, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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81
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Sanabria A, Kowalski LP, Shah JP, Nixon IJ, Angelos P, Williams MD, Rinaldo A, Ferlito A. Growing incidence of thyroid carcinoma in recent years: Factors underlying overdiagnosis. Head Neck 2017; 40:855-866. [PMID: 29206325 DOI: 10.1002/hed.25029] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/24/2017] [Accepted: 10/25/2017] [Indexed: 01/03/2023] Open
Abstract
There is an increasing incidence of well-differentiated thyroid cancer worldwide. Much of the increase is secondary to increased detection of small, low-risk tumors, with questionable clinical significance. This review addresses the factors that contribute to the increasing incidence and considers environmental, and patient-based and clinician-led influences. Articles addressing the causes of the increased incidence were critically reviewed. A complex interplay of environmental, medical, and social pressures has resulted in increased awareness of the thyroid disease risk, increased screening of thyroid cancers, and increased diagnosis of thyroid cancers. Although there is evidence to suggest that the true disease incidence may be changing slightly, most of the increase is related to factors that promote early diagnosis of low-risk lesions, which is resulting in a significant phenomenon of overdiagnosis. An improved understanding of these pressures at a global level will enable healthcare policymakers to react appropriately to this challenge in the future.
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Affiliation(s)
- Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia, Clinica Vida/Instituto de Cancerología Las Americas, Medellin, Colombia, South America
| | - Luiz P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, SP, Brazil
| | - Jatin P Shah
- Department of Head and Neck Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Peter Angelos
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Michelle D Williams
- Department of Pathology, Division of Pathology/Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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82
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Chang LA, Miller DL, Lee C, Melo DR, Villoing D, Drozdovitch V, Thierry-Chef I, Winters SJ, Labrake M, Myers CF, Lim H, Kitahara CM, Linet MS, Simon SL. Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930-2010. HEALTH PHYSICS 2017; 113:458-473. [PMID: 28968349 PMCID: PMC5677542 DOI: 10.1097/hp.0000000000000723] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study summarizes and compares estimates of radiation absorbed dose to the thyroid gland for typical patients who underwent diagnostic radiology examinations in the years from 1930 to 2010. The authors estimated the thyroid dose for common examinations, including radiography, mammography, dental radiography, fluoroscopy, nuclear medicine, and computed tomography (CT). For the most part, a clear downward trend in thyroid dose over time for each procedure was observed. Historically, the highest thyroid doses came from the nuclear medicine thyroid scans in the 1960s (630 mGy), full-mouth series dental radiography (390 mGy) in the early years of the use of x rays in dentistry (1930s), and the barium swallow (esophagram) fluoroscopic exam also in the 1930s (140 mGy). Thyroid uptake nuclear medicine examinations and pancreatic scans also gave relatively high doses to the thyroid (64 mGy and 21 mGy, respectively, in the 1960s). In the 21st century, the highest thyroid doses still result from nuclear medicine thyroid scans (130 mGy), but high thyroid doses are also associated with chest/abdomen/pelvis CT scans (18 and 19 mGy for males and females, respectively). Thyroid doses from CT scans did not exhibit the same downward trend as observed for other examinations. The largest thyroid doses from conventional radiography came from cervical spine and skull examinations. Thyroid doses from mammography (which began in the 1960s) were generally a fraction of 1 mGy. The highest average doses to the thyroid from mammography were about 0.42 mGy, with modestly larger doses associated with imaging of breasts with large compressed thicknesses. Thyroid doses from dental radiographic procedures have decreased markedly throughout the decades, from an average of 390 mGy for a full-mouth series in the 1930s to an average of 0.31 mGy today. Upper GI series fluoroscopy examinations resulted in up to two orders of magnitude lower thyroid doses than the barium swallow. There are considerable uncertainties associated with the presented doses, particularly for characterizing exposures of individual identified patients. Nonetheless, the tabulations provide the only comprehensive report on the estimation of typical radiation doses to the thyroid gland from medical diagnostic procedures over eight decades (1930-2010). These data can serve as a resource for epidemiologic studies that evaluate the late health effects of radiation exposure associated with diagnostic radiologic examinations.
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Affiliation(s)
- Lienard A Chang
- *Radiation Epidemiology Branch (REB)/Division of Cancer Epidemiology and Genetics (DCEG)/National Cancer Institute (NCI)/National Institutes of Health (NIH), Bethesda, MD. Now at Department of Radiation Safety and Imaging Physics/Houston Methodist Hospital, Houston, TX; †Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD; ‡REB/DCEG/NCI/NIH, Bethesda, MD; §International Agency for Research on Cancer (IARC), Lyon, France
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83
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Olmsted C, Arunachalam R, Gao X, Pesce L, Lal G. Pediatric differentiated thyroid carcinoma: trends in practice and outcomes over 40 years at a single tertiary care institution. J Pediatr Endocrinol Metab 2017; 30:1067-1074. [PMID: 28902626 DOI: 10.1515/jpem-2016-0327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 07/21/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study aims to analyze changes in characteristics, practice and outcomes of pediatric differentiated thyroid cancer (DTC) at our tertiary care institution. METHODS Patients <21 years of age diagnosed between 1973 and 2013 were identified. Clinicopathological data, treatment and outcomes were obtained by a retrospective review. RESULTS Thirteen males and 68 females were divided into Group A (n=35, diagnosed before July 1993) and Group B (n=46, diagnosed after July 1993). Group B was more likely to undergo neck ultrasound (US) (70% vs. 23%, p<0.0001) and fine-needle aspiration (FNA) biopsy (80% vs. 26%, p<0.0001). Patients in Group B more often underwent total thyroidectomy as a definitive surgical treatment (87% vs. 69%, p=0.04). There was no difference in radioactive iodine use. Recurrence-free survival was similar. CONCLUSIONS Increased use of US and FNA has affected initial surgical management in the latter part of the study, possibly due to extension of adult DTC guidelines. The effects of the new pediatric DTC guidelines need further study.
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84
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Kim YC, Kim KH, Son DY, Jeong DN, Seo JY, Choi YS, Han IT, Lee SY, Park NG. Printable organometallic perovskite enables large-area, low-dose X-ray imaging. Nature 2017; 550:87-91. [DOI: 10.1038/nature24032] [Citation(s) in RCA: 517] [Impact Index Per Article: 73.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 08/04/2017] [Indexed: 12/22/2022]
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85
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Thyroid Cancer Incidence around the Belgian Nuclear Sites, 2000-2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090988. [PMID: 28858225 PMCID: PMC5615525 DOI: 10.3390/ijerph14090988] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/03/2017] [Accepted: 08/07/2017] [Indexed: 11/23/2022]
Abstract
The present study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the nuclear sites in Belgium. Adjusted Rate Ratios were obtained from Poisson regressions for proximity areas of varying sizes. In addition, focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. Residential proximity to the nuclear site, prevailing dominant winds frequency from the site, and simulated radioactive discharges were used as surrogate exposures. No excess incidence of thyroid cancer was observed around the nuclear power plants of Doel or Tihange. In contrast, increases in thyroid cancer incidence were found around the nuclear sites of Mol-Dessel and Fleurus; risk ratios were borderline not significant. For Mol-Dessel, there was evidence for a gradient in thyroid cancer incidence with increased proximity, prevailing winds, and simulated radioactive discharges. For Fleurus, a gradient was observed with increasing prevailing winds and, to a lesser extent, with increasing simulated radioactive discharges. This study strengthens earlier findings and suggests increased incidences in thyroid cancer around two of the four Belgian nuclear sites. Further analyses will be performed at a more detailed geographical level.
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86
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Lubin JH, Adams MJ, Shore R, Holmberg E, Schneider AB, Hawkins MM, Robison LL, Inskip PD, Lundell M, Johansson R, Kleinerman RA, de Vathaire F, Damber L, Sadetzki S, Tucker M, Sakata R, Veiga LHS. Thyroid Cancer Following Childhood Low-Dose Radiation Exposure: A Pooled Analysis of Nine Cohorts. J Clin Endocrinol Metab 2017; 102:2575-2583. [PMID: 28323979 PMCID: PMC5505197 DOI: 10.1210/jc.2016-3529] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/02/2017] [Indexed: 12/18/2022]
Abstract
CONTEXT The increased use of diagnostic and therapeutic procedures that involve radiation raises concerns about radiation effects, particularly in children and the radiosensitive thyroid gland. OBJECTIVES Evaluation of relative risk (RR) trends for thyroid radiation doses <0.2 gray (Gy); evidence of a threshold dose; and possible modifiers of the dose-response, e.g., sex, age at exposure, time since exposure. DESIGN AND SETTING Pooled data from nine cohort studies of childhood external radiation exposure and thyroid cancer with individualized dose estimates, ≥1000 irradiated subjects or ≥10 thyroid cancer cases, with data limited to individuals receiving doses <0.2 Gy. PARTICIPANTS Cohorts included the following: childhood cancer survivors (n = 2); children treated for benign diseases (n = 6); and children who survived the atomic bombings in Japan (n = 1). There were 252 cases and 2,588,559 person-years in irradiated individuals and 142 cases and 1,865,957 person-years in nonirradiated individuals. INTERVENTION There were no interventions. MAIN OUTCOME MEASURE Incident thyroid cancers. RESULTS For both <0.2 and <0.1 Gy, RRs increased with thyroid dose (P < 0.01), without significant departure from linearity (P = 0.77 and P = 0.66, respectively). Estimates of threshold dose ranged from 0.0 to 0.03 Gy, with an upper 95% confidence bound of 0.04 Gy. The increasing dose-response trend persisted >45 years after exposure, was greater at younger age at exposure and younger attained age, and was similar by sex and number of treatments. CONCLUSIONS Our analyses reaffirmed linearity of the dose response as the most plausible relationship for "as low as reasonably achievable" assessments for pediatric low-dose radiation-associated thyroid cancer risk.
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Affiliation(s)
- Jay H. Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - M. Jacob Adams
- University of Rochester School of Medicine and Dentistry, Department of Public Health Sciences, Rochester, New York 14642
| | - Roy Shore
- Radiation Effects Research Foundation, Hiroshima 732-0815, Japan
| | - Erik Holmberg
- Department of Oncology and Radiation Physics and the Oncological Centre, Sahlgrenska University Hospital, S-413-45 Goteborg, Sweden
| | - Arthur B. Schneider
- University of Illinois College of Medicine, Section of Endocrinology, Diabetes, and Metabolism, Chicago, Illinois 60612
| | - Michael M. Hawkins
- Centre for Childhood Cancer Survivor Studies, Department of Public Health and Epidemiology, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-3678
| | - Peter D. Inskip
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - Marie Lundell
- Department of Medical Physics, Radiumhemmet, Karolinska University Hospital and Karolinska Institute, SE-171 76 Stockholm, Sweden
| | - Robert Johansson
- Oncology, Department of Radiation Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Ruth A. Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - Florent de Vathaire
- Cancer Epidemiology Research Unit, National Institute for Health and Medical Research–Institut Gustave Roussy, 94 805 Villejuif, France
| | - Lena Damber
- Oncology, Department of Radiation Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Tel Hashomer, 52621 Israel
| | - Margaret Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892
| | - Ritsu Sakata
- Radiation Effects Research Foundation, Hiroshima 732-0815, Japan
| | - Lene H. S. Veiga
- Institute for Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, 22783-127 Rio de Janeiro, Brazil
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87
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Li X, Semkow TM, Bradt CJ, Syed UF, Bari A, Torres MA, Nishikawa K, Khan AJ, Menia TA. Radiochemical analysis of a wide range of 131I activities in water and milk using well-type germanium detector. J Radioanal Nucl Chem 2017. [DOI: 10.1007/s10967-017-5292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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88
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Canfarotta M, Moote D, Finck C, Riba-Wolman R, Thaker S, Lerer TJ, Payne RJ, Cote V. McGill Thyroid Nodule Score in Differentiating Benign and Malignant Pediatric Thyroid Nodules: A Pilot Study. Otolaryngol Head Neck Surg 2017; 157:589-595. [PMID: 28653562 DOI: 10.1177/0194599817715629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective The McGill Thyroid Nodule Score (MTNS) is a preoperative tool used to predict the risk for well-differentiated thyroid cancer given a specific nodule in adults. We evaluated the clinical utility of a modified pediatric MTNS with children and adolescents. Study Design Case series with chart review. Setting Tertiary care children's hospital. Subjects and Methods This is a retrospective chart review of 46 patients ≤18 years of age presenting with a solitary or dominant thyroid nodule treated with surgical resection between September 2008 and December 2015. The cumulative MTNS for each nodule was calculated and compared with the final pathology. Results Of 46 patients, 10 (21.7%) were diagnosed with well-differentiated thyroid cancer (80% papillary thyroid carcinoma, 10% follicular variant of papillary thyroid carcinoma, 10% follicular thyroid carcinoma). Malignant nodules were associated with a greater mean MTNS (benign, 5.72 ± 3.03; malignant, 16 ± 3.13; P < .05). The sensitivity, specificity, and positive predictive value of malignancy were 100%, 94.4%, and 83.3% for scores ≥10 and 80%, 100%, and 100% for scores ≥11, respectively. In nodules with indeterminate cytology (Bethesda III and IV), the pediatric MTNS showed good differentiation between benign and malignant disease, with mean scores of 7.95 and 12.5, respectively ( P = .006). Conclusion This pilot study suggests that a comprehensive scoring system may help assess the risk of malignancy in pediatric thyroid nodules and differentiate nodules with indeterminate cytology into higher- and lower-risk categories. Given these findings, larger, multi-institutional studies are warranted.
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Affiliation(s)
- Michael Canfarotta
- 1 School of Medicine University of Connecticut, Farmington, Connecticut, USA
| | - Douglas Moote
- 2 Division of Pediatric Radiology, Connecticut Children's Medical Center, Connecticut, USA
| | - Christine Finck
- 3 Division of Pediatric Surgery, Connecticut Children's Medical Center, Connecticut, USA
| | - Rebecca Riba-Wolman
- 4 Department of Pediatrics and Endocrinology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Shefali Thaker
- 5 Department of Research, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Trudy J Lerer
- 5 Department of Research, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Richard J Payne
- 6 Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montréal, Canada
| | - Valerie Cote
- 7 Division of Pediatric Otolaryngology-Head and Neck Surgery, Connecticut Children's Medical Center, Hartford, Connecticut, USA
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89
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Xhaard C, Dumas A, Souchard V, Ren Y, Borson-Chazot F, Sassolas G, Schvartz C, Colonna M, Lacour B, Wonoroff AS, Velten M, Clero E, Maillard S, Marrer E, Bailly L, Mariné Barjoan E, Schlumberger M, Orgiazzi J, Adjadj E, Rubino C, Bouville A, Drozdovitch V, de Vathaire F. Are dietary reports in a case-control study on thyroid cancer biased by risk perception of Chernobyl fallout? Rev Epidemiol Sante Publique 2017; 65:301-308. [PMID: 28579185 DOI: 10.1016/j.respe.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 02/07/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND In retrospective case-control studies performed following nuclear tests or nuclear accidents, individual thyroid radiation dose reconstructions are based on fallout and meteorological data from the residential area, demographic characteristics, and lifestyle as well as dietary information. Collecting the latter is a controversial step, as dietary declarations may be affected by the subjects' beliefs about their risk behavior. This report analyses the potential for such bias in a case-control study performed in eastern France. METHODS The study included 765 cases of differentiated thyroid carcinoma matched with 831 controls. Risk perceptions and beliefs of cases and controls were compared using Chi2 tests and differences in dietary reports were analyzed using a two-way ANOVA. RESULTS In general, atmospheric pollution and living near a nuclear power plant were the two major risks that may influence thyroid cancer occurrence cited by cases and controls. When focusing in particular on the consequences of the Chernobyl accident, cases were more likely to think that the consequences were responsible for thyroid cancer occurrence than controls. Vegetable consumption during the two months after the Chernobyl accident was correlated with the status of subjects, but not to their beliefs. Conversely, consumption of fresh dairy products was not correlated with the status or beliefs of subjects. CONCLUSION We found no evidence of systematic bias in dietary reports according to the status or beliefs held by subjects about the link between thyroid cancer occurrence and Chernobyl fallout. As such, these dietary reports may be used in further studies involving individual dosimetric reconstructions.
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Affiliation(s)
- C Xhaard
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - A Dumas
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - V Souchard
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - Y Ren
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - F Borson-Chazot
- Fédération d'endocrinologie, hospices civils de Lyon, groupement hospitalier Lyon-Est, 69677 Bron, France; Rhône-Alpes thyroid cancer registry, cancer research center of Lyon (UMR Inserm 1052, CNRS 5286), RTH Laennec faculty of medicine, university of Lyon, 69008 Lyon, France
| | - G Sassolas
- Rhône-Alpes thyroid cancer registry, cancer research center of Lyon (UMR Inserm 1052, CNRS 5286), RTH Laennec faculty of medicine, university of Lyon, 69008 Lyon, France
| | - C Schvartz
- Thyroid cancer registry of Champagne-Ardennes, institut Jean-Godinot, 51100 Reims, France
| | - M Colonna
- Cancer registry of Isère, 38240 Meylan, France
| | - B Lacour
- French national registry of childhood solid tumours, CHU de Nancy, 54505 Vandœuvre, France; Inserm UMRS1018, CESP, 94800 Villejuif, France
| | - A S Wonoroff
- Cancer registry of doubs, EA 3181, university hospital Besançon, 25030 Besançon, France
| | - M Velten
- Cancer Registry of Bas-Rhin, EA 3430, faculty of medicine, university of Strasbourg, 67085 Strasbourg, France
| | - E Clero
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - S Maillard
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - E Marrer
- Cancer registry of Haut-Rhin, Mulhouse hospital, 68051 Mulhouse, France
| | - L Bailly
- Public health department, university hospital Nice, 06202 Nice, France
| | - E Mariné Barjoan
- Public health department, university hospital Nice, 06202 Nice, France
| | | | - J Orgiazzi
- Department of endocrinology, Hospices civils de Lyon, 69310 Lyon, France
| | - E Adjadj
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - C Rubino
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France
| | - A Bouville
- Radiation epidemiology branch, division of cancer epidemiology and genetics, national cancer institute, Bethesda, USA
| | - V Drozdovitch
- Radiation epidemiology branch, division of cancer epidemiology and genetics, national cancer institute, Bethesda, USA
| | - F de Vathaire
- Centre d'épidémiologie et de santé des populations (Cesp), U1018, epidemiology radiation group, Institut national de la santé et de la recherche médicale (Inserm), 94800 Villejuif, France; Gustave-Roussy, 94800 Villejuif, France; Université Paris-Saclay, 94800 Villejuif, France.
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90
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Lonjou C, Damiola F, Moissonnier M, Durand G, Malakhova I, Masyakin V, Le Calvez-Kelm F, Cardis E, Byrnes G, Kesminiene A, Lesueur F. Investigation of DNA repair-related SNPs underlying susceptibility to papillary thyroid carcinoma reveals MGMT as a novel candidate gene in Belarusian children exposed to radiation. BMC Cancer 2017; 17:328. [PMID: 28499365 PMCID: PMC5429528 DOI: 10.1186/s12885-017-3314-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 05/02/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Genetic factors may influence an individual's sensitivity to ionising radiation and therefore modify his/her risk of developing papillary thyroid carcinoma (PTC). Previously, we reported that common single nucleotide polymorphisms (SNPs) within the DNA damage recognition gene ATM contribute to PTC risk in Belarusian children exposed to fallout from the Chernobyl power plant accident. Here we explored in the same population the contribution of a panel of DNA repair-related SNPs in genes acting downstream of ATM. METHODS The association of 141 SNPs located in 43 DNA repair genes was examined in 75 PTC cases and 254 controls from the Gomel region in Belarus. All subjects were younger than 15 years at the time of the Chernobyl accident. Conditional logistic regressions accounting for radiation dose were performed with PLINK using the additive allelic inheritance model, and a linkage disequilibrium (LD)-based Bonferroni correction was used for correction for multiple testing. RESULTS The intronic SNP rs2296675 in MGMT was associated with an increased PTC risk [per minor allele odds ratio (OR) 2.54 95% CI 1.50, 4.30, P per allele = 0.0006, P corr.= 0.05], and gene-wide association testing highlighted a possible role for ERCC5 (P Gene = 0.01) and PCNA (P Gene = 0.05) in addition to MGMT (P Gene = 0.008). CONCLUSIONS These findings indicate that several genes acting in distinct DNA repair mechanisms contribute to PTC risk. Further investigation is needed to decipher the functional properties of the methyltransferase encoded by MGMT and to understand how alteration of such functions may lead to the development of the most common type of thyroid cancer.
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Affiliation(s)
- Christine Lonjou
- Institut Curie, 75248 Paris, France
- PSL Research University, 75005 Paris, France
- INSERM, U900, 75248 Paris, France
- Mines Paris Tech, 77305 Fontainebleau, France
| | | | - Monika Moissonnier
- Environment and Radiation, International Agency for Research on Cancer (IARC), 69372 Lyon, France
| | | | - Irina Malakhova
- Republican Scientific and Practical Center for Medical Technologies, Informatisation, Administration and Management of Health (RSPC MT), 220013 Minsk, Belarus
| | - Vladimir Masyakin
- Republican Research Center for Radiation Medicine & Human Ecology, 246040 Gomel, Belarus
| | | | - Elisabeth Cardis
- Centre for Research in Environmental Epidemiology (CREAL), IMIM (Hospital del Mar Research Institute), CIBER Epidemiología y Salud Pública (CIBERESP), 08003 Barcelona, Spain
| | - Graham Byrnes
- Environment and Radiation, International Agency for Research on Cancer (IARC), 69372 Lyon, France
| | - Ausrele Kesminiene
- Environment and Radiation, International Agency for Research on Cancer (IARC), 69372 Lyon, France
| | - Fabienne Lesueur
- Institut Curie, 75248 Paris, France
- PSL Research University, 75005 Paris, France
- INSERM, U900, 75248 Paris, France
- Mines Paris Tech, 77305 Fontainebleau, France
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91
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Mathew IE, Mathew A. Rising Thyroid Cancer Incidence in Southern India: An Epidemic of Overdiagnosis? J Endocr Soc 2017; 1:480-487. [PMID: 29264503 PMCID: PMC5686600 DOI: 10.1210/js.2017-00097] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 03/30/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Thyroid cancer incidence is rising in high-income countries. This increase in disease burden is attributed to the phenomenon of overdiagnosis. OBJECTIVE We aimed to investigate trends in thyroid cancer rates in India, focusing on the state of Kerala in southern India, which has reported a high incidence of the disease. DESIGN Population-based study using data from the National Cancer Registry Program. PARTICIPANTS We used data from the Population Based Cancer Registries for Thiruvananthapuram (capital of Kerala state), Delhi, Mumbai, Bangalore, and Chennai. We used data for three reporting periods from 2005 to 2014 (represented as 2006, 2009, and 2012). MAIN OUTCOME MEASURES We reported the age-adjusted incidence rate (AARi) and mortality rate (AARm) per 100,000 women and the proportion of thyroid cancers diagnosed in females per 100 cancer cases. RESULTS During 2006, the AARi for thyroid cancer in women in Thiruvananthapuram was 6.9 per 100,000, rising to 10 in 2009 and 13.3 in 2012. There was a 93% increase in incidence rates over less than a decade. The AARis in the other four cities were stable. In 2012, Thiruvananthapuram had at least a fourfold higher incidence compared with other regions. Thyroid was the primary site in one of every 10 cancers diagnosed in Thiruvananthapuram, and large numbers of patients were <40 years of age. The AARm remained stable in all regions. CONCLUSION We reported a high burden of thyroid cancer in Kerala, India, which is most likely due to overdiagnosis.
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Affiliation(s)
- Indu Elizabeth Mathew
- Department of Internal Medicine, Division of Endocrinology, University of Kentucky Medical Center, Lexington, Kentucky 40536
| | - Aju Mathew
- Department of Internal Medicine, Division of Medical Oncology, University of Kentucky, Markey Cancer Center, Lexington, Kentucky 40536
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92
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Davies J, Cross S, Evanson J. RE: Radiological assessment of paediatric cervical spine injury in blunt trauma: the potential impact of new NICE guidelines on the use of CT. A reply. Clin Radiol 2017; 72:263-264. [DOI: 10.1016/j.crad.2016.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
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93
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Iglesias ML, Schmidt A, Ghuzlan AA, Lacroix L, Vathaire FD, Chevillard S, Schlumberger M. Radiation exposure and thyroid cancer: a review. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:180-187. [PMID: 28225863 PMCID: PMC10118869 DOI: 10.1590/2359-3997000000257] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/31/2016] [Indexed: 11/21/2022]
Abstract
The association between radiation exposure and the occurrence of thyroid cancer has been well documented, and the two main risk factors for the development of a thyroid cancer are the radiation dose delivered to the thyroid gland and the age at exposure. The risk increases after exposure to a mean dose of more than 0.05-0.1 Gy (50-100mGy). The risk is more important during childhood and decreases with increased age at exposure, being low in adults. After exposure, the minimum latency period before the appearance of thyroid cancers is 5 to 10 years. Papillary carcinoma (PTC) is the most frequent form of thyroid carcinoma diagnosed after radiation exposure, with a higher prevalence of the solid subtype in young children with a short latency period and of the classical subtype in cases with a longer latency period after exposure. Molecular alterations, including intra-chromosomal rearrangements, are frequently found. Among them, RET/PTC rearrangements are the most frequent. Current research is directed on the mechanism of genetic alterations induced by radiation and on a molecular signature that can identify the origin of thyroid carcinoma after a known or suspected exposure to radiation.
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Affiliation(s)
| | - Angelica Schmidt
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires. Buenos Aires, Argentina
| | - Abir Al Ghuzlan
- Institut Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - Ludovic Lacroix
- Institut Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - Florent de Vathaire
- Institut Gustave Roussy, Université Paris-Sud, Villejuif, France.,Cancer and Radiation Team, INSERM Unit 1018, Villejuif, France
| | - Sylvie Chevillard
- CEA, Institute of Cellular and Molecular Radiobiology, Laboratory of Experimental Cancerology, CEA, Fontenay-aux-Roses, France
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94
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Wang TY, Farber SH, Perkins SS, Back AG, Byrd SA, Chi D, Vincent D, Karikari IO. Internally Randomized Control Trial of Radiation Exposure Using Ultra-low Radiation Imaging Versus Traditional C-arm Fluoroscopy for Patients Undergoing Single-level Minimally Invasive Transforaminal Lumbar Interbody Fusion. Spine (Phila Pa 1976) 2017; 42:217-223. [PMID: 28207655 DOI: 10.1097/brs.0000000000001720] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Randomized controlled trial. OBJECTIVE To compare radiation exposure between ultra-low radiation imaging (ULRI) with image enhancement and standard-dose fluoroscopy for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA Although the benefits of MIS are lauded by many, there is a significant amount of radiation exposure to surgeon and operating room personnel. Our goal with this work was to see if by using ultra-low dose radiation settings coupled with image enhancement, this exposure could be minimized. METHODS An institutional review board approved, prospective, internally randomized controlled trial was performed comparing ultra-low dose settings coupled with image enhancement software to conventional fluoroscopic imaging. In this study, each patient served as their own control, randomly assigning one side of MIS-TLIF for cannulation and K-wire placement using each imaging modality. Further, the case was also randomly divided into screw placement and cage placement/final images to allow further comparisons amongst patients. Radiation production from the C-arm fluoroscope and radiation exposure to all operating room personnel were recorded. RESULTS Twenty-four patients were randomly assigned to undergo a single level MIS-TLIF. In no case was low radiation imaging abandoned, and no patient had a neurologic decline or required hardware repositioning. Everyone in the operating room-the physician, scrub nurse, circulator, and anesthesiologist-all benefited with 61.6% to 83.5% reduction in radiation exposure during cannulation and K-wire placement to screw insertion aided by ULRI. In every case but the anesthesiologist dose, this was statistically significant (P < 0.05). This benefit required no additional time (P = 0.78 for K-wire placement). CONCLUSION ULRI, when aided by image enhancement software, affords the ability for all parties in the operating room to substantially decrease their radiation exposure compared with standard-dose C-arm fluoroscopy without adding additional time or an increased complication rate. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- Timothy Y Wang
- Department of Neurological Surgery, Duke University Medical Center, Durham, NC
| | - S Harrison Farber
- Department of Neurological Surgery, Duke University Medical Center, Durham, NC
| | - Scott S Perkins
- Department of Neurological Surgery, Duke University Medical Center, Durham, NC
| | - Adam G Back
- Department of Neurological Surgery, Duke University Medical Center, Durham, NC
| | - Sarah A Byrd
- Department of Neurological Surgery, Duke University Medical Center, Durham, NC
| | - Debbie Chi
- Department of Neurological Surgery, Duke University Medical Center, Durham, NC
| | | | - Isaac O Karikari
- Department of Neurological Surgery, Duke University Medical Center, Durham, NC
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95
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McNally RJQ, Wakeford R, James PW, Basta NO, Alston RD, Pearce MS, Elliott AT. A geographical study of thyroid cancer incidence in north-west England following the Windscale nuclear reactor fire of 1957. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:934-952. [PMID: 27893453 DOI: 10.1088/0952-4746/36/4/934] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The Windscale nuclear reactor fire at Sellafield, United Kingdom, in October 1957 led to an uncontrolled release of iodine-131 (radioactive half-life, 8 d) into the atmosphere. Contamination from the accident was most pronounced in the counties of Cumbria and Lancashire, north-west England. Radioiodine concentrates in the thyroid gland producing an excess risk of thyroid cancer, notably among those exposed as children, which persists into later life. For an initial investigation of thyroid cancer incidence in north-west England, data were obtained on cases of thyroid cancer among people born during 1929-1973 and diagnosed during 1974-2012 while resident in England, together with corresponding populations. Incidence rate ratios (IRRs), with Poisson 95% confidence intervals (CIs), compared thyroid cancer incidence rates in Cumbria and in Lancashire with those in the rest of England. For those aged <20 years in 1958, a statistically significantly increased IRR was found for those diagnosed during 1974-2012 while living in Cumbria (IRR = 1.29; 95% CI 1.09-1.52), but the equivalent IRR for Lancashire was marginally non-significantly decreased (IRR = 0.91; 95% CI 0.80-1.04). This pattern of IRRs was also apparent for earlier births, and the significantly increased IRR in Cumbria extended to individuals born in 1959-1963, who would not have been exposed to iodine-131 from the Windscale accident. Moreover, significant overdispersion was present in the temporal distributions of the IRRs, so that Poisson CIs substantially underestimate statistical uncertainties. Consequently, although further investigations are required to properly understand the unusual patterns of thyroid cancer IRRs in Cumbria and Lancashire, the results of this preliminary study are not consistent with an effect of exposure to iodine-131 from the Windscale accident.
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Affiliation(s)
- Richard J Q McNally
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
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96
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Abstract
During the past few decades, the incidence of thyroid cancer has increased substantially in many countries, including the USA. The rise in incidence seems to be attributable both to the growing use of diagnostic imaging and fine-needle aspiration biopsy, which has led to enhanced detection and diagnosis of subclinical thyroid cancers, and environmental factors. The latest American Thyroid Association (ATA) practice guidelines for the management of adult patients with thyroid nodules and differentiated thyroid cancer differ substantially from the previous ATA guidelines published in 2009. Specifically, the problems of overdiagnosis and overtreatment of a disease that is typically indolent, where treatment-related morbidity might not be justified by a survival benefit, now seem to be acknowledged. As few modifiable risk factors for thyroid cancer have been established, the specific environmental factors that have contributed to the rising incidence of thyroid cancer remain speculative. However, the findings of several large, well-designed epidemiological studies have provided new information about exposures (such as obesity) that might influence the development of thyroid cancer. In this Review, we describe the changing incidence of thyroid cancer, suggest potential explanations for these trends, emphasize the implications for patients and highlight ongoing and potential strategies to combat this growing clinical and public health issue.
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MESH Headings
- Adenocarcinoma, Follicular/diagnostic imaging
- Adenocarcinoma, Follicular/epidemiology
- Adenocarcinoma, Follicular/pathology
- Age Distribution
- Biopsy, Fine-Needle
- Carcinoma/diagnostic imaging
- Carcinoma/epidemiology
- Carcinoma/pathology
- Carcinoma, Neuroendocrine/diagnostic imaging
- Carcinoma, Neuroendocrine/epidemiology
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Papillary
- Humans
- Incidence
- Medical Overuse
- Obesity/epidemiology
- Radiation Exposure/statistics & numerical data
- Risk Factors
- Sex Distribution
- Smoking/epidemiology
- Thyroid Cancer, Papillary
- Thyroid Carcinoma, Anaplastic/diagnostic imaging
- Thyroid Carcinoma, Anaplastic/epidemiology
- Thyroid Carcinoma, Anaplastic/pathology
- Thyroid Neoplasms/diagnostic imaging
- Thyroid Neoplasms/epidemiology
- Thyroid Neoplasms/pathology
- Thyroid Nodule/diagnostic imaging
- Thyroid Nodule/epidemiology
- Thyroid Nodule/pathology
- United States/epidemiology
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Affiliation(s)
- Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 7E-536, Bethesda, Maryland 20892-9778, USA
| | - Julie A Sosa
- Section of Endocrine Surgery, Department of Surgery, Duke University, Seeley Mudd Building #484, 10 Searle Center Drive, DUMC #2945, Durham, North Carolina 27710, USA
- Duke Clinical Research Institute, North Pavilion, 2400 Pratt Street, Durham, North Carolina 27705, USA
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97
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Association of Xerostomia and Ultrasonographic Features of the Major Salivary Glands After Radioactive Iodine Ablation for Papillary Thyroid Carcinoma. AJR Am J Roentgenol 2016; 207:1077-1081. [DOI: 10.2214/ajr.15.15776] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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98
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Parisi MT, Eslamy H, Mankoff D. Management of Differentiated Thyroid Cancer in Children: Focus on the American Thyroid Association Pediatric Guidelines. Semin Nucl Med 2016; 46:147-64. [PMID: 26897719 DOI: 10.1053/j.semnuclmed.2015.10.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
First introduced in 1946, radioactive iodine (I-131) produces short-range beta radiation with a half-life of 8 days. The physical properties of I-131 combined with the high degree of uptake in the differentiated thyroid cancers (DTCs) led to the use of I-131 as a therapeutic agent for DTC in adults. There are two indications for the potential use of I-131 therapy in pediatric thyroid disorders: nonsurgical treatment of hyperthyroidism owing to Graves' disease and the treatment of children with intermediate- and high-risk DTC. However, children are not just miniature adults. Not only are children and the pediatric thyroid gland more sensitive to radiation than adults but also the biologic behavior of DTC differs between children and adults as well. As opposed to adults, children with DTC typically present with advanced disease at diagnosis; yet, they respond rapidly to therapy and have an excellent prognosis that is significantly better than that in adult counterparts with advanced disease. Unfortunately, there are also higher rates of local and distant disease recurrence in children with DTC compared with adults, mandating lifelong surveillance. Further, children have a longer life expectancy during which the adverse effects of I-131 therapy may become manifest. Recognizing the differences between adults and children with DTC, the American Thyroid Association commissioned a task force of experts who developed and recently published a guideline to address the unique issues related to the management of thyroid nodules and DTC in children. This article reviews the epidemiology, diagnosis, staging, treatment, therapy-related effects, and suggestions for surveillance in children with DTC, focusing not only on the differences between adults and children with this disease but also on the latest recommendations from the inaugural pediatric management guidelines of the American Thyroid Association.
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Affiliation(s)
- Marguerite T Parisi
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA; Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA.
| | - Hedieh Eslamy
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA
| | - David Mankoff
- Department of Nuclear Medicine, University of Pennsylvania, Philadelphia, PA
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99
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Cui LW, Probst MA, Hoffman JR, Mower WR. Sensitivity of plain radiography for pediatric cervical spine injury. Emerg Radiol 2016; 23:443-8. [DOI: 10.1007/s10140-016-1417-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/15/2016] [Indexed: 11/29/2022]
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100
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Evaluation of a Net Dose-Reducing Organ-Based Tube Current Modulation Technique: Comparison With Standard Dose and Bismuth-Shielded Acquisitions. AJR Am J Roentgenol 2016; 206:1233-40. [DOI: 10.2214/ajr.15.15778] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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