Radiation Dose-Response Relationships for Thyroid Nodules and Autoimmune Thyroid Diseases in Hiroshima and Nagasaki Atomic Bomb Survivors 55–58 Years After Radiation Exposure

Abstract Radiation exposure is a possible predisposing factor for monoclonal gammopathy of undetermined significance (MGUS), but the association has been uncertain. We investigated the relationship between radiation exposure and MGUS prevalence by using data from the M-protein screening for Nagasaki atomic bomb survivors between 1988 and 2004. Radiation exposure was assessed by exposure distance from the hypocenter and exposure radiation dose. We computed prevalence ratios (PRs) and the 95% confidence intervals (CIs) adjusting for exposure age and sex. A total of 1082 cases of MGUS were identified from 52 525 participants. MGUS prevalence was significantly higher in people exposed at distance within 1.5 km than beyond 3.0 km (PR, 1.4; 95% CI, 1.1-1.9) among those exposed at age 20 years or younger, but it was not found among those exposed at age 20 years or older. MGUS prevalence was also significantly higher in people exposed to more than 0.1 Gy than those exposed to less than 0.01 Gy (PR, 1.7; 95% CI, 1.0-2.8) among those exposed at age 20 years or younger. Thus, people exposed at younger age exhibited a significantly high risk of MGUS when exposed to a high radiation dose. There was no clear association between radiation exposure and the malignant progression of MGUS. Further detailed analysis is needed.

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Incidence of lymphoid neoplasms among atomic bomb survivors by histological subtype: 1950-1994

Blood ◽

10.1182/blood.2020010475 ◽

2021 ◽

Author(s):

Megumu Fujihara ◽

Ritsu Sakata ◽

Noriaki Yoshida ◽

Kotaro Ozasa ◽

Dale L Preston ◽

...

Keyword(s):

T Cell ◽

Radiation Dose ◽

B Cell ◽

Dose Response ◽

Atomic Bomb ◽

Nk Cell ◽

Precursor Cell ◽

Atomic Bomb Survivors ◽

Lymphoid Neoplasms ◽

The Relationship

Epidemiological data have provided limited and inconsistent evidence on the relationship between radiation exposure and lymphoid neoplasms. We classified 553 lymphoid neoplasm cases diagnosed between 1950 and 1994 in the Life Span Study (LSS) cohort of atomic bomb survivors into WHO subtypes. Mature B-cell neoplasms represented 58%, mature T-cell and NK-cell neoplasms 20%; precursor cell neoplasms, 5%, and Hodgkin lymphoma, 3%; with the remaining 15% classified as non-Hodgkin lymphoid neoplasms or lymphoid neoplasms, not otherwise specified. We used Poisson regression methods to assess the relationship between radiation exposure and the more common subtypes. As in earlier reports, a significant dose response for non-Hodgkin lymphoid neoplasms as a group was seen for males but not females. However, subtype analyses showed that radiation dose was strongly associated with increased precursor cell neoplasms rates, with an estimated excess relative risk per Gy of 16 (95% Confidence interval: 7.0, >533) at age 50. The current data based primarily of tissue-based diagnoses suggest that the association between radiation dose and lymphoid neoplasms as a group is largely driven by the radiation effect on precursor cell neoplasms while presenting no evidence of a radiation dose response for major categories of mature cell neoplasms, either B- or T-/NK-cell, or more specific disease entities (diffuse large B-cell lymphoma, plasma cell myeloma, adult T-cell leukemia/lymphoma) or Hodgkin lymphoma.

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Multicenter study on TGPO autoantibody prevalence in various thyroid and non-thyroid diseases; relationships with thyroglobulin and thyroperoxidase autoantibody parameters

Acta Endocrinologica ◽

10.1530/eje.0.1410563 ◽

1999 ◽

pp. 563-569 ◽

Cited By ~ 19

Author(s):

V Estienne ◽

C Duthoit ◽

VD Costanzo ◽

PJ Lejeune ◽

M Rotondi ◽

...

Keyword(s):

Thyroid Nodules ◽

Solid Phase ◽

Post Partum ◽

Large Population ◽

Collaborative Study ◽

Normal Subjects ◽

Thyroid Diseases ◽

Serum Samples ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid

OBJECTIVE: TGPO autoantibodies (aAbs) that bind simultaneously to thyroglobulin (Tg) and thyroperoxidase (TPO) are present in the serum of patients with autoimmune thyroid diseases (AITD) and have been found to differ from monospecific Tg and TPO aAbs. To obtain further insights on the prevalence defined as the rate of occurrence and significance of TGPO aAbs in a large population, we carried out a collaborative study involving 15 European teams. METHODS: Serum samples from 3122 patients with various thyroid and non-thyroid diseases and normal subjects were assayed using a novel TGPO aAb detection kit. This test was designed so that TGPO aAbs are trapped between the Tg-coated solid phase and the soluble TPO labeled with a radioiodinated monoclonal antibody. RESULTS: Only three out of the 220 normal subjects (prevalence of 1.4%) were found to have positive TGPO aAb levels, which were mainly observed in the patients with AITD: the group of patients suffering from Hashimoto's thyroiditis had a TGPO aAb prevalence of 40.5% (n=437 patients), those with Graves' disease, a prevalence of 34.6% (n=645) and those with post-partum thyroiditis, 16.0% (n=243). Among the non-AITD patients with positive TGPO aAb levels, the TGPO aAb prevalence ranged from 20.7% among those with thyroid cancer (n=246) to 0% among those with toxic thyroid nodules (n=47). Among the patients with non-thyroid diseases, the TGPO aAb prevalence ranged from 9.8% in the case of Biermer's pernicious anemia (n=78) to 0% in that of premature ovarian failure (n=44). It is worth noting that the groups showing the highest TGPO aAb prevalence also contained the patients with the highest TGPO aAb titers. Statistical comparisons between the TGPO aAb prevalences in the various groups showed that TGPO aAb could be used as a parameter to distinguish between the groups of Hashimoto's and Graves' patients and between the women with post-partum thyroiditis and the post-partum women with only Tg and/or TPO aAb established during early pregnancy. Unexpectedly, the correlations between TGPO aAbs and Tg and TPO aAbs were found to depend mainly on the assay kit used. CONCLUSION: High TGPO aAb titers are consistently associated with AITD but the reverse was not found to be true. TGPO aAbs are a potentially useful tool, however, for establishing Hashimoto's diagnosis, and would be worth testing in this respect with a view to using them for routine AITD investigations.

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Risk Factors Associated with Benign and Malignant Thyroid Nodules in Autoimmune Thyroid Diseases

ISRN Endocrinology ◽

10.1155/2013/673146 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Priscila Carneiro Moreira Lima ◽

Arnaldo Moura Neto ◽

Marcos Antonio Tambascia ◽

Denise Engelbrecht Zantut Wittmann

Keyword(s):

Thyroid Carcinoma ◽

Hashimoto’S Thyroiditis ◽

Thyroid Nodules ◽

Thyroid Volume ◽

Thyroid Diseases ◽

Hashimoto's Thyroiditis ◽

Graves Disease ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Demographical Data

Objectives. Assess the prevalence of thyroid nodules and predictors of malignant origin in patients with autoimmune thyroid diseases. Patients and Methods. Retrospective study including 275 patients, 198 with Graves' disease and 77 with Hashimoto’s thyroiditis. Clinical and demographical data, ultrasonographical nodule characteristics, total thyroid volume and histological characteristics were recorded. Results. Graves’ disease: the prevalence of thyroid nodules and thyroid carcinoma were 27.78% and 5.05%, respectively. Older age (OR = 1.054; 95% CI = 1.029–1.080) and larger thyroid volumes (OR = 1.013; 95% CI = 1.003–1.022) increased the chance of nodules. Younger age (OR = 1.073; 95% CI = 1.020–1.128) and larger thyroid volume (OR = 1.018; 95% CI = 1.005–1.030) predicted thyroid carcinoma. Hashimoto’s thyroiditis: the prevalence of thyroid nodules and carcinomas were 50.7% and 7.8%, respectively. Nodules were predicted by thyroid volume (OR = 1.030; 95% CI = 1.001–1.062). We found higher number of nodules in patients with thyroid carcinoma than in those with benign nodules (3 versus 2; ). Patients with Hashimoto’s thyroiditis presented nodules more frequently than patients with Graves’ disease (50.65% versus 27.28%; ), while the prevalence of carcinoma was similar (). Conclusions. Larger goiter was associated with carcinoma in Graves’ disease and Hashimoto’s thyroiditis. Younger patients presented higher risk of papillary thyroid carcinoma in Graves’ disease. The prevalence of carcinoma was similar in both conditions.

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Development and Application of a Novel Sensitive Immunometric Assay for Calcitonin in a Large Cohort of Patients with Medullary and Differentiated Thyroid Cancer, Thyroid Nodules, and Autoimmune Thyroid Diseases

European Thyroid Journal ◽

10.1159/000363055 ◽

2014 ◽

Vol 3 (2) ◽

pp. 117-124 ◽

Cited By ~ 4

Author(s):

Cléber P. Camacho ◽

Susan C. Lindsey ◽

Teresa S. Kasamatsu ◽

Alberto L. Machado ◽

João Roberto M. Martins ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Thyroid Nodules ◽

Thyroid Diseases ◽

Large Cohort ◽

Autoimmune Thyroid Diseases ◽

Autoimmune Thyroid ◽

Immunometric Assay

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Risk of Myelodysplastic Syndromes in People Exposed to Ionizing Radiation: A Retrospective Cohort Study of Nagasaki Atomic Bomb Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2010.31.3080 ◽

2011 ◽

Vol 29 (4) ◽

pp. 428-434 ◽

Cited By ~ 74

Author(s):

Masako Iwanaga ◽

Wan-Ling Hsu ◽

Midori Soda ◽

Yumi Takasaki ◽

Masayuki Tawara ◽

...

Keyword(s):

Cohort Study ◽

Radiation Dose ◽

Ionizing Radiation ◽

Dose Response ◽

Myelodysplastic Syndromes ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Radiation Effects ◽

Atomic Bomb ◽

Atomic Bomb Survivors

Purpose The risk of myelodysplastic syndromes (MDS) has not been fully investigated among people exposed to ionizing radiation. We investigate MDS risk and radiation dose-response in Japanese atomic bomb survivors. Patients and Methods We conducted a retrospective cohort study by using two databases of Nagasaki atomic bomb survivors: 64,026 people with known exposure distance in the database of Nagasaki University Atomic-Bomb Disease Institute (ABDI) and 22,245 people with estimated radiation dose in the Radiation Effects Research Foundation Life Span Study (LSS). Patients with MDS diagnosed from 1985 to 2004 were identified by record linkage between the cohorts and the Nagasaki Prefecture Cancer Registry. Cox and Poisson regression models were used to estimate relationships between exposure distance or dose and MDS risk. Results There were 151 patients with MDS in the ABDI cohort and 47 patients with MDS in the LSS cohort. MDS rate increased inversely with exposure distance, with an excess relative risk (ERR) decay per km of 1.2 (95% CI, 0.4 to 3.0; P < .001) for ABDI. MDS risk also showed a significant linear response to exposure dose level (P < .001) with an ERR per Gy of 4.3 (95% CI, 1.6 to 9.5; P < .001). After adjustment for sex, attained age, and birth year, the MDS risk was significantly greater in those exposed when young. Conclusion A significant linear radiation dose-response for MDS exists in atomic bomb survivors 40 to 60 years after radiation exposure. Clinicians should perform careful long-term follow-up of irradiated people to detect MDS as early as possible.

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