演題抄録

臓器別シンポジウム

開催概要
開催回
第52回・2014年・横浜
 

Childhood Thyroid Cancer

演題番号 : OS3-4

[筆頭演者]
Thomas Geraldine:1 

1:Department of Surgery and Cancer, Imperial College London, UK

 

Thyroid cancer (TC) in those aged under 14 at operation is rare (0.5-1.5 per million per year), but the incidence rises steeply following the onset of adolescence. There was a large increase in the incidence of TC, and in particular papillary TC (PTC) following exposure of 10 million children to radioiodine in fallout following the Chernobyl accident in 1986. This, coupled with the systematic collection by the Chernobyl Tissue Bank of samples from these patients, has enabled detailed study of the molecular biology of childhood PTC. In brief, childhood PTC is associated with a high frequency of ret rearrangement, and a low frequency of BRAF mutation compared with adult onset PTC. Rearrangements of other tyrosine kinase genes are also found. Recent reports suggest that amplifications of 7q are specifically associated with radiation exposure, but this requires further validation to avoid confounders. Some authors have suggested that specific mRNA profiles relate to radiation exposure, but these are also age dependent, and require validation in age-matched non-radiation exposed cohorts. Both genomic and transcriptomic alterations are correlated with pathomorphology, with ret rearrangements being correlated with solid morphology and BRAF alterations being associated with papillary morphology. Given the much lower radiation doses to the thyroid and the lack of proven radiation biomarkers from the Chernobyl studies, caution is urged in attempts to use these results to guide interpretation of biomarker studies in the Fukushima population.

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