甲状腺乳头状癌放疗后RET/PTC基因重排频率的剂量-反应依赖性。分子流行病学资料的简单池化分析[j]。

A N Koterov, L N Ushenkova, A P Biryukov
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引用次数: 0

摘要

在先前形成的甲状腺乳头状癌中RET/PTC重排分子流行病学资料库中包含的所有可能的关于该主题的出版物的基础上,对确定不同辐照组放射源性癌中RET/PTC频率的剂量效应依赖性进行了汇总分析(“简单汇总数据”)。(他们是接受放射治疗的人群、切尔诺贝利核电站(CNPP)附近的居民和核爆炸的受害者)。Pearson线性相关趋势(r = 0.746;(p = 0.148)揭示了受CNPP事故影响地区RET/PTC频率与甲状腺估计剂量之间的关系。但由于污染最严重的戈梅利地区的指标异常低,这种趋势被认为是随机的。这种暂时被称为“病例对照”的方法显示,有RET/PTC和没有RET/PTC的癌症的甲状腺剂量值存在可靠的差异。发现了变化的多样性:放射治疗影响中RET/PTC的缺乏与高剂量有关,而在CNPP事故和核爆炸受害者中,情况正好相反。可能,在第一种情况下,暴露于非常高剂量后发生了“细胞清洁”现象。对各组甲状腺平均/中位剂量与这些组中肿瘤RET/PTC频率之间的直接Pearson相关性的搜索显示,在连续剂量尺度上,剂量效应依赖性的可靠性很高(RET/PTC总量和RET/PTC1分别:r = 0.830;P = 0.002, r = 0.906;P = 0.0003);而RET/PTC3无显著相关性。当使用加权最小二乘回归分析(从样本中癌症的数量出发)时,指定的规律仍然存在。试图通过排除与CNPP事故相关的所有样本的数据来影响相关强度,并没有显著降低RET/PTC的关联强度。在顺序尺度剂量(背景,“低”(0.1 Gy),“中”(0.1 Gy)和“大”(1-10 Gy)剂量)的基础上(Spearman)也发现与RET/PTC总频率的剂量有显著相关性(r = 0.736;p = 0.0098),但对于某些类型的重排,结果与之前的分析相反(只有RET/PTC3的效果显著:r = 0.731;P = 0.024)。Cochrane-Armitage-test对RET/PTC总频次、RET/PTC1频次和RET/PTC3频次随正常甲状腺剂量的线性剂量反应趋势进行了记录(p分别为< 0.0001 < 0.0001和0.007)。因此;经过20多年甲状腺放射源性癌RET/PTC的分子和流行病学研究,首次获得了研究参数与辐射因子之间存在剂量效应依赖关系的综合证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Dose-Response Dependences for Frequency of RET/PTC Gene Rearrangements in Papillary Thyroid Carcinoma after Irradiation. Simple Pooling Analysis of Molecular Epidemiological Data].

On the basis of all possible publications on the theme included in the previously formed base of sources on molecular epidemiology of RET/PTC rearrangements in thyroid papillary carcinoma a pooled analysis ("simple pooling data") on determination of the dose-effect dependences for RET/PTC frequency in radiogenic carcinomas of various irradiated groups was performed. (They are groups subjected to radiotherapeutic exposure, residents near the Chernobyl nuclear power plant (CNPP) and victims of nuclear bombing). The tendency to Pearson linear correlation (r = 0.746; p = 0.148) between the frequency of RET/PTC and the estimated dose on thyroid in the regions affected by the CNPP accident was revealed. But this tendency was recognized to be random owing to abnormally low values of the indicator for the most contaminated Gomel region. The method tentatively called "case-control" showed reliable differences in thyroid dose values for carcinomas with RET/PTC and without those. The versatility of changes was found: the lack of RET/PTC for radiotherapeutic impacts was associated with higher doses, whereas in case of the CNPP accident and for nuclear bombing victims it was the opposite. Probably, in the first case the "cellular cleaning" phenomenon after exposure to very high doses took place. Search of direct Pearson correlations between average/median thyroid doses on groups and RET/PTC frequency in carcinomas of these groups showed a high reliability for the dose-effect dependences- at the continuous dose scale (for RET/PTC in total and RET/PTC1 respectively: r = 0.830; p = 0.002 and r = 0.906; p = 0.0003); while there was no significant correlation received for RET/PTC3. When using the weighting least square regression analysis (proceeding from the number of carcinomas in samples), the specified regularities remained. Attempts to influence the strength of correlation by exception ofthe data of all the samples connected with the accident on the CNPP did not significantly reduce the strength of associations for RET/PTC in total. On the basis of ordinal scale doses (background, "low" (0.1 Gy), "middle" (0.1-1 Gy) and "large" (1-10 Gy) dose) also found was a significant correlation (Spearman) with the dose for the frequency RET/PTC in total (r = 0.736; p = 0.0098), but for certain types of rearrangements the results were reverse to the previous analysis (the effect was significant only for the RET/PTC3: r = 0.731; p = 0.024). The linear dose-response trends of the Cochrane-Armitage-test for the frequency of RET/PTC in total, RET/PTC1 and RET/PTC3 depending on the dose to the thyroid in the ordinal scale were registered (p, respectively: < 0.0001 < 0.0001 and 0.007). Thus; after more than 20 years of the molecular and epidemiological research of RET/PTC in thyroid radiogenic carcinomas the comprehensive evidence of the dose-effect dependence existence indicating a real relationship between the studied parameters and a radiation factor was obtained for the first time.

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