Role of biomarkers in predicting the occurrence of thyroid neoplasms in radiation-exposed children

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; < 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; = 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.

Elastic Stable Intramedullary Nailing for Pediatric Humeral Shaft Fractures Under Ultrasonographic Guidance: A Retrospective Study

“…Radiation-related cancer risk is greater in younger people and lasts a lifetime (16)(17)(18). Thus, examination methods that minimize damage during diagnosis and treatment are desired.…”

Application of Ultrasonography in Conservative Treatment of Humeral Shaft Fracture in Children

“…But frequent X-ray examination means more radiation exposure time, children are considerably more sensitive to the carcinogenic effects of radiation than adults, and the risk of cancer increases with increasing time of radiation exposure time such as cancer of the thyroid, breast, brain and skin, as well as leukemia. Risks of radiation-related cancer are greater as patients younger, also these risks will last a lifetime [11][12][13]. Therefore, it is an inevitable trend of medical development to nd methods of examination which would not cause additional damage in the process of diagnosis and treatment.…”

Цитологічно Підтверджений Вузловий Зоб У Членів Українсько-Американського Когортного Дослідження: Дескриптивний Аналіз Результатів Обстеження За 1998- 2015 Роки

“…За результатами дослідження рівнів ТГ і ТТГ як маркерів тиреоїдних новоутворень у когорті пацієнтів з опроміненням області шиї в дитячому віці (764 осіб, 25 років спостереження), вихідні рівні ТТГ не асоціювались із ризиком розвитку будь-яких вузлів ЩЗ, а рівні ТГ були вищі в осіб із вузлами ЩЗ і асоціювались із підвищеним ризиком вузлоутворення, але не було різниці в їх рівнях у пацієнтів із доброякісними та злоякісними утворами [44]. У переважної більшості обстежених у нашому дослідженні ТГ був у межах норми.…”