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Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 2. P. 47-52

DOI: 10.12737/article_58f0b9573ddc88.95867893

On RET/PTC Rearrangements in Thyroid Carcinoma after the Chernobyl Accident

S.V. Jargin

Peoples’ Friendship University, Moscow. Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

S.V. Jargin – Associate Professor, PhD in Medicine

Abstract

A major part of thyroid cancer (TC) cases detected during the first 10 years after the Chernobyl accident were represented by papillary carcinoma with the solid pattern and gene rearrangements RET/PTC3. On the contrary, among TC diagnosed 10 years after the accident and later predominated RET/PTC1. Reportedly, RET/PTC3 are associated with more aggressive TC, a larger size and a higher tumor stage at the time of diagnosis. The prevalence of RET/PTC tended to decrease with time after the accident. The cohort of early post-Chernobyl TC with the predominance of RET/PTC3 was deemed globally unique. In the sporadic TC, RET/PTC1 is predominant. It should be mentioned that early post-Chernobyl TC are not unique globally but in more developed countries, where a majority of studies has been performed. In a TC cohort from India RET/PTC3 predominated. RET/PTC3 was more frequent among non-exposed TC patients from Ukraine compared to those who were from France. The prevalence of RET/PTC among pediatric TC after the Fukushima-1 accident has been low, while RET/PTC1 is predominating. According to the hypothesis discussed here, RET/PTC are associated with certain steps of the tumor progression of papillary TC, the RET/PTC3 – with a later step. It is therefore expected that the prevalence of RET/PTC3 would correlate with the disease duration. It was reported on correlations between the prevalence of RET/PTC and individual dose estimates. Correlations do not necessarily prove cause-effect relationships. The screening was more intensive on the more contaminated territories. Dose-dependent self-selection of patients could contribute to the correlations. Pediatric TC was rarely diagnosed prior to the accident on the contaminated territories. Accordingly, there was a pool of neglected TC. Besides, some non-exposed patients could have been registered as Chernobyl victims. The pool of neglected cases was gradually exhausted by the screening. Improving diagnostics has also contributed to the earlier TC detection. The RET/PTC dynamics were in accordance with this hypothesis: the prevalence of tumors with RET rearrangements declined, while among RET-positive TC the percentage of RET/PTC1 increased and RET/PTC3 – decreased. In conclusion, RET/PTC rearrangements in TC after the Chernobyl accident, the RET/PTC3 in particular, have probably been related to the disease duration, so that the features of successive waves of TC after the accident must have been largely determined by evolving modalities of screening and diagnostics, as well as by exhaustion of the pool of neglected cancers.

Key words: Ionizing radiation, Chernobyl, mutation, RET/PTC, thyroid carcinoma, cancer

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For citation: On RET/PTC Rearrangements in Thyroid Carcinoma after the Chernobyl Accident. Medical Radiology and Radiation Safety. 2017;62(2):47-52. Russian. DOI: 10.12737/article_58f0b9573ddc88.95867893

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