职业照射与甲状腺功能损伤研究进展

Research progress on occupational exposure and thyroid functional injury

甲状腺是电离辐射的重要靶器官之一,长期低剂量电离辐射可能引起甲状腺不同程度的形态改变和功能紊乱。不同类别职业照射在射线种类、辐射剂量、照射方式和照射时间等方面存在较大差异。职业照射对甲状腺功能影响的研究主要集中在放射诊疗工作人员,关于核工业和其他核技术应用放射工作人员的研究相对较少。甲状腺功能易受到社会人口特征如性别、年龄、吸烟、饮酒、遗传、自身免疫等混杂因素影响,长期低剂量职业照射对甲状腺功能影响的研究结论尚不一致,其潜在损伤机制亦具有多样性。甲状腺癌的发生发展与其相关基因的改变密切相关,其常见的分子机制有基因重排、基因拷贝数变异、基因差异表达和基因多态性;但辐射相关基因及其分子机制仍需进一步完善,以期发现辐射接触标志物或辐射诱发甲状腺癌的特有遗传易感基因,为职业照射人群早监测、早干预和特异性治疗提供基础。

Thyroid gland is one of the important target organs of ionizing radiation.Long-term low-dose ionizing radiation may cause morphological changes and dysfunction of thyroidat different degrees.There are big differences in radiation type,radiation dose,radiation mode and exposure time among different occupational exposures.The studies on the effects of occupational exposure on thyroid function were mainly focused on diagnostic and radiological workers,and few focused on radiological workers in the nuclear industry and other applications of nuclear technology.Thyroid function is susceptible to social and demographic characteristics such as gender,age,smoking,alcohol consumption,genetics,autoimmune and other confounding factors.The effects of long-term low-dose occupational exposure on thyroid function are not consistent,and the potential injury mechanisms are diverse.The occurrence and development of thyroid cancer is closely related to the change of related genes,and its common molecular mechanism include gene rearrangement,gene copy number variation,gene differential expression and gene polymorphism.However,radiation-related genes and their molecular mechanisms still need to be explored,so as to find radiation exposure markers or specific genetic susceptibility genes of radiation-induced thyroid cancer,and provide a basis for early monitoring,early intervention and specific treatment for the occupational exposure population.