环境颗粒物空气污染与甲状腺乳头状癌风险增加有关。
Ambient particulate matter air pollution is associated with increased risk of papillary thyroid cancer.
机构信息
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Global Health, Peking University School of Public Health, Beijing, China; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
出版信息
Surgery. 2022 Jan;171(1):212-219. doi: 10.1016/j.surg.2021.05.002. Epub 2021 Jun 29.
BACKGROUND
The association between exposure to air pollution and papillary thyroid carcinoma is unknown. We sought to estimate the relationship between long-term exposure to the fine (diameter ≤ 2.5 μm) particulate matter component of air pollution and the risk of papillary thyroid cancer.
METHODS
Adult (age ≥18) patients with newly diagnosed papillary thyroid carcinoma between January 1, 2013 and December 31, 2016 across a single health system were identified using electronic medical records. Data from 1,990 patients with papillary thyroid carcinoma were compared with 3,980 age- and sex-matched control subjects without any evidence of thyroid disease. Cumulative fine (diameter <2.5 μm) particulate matter exposure was estimated by incorporating patients' residential zip codes into a deep learning neural networks model, which uses both meteorological and satellite-based measurements. Conditional logistic regression was performed to assess for association between papillary thyroid carcinoma and increasing fine (diameter ≤2.5 μm) particulate matter concentrations over 1, 2, and 3 years of cumulative exposure preceding papillary thyroid carcinoma diagnosis.
RESULTS
Increased odds of developing papillary thyroid carcinoma was associated with a 5 μg/m increase of fine (diameter ≤2.5 μm) particulate matter concentrations over 2 years (adjusted odds ratio = 1.18, 95% confidence interval: 1.00-1.40) and 3 years (adjusted odds ratio = 1.23, 95% confidence interval: 1.05-1.44) of exposure. This risk differed by smoking status (pn = 0.04). Among current smokers (n = 623), the risk of developing papillary thyroid carcinoma was highest (adjusted odds ratio = 1.35, 95% confidence interval: 1.12-1.63).
CONCLUSION
Increasing concentration of fine (diameter ≤2.5 μm) particulate matter in air pollution is significantly associated with the incidence of papillary thyroid carcinoma with 2 and 3 years of exposure. Our novel findings provide additional insight into the potential associations between risk factors and papillary thyroid carcinoma and warrant further investigation, specifically in areas with high levels of air pollution both nationally and internationally.
背景
目前尚不清楚暴露于空气污染与甲状腺乳头状癌之间的关联。我们试图评估长期暴露于空气污染中细颗粒物（直径≤2.5μm）与甲状腺乳头状癌风险之间的关系。
方法
通过电子病历，我们在单个医疗系统中确定了 2013 年 1 月 1 日至 2016 年 12 月 31 日期间新诊断为甲状腺乳头状癌的成年（年龄≥18 岁）患者。将 1990 例甲状腺乳头状癌患者的数据与 3980 例年龄和性别匹配的无甲状腺疾病证据的对照患者进行比较。通过将患者的居住邮政编码纳入深度学习神经网络模型，估算出细颗粒物（直径<2.5μm）的累积暴露量，该模型同时使用气象和卫星测量数据。采用条件逻辑回归评估在甲状腺乳头状癌诊断前的 1 年、2 年和 3 年内，细颗粒物（直径≤2.5μm）的累积暴露量增加与甲状腺乳头状癌之间的关联。
结果
与细颗粒物（直径≤2.5μm）浓度每增加 5μg/m2 相关的甲状腺乳头状癌发病风险在 2 年（调整后的比值比=1.18，95%置信区间：1.00-1.40）和 3 年（调整后的比值比=1.23，95%置信区间：1.05-1.44）时呈上升趋势。这种风险因吸烟状况而异（p=0.04）。在当前吸烟者（n=623）中，患甲状腺乳头状癌的风险最高（调整后的比值比=1.35，95%置信区间：1.12-1.63）。
结论
空气污染中细颗粒物（直径≤2.5μm）浓度的增加与甲状腺乳头状癌的发病率显著相关，其暴露时间分别为 2 年和 3 年。我们的新发现为风险因素与甲状腺乳头状癌之间的潜在关联提供了更多的见解，并需要进一步的研究，特别是在全国和国际范围内空气污染水平较高的地区。
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