PDF(Pubmed)
Abstract：
The increased risk of liver malignancies was found in workers of the first Russian nuclear production facility, Mayak Production Association, who had been chronically exposed to gamma rays externally and to alpha particles internally due to plutonium inhalation. In the present study, we updated the radiogenic risk estimates of the hepatobiliary malignancies using the extended follow-up period (1948-2018) of the Mayak worker cohort and the improved «Mayak worker dosimetry system-2013». The cohort comprised 22,377 workers hired at the Mayak PA between 1948 and 1982. The analysis considered 62 liver malignancies (32 hepatocellular carcinomas, 13 intrahepatic cholangiocarcinomas, 16 angiosarcomas, and 1 anaplastic cancer) and 33 gallbladder adenocarcinomas. The analysis proved the positive significant association of the liver malignancy risk (the total of histological types, hepatocellular carcinoma) with the liver absorbed alpha dose from internal exposure. The excess relative risk per Gy (95% confidence interval) of alpha dose (the linear model) was 7.56 (3.44; 17.63) for the total of histological types and 3.85 (0.95; 13.30) for hepatocellular carcinoma. Indications of non-linearity were observed in the dose-response for internal exposure to alpha radiation. No impact of external gamma-ray exposure on the liver malignancy incidence was found. In the study cohort, the number of angiosarcomas among various types of liver malignancies was very high (25.8%), and most of these tumors (73.3%) were registered in individuals internally exposed to alpha radiation at doses ranging between 6.0 and 21.0 Gy. No association with chronic occupational radiation exposure was observed for the incidence of gallbladder malignancies.
摘要：
在俄罗斯第一个核生产设施的工人中发现肝脏恶性肿瘤的风险增加，Mayak生产协会,由于吸入钚，长期暴露于外部伽马射线和内部α粒子。在本研究中,我们使用Mayak工人队列的延长随访期(1948-2018)和改进的"Mayak工人剂量测定系统-2013"更新了肝胆恶性肿瘤的放射性风险估计值.该队列包括1948年至1982年在MayakPA雇用的22,377名工人。该分析考虑了62例肝脏恶性肿瘤（32例肝细胞癌，13肝内胆管癌，16血管肉瘤，1例间变性癌）和33例胆囊腺癌。分析证明了肝脏恶性肿瘤风险的正相关(组织学类型的总数，肝细胞癌），肝脏吸收的α剂量来自内部暴露。每个Gy的过量相对风险（95％置信区间）的α剂量（线性模型）为7.56（3.44;17.63）的总组织学类型和3.85（0.95;13.30）的肝细胞癌。在内部暴露于α辐射的剂量反应中观察到非线性的迹象。未发现外部伽马射线暴露对肝脏恶性肿瘤发生率的影响。在研究队列中，在各种类型的肝脏恶性肿瘤中，血管肉瘤的数量非常高(25.8%)，这些肿瘤中的大多数(73.3%)是在接受剂量范围在6.0~21.0Gy的α射线内部照射的个体中登记的.未观察到胆囊恶性肿瘤的发生率与慢性职业辐射暴露有关。
