Morphologic characteristics of Chernobyl-related childhood papillary thyroid carcinomas are independent of radiation exposure but vary with iodine intake.

BACKGROUND: The Chernobyl accident caused an unprecedented increase in papillary thyroid carcinoma (PTC) incidence with a surprisingly short latency and unusual morphology. We have investigated whether unexpected features of the PTC incidence after Chernobyl were radiation specific or influenced by iodine deficiency. METHODS: PTCs from children from Belarus, Ukraine, and the Russian Federation exposed to fallout from Chernobyl were compared with PTCs from children not exposed to radiation from the same countries, from England and Wales (E&W) and from Japan. The degree and type of differentiation, fibrosis, and invasion were quantified. RESULTS: There were no significant differences between PTCs from radiation-exposed children from Belarus, Ukraine, and the Russian Federation and PTCs from children from the same countries who were not exposed to radiation. Childhood PTCs from Japan were much more highly differentiated (p < 0.001), showed more papillary differentiation (p < 0.001) and were less invasive (p < 0.01) than "Chernobyl" tumors, while tumors from E&W generally showed intermediate levels of degree and type of differentiation and invasion. There was a marked difference between the sex ratios of children with PTCs who were radiation exposed and those who were not exposed (F:M exposed vs. unexposed 1.5:1 vs. 4.2:1; chi(2) = 7.90, p < or = 0.01005). CONCLUSIONS: The aggressiveness and morphological features of Chernobyl childhood PTCs are not associated with radiation exposure. The differences found between tumors from the Chernobyl area, E&W, and Japan could be influenced by many factors. We speculate that dietary iodine levels may have wide implications in radiation-induced thyroid carcinogenesis, and that iodine deficiency could increase incidence, reduce latency, and influence tumor morphology and aggressiveness.

Quantitative changes in thyroid lymphoid cells as a marker of malignancy.

OBJECTIVE: To investigate the possibility of using morphometric changes in lymphoid cells in thyroid tissue as a marker of malignant tumors. STUDY DESIGN: Morphometry of biopsy material was performed with a semiautomated, computerized image analyzer. RESULTS: Nine features were selected. These features formed the criteria for differentiation between malignant and benign disease. Equations for the calculation of a weighting coefficient for each feature and a diagnostic index were derived. The values for the diagnostic index for the groups with malignant and benign pathology differed significantly. CONCLUSION: One can determine the presence of a malignant tumor in the thyroid gland from the diagnostic index value.

Morphometric analysis of the degree of aggregation of follicular cells in the diagnosis of malignant thyroid tumors.

OBJECTIVE: To develop a system of decision criteria based on a set of features of the degree of thyrocyte aggregation with assessment of their weighting coefficient in the diagnosis of malignant and benign thyroid pathology. STUDY DESIGN: Autopsy, operative and aspiration biopsy material were the object of the study. Light microscopic morphometry was performed with semiautomated computer analysis of images. RESULTS: Of all the sets of features of the degree of thyrocyte aggregation, 10 were chosen that provided the least overlap between the groups of malignant and benign pathology. Boundary values of these features to discriminate between malignant and benign pathology were assembled into a set of diagnostic decision criteria for thyroid carcinoma diagnosis. Based on results from trials, an equation for the calculation of a weighting coefficient for each feature was derived. A diagnostic index was determined by the sum of values of weighting coefficients of the features within the range of values listed in the set of diagnostic decision criteria. CONCLUSION: A set of diagnostic decision criteria was developed for thyroid carcinoma diagnosis that is based on morphometric features reflecting the regularities of changes in the structure of thyrocyte aggregates with malignant and benign pathology. Weighting coefficients of features were assessed, making it possible to perform a probabilistic carcinoma diagnosis.