Endocrine Abstracts

Background

An increase of pediatric thyroid cancer has been reported in Fukushima area. While there is no adult survey to date except NPP workers. Our institute is located 40 km from the NPP and has been playing a major medical role in this area (population 340, 000). We analyzed patients with NOD whether there is any difference in cytological findings between pre- and post-NPP accident. Patients and methods:1, 065 new patients (2005–2020) with NOD were examined; pre(A), 780 patients (46%) and post (B), 907patients. Cytological diagnosis was made 1, 802 times. Ultra-sonogram (US) and hormonal assay were performed in each patient. Follow-up study was performed in 316 patients (28%).

Results

1) Yearly assay number: 318 FNAB was performed between 2007 and 2008 (a peak) then decreased to 154 between 2015 to 2016 (4 years after NPP accident, lowest). 2) Age: Period A, 59±15 years; B, 61±14 (P <0.004). 3) Gender: Proportion of female, A, 637 (82%) B, 739 (82) (NS). 4) Level of serum thyroglobulin (Tg): A, 708±3, 109 (median 98) ng/ml, B, 400±1.178 (median 95) (P<0.01). 3. Size (diameter): A, 25±73mm (median 20). B, 23±13.3 mm (median 21) (NS). 5) Tg/size: A, 21.4±68 (Med 5.2) B, 15.6±40, 2 (Med 4.8). (NS). 6) Cytological classification: Class 2, A, 454 (46%), B, 544 (55%); class 3, A, 27 (42%), B, 38 (59%); class 4, A 5 (42%), B, 7 (58%); class 5, A, 46 (70%), B, 20 (30%) (Kai2< 0.004). 7) Cytological diagnosis: Papillary carcinoma, A, 45 (65%), B, 24 (35%); Cellular atypia, A, 15 (32%), B, 32 (68%); Follicular neoplasm, A, 23 (49%), B, 34 (60%); Adenomatous goiter (AG), A, 152 (37%), B, 271 (63%); Benign goiter A, 197 (50%), B, 106 (50%); Cyst, A, 166 (57%), B, 124 (43%); Chronic thyroiditis, A, 46 (63%), B, 27 (37%) (Kai2, P <0.0001).

Discussion

There was no increase of NOD patients nor carcinoma diagnosis after NPP accident. Although AG was more frequently diagnosed in period B, the increase started early years of period A. Tg level decreased in period B corresponding to lesser size, possibly due to early detection by widespread US.

Conclusion

There was no apparent effect of NPP accident in adult NOD around our institution.