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  Table of Contents  
LETTER TO THE EDITOR
Year : 2015  |  Volume : 52  |  Issue : 3  |  Page : 472-473
 

Occurrence of precancerous lesion in the post nuclear crisis condition


Wiwanitkit House, Bangkhae, Bangkok, Thailand

Date of Web Publication18-Feb-2016

Correspondence Address:
V Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.176726

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How to cite this article:
Wiwanitkit V. Occurrence of precancerous lesion in the post nuclear crisis condition. Indian J Cancer 2015;52:472-3

How to cite this URL:
Wiwanitkit V. Occurrence of precancerous lesion in the post nuclear crisis condition. Indian J Cancer [serial online] 2015 [cited 2019 Jun 27];52:472-3. Available from: http://www.indianjcancer.com/text.asp?2015/52/3/472/176726


Sir,

One of the major public health issues in the current year (2011) are the health hazards associated with exposure to the leak nuclides from the disrupted nuclear power plant in Fukushima, Japan. Many serious health consequences are expected. Based on the previous similar scenario, the Chernobyl crisis, many diseases can be detected in exposed populations for long time.

An important confirmed problem is the increased incidence of cancer. There is no doubt that exposure can result in carcinogenesis, especially for thyroid cancer.[1] The alteration of normal cell structure and function can be seen and this is the root cause of the problem. However there is little published literature on the incidence of pre-cancerous lesions in this scenario and this letter aims to address this issue briefly. This is true for pre-cancerous thyroid lesions with very limited published literature on the incidence after exposure to radioactive nuclides. The autopsy findings of the population exposed in Chernobyl crisis showed no significant increase in pre-cancerous thyroid lesions. Increase in incidence of lung cancer is reported after exposure to leak nuclides and increased incidence of precancerous bronchial neoplasm can also be detected. Chizhikov et al. reported that “extensive cancer-related molecular abnormalities sequentially occur in radiation damaged bronchial epithelium of former Chernobyl clean-up workers.”[2] The long term exposure to radioactive particles is associated with significant allelic loss at 3p12, 3p14.2 (FHIT), 3p21, 3p22-24 (hMLH1) and 9p21 (p16INK4A) in bronchial epithelium.[2] Hence, molecular following up on bronchial epithelium derived from bronchoalveolar lavage for the highly exposed subjects is recommended.

Prostatic intraepithelial neoplasia (PIN) is well mentioned in the exposed population. Vosianov et al. found increased incidence of PIN among the cases with benign prostatic hypertrophy after the Chenobly accident.[3] Vosianov et al. also identified the apoptotic change that implies further cancer development.[3] Precancerous lesion development in the urinary bladder can also be observed in this scenario. Closed following up on prostate gland by rectal examination is recommended for the highly exposed subjects and early surgical management with histological study for assessment of malignant transformation is suggested for any cases with abnormal per rectal examination.[3] Upregulation of fibroblast growth factor receptor 3 and epidermal growth factor receptors in association with Raf-1 was seen in urothelial dysplasia and carcinoma in situ after the Chernobyl accident.[4] It is hypothesized that long term exposure causes oxidative stress that further induces gene alteration in urinary bladder urothelium.[5] Romanenko et al. noted that “The microenvironmental changes induced by chronic long-term, low-dose IR (please give expansion and put IR in brackets) also appear to promote angiogenesis and remodeling of the extracellular matrix that could facilitate invasion as well as progression of pre-existing initiated cells to malignancy.”[5] The use of urine cytology investigation might be helpful in following up the highly exposed subjects and the urinary bladder biopsy for histological test is recommended in the cases with abnormal urine examination.[4],[5]


  Conclusion Top


Precancerous lesions can occur after exposure to leaked nuclides after a nuclear accident. Following up of these precancerous lesions may be a good strategy in secondary prevention of cancers post nuclide exposure. Indeed, cancerous screening is an important focus in public health management in the post nuclear crisis.[6] Screening for possible cancer development in the population living in the contaminated area is recommended and the already discussed screenings can be selected.[6]

 
  References Top

1.
Wiwanitkit V. Nuclear denotation and increased incidence of cancer: A present concern in cancer research. J Cancer Res Ther 2011;7:478-80.  Back to cited text no. 1
    
2.
Chizhikov V, Chikina S, Gasparian A, Zborovskaya I, Steshina E, Ungiadze G, et al. Molecular follow-up of preneoplastic lesions in bronchial epithelium of former Chernobyl clean-up workers. Oncogene 2002;21:2398-405.  Back to cited text no. 2
    
3.
Vosianov AF, Romanenko AM, Zabarko LB, Szende B, Wang CY, Landas S, et al. Prostatic intraepithelial neoplasia and apoptosis in benign prostatic hyperplasia before and after the Chernobyl accident in Ukraine. Pathol Oncol Res 1999;5:28-31.  Back to cited text no. 3
    
4.
Romanenko AM, Morimura K, Kinoshita A, Wanibuchi H, Takahashi S, Zaparin WK, et al. Upregulation of fibroblast growth factor receptor 3 and epidermal growth factor receptors, in association with Raf-1, in urothelial dysplasia and carcinoma in situ after the Chernobyl accident. Cancer Sci 2006;97:1168-74.  Back to cited text no. 4
    
5.
Romanenko A, Morimura K, Wanibuchi H, Salim EI, Kinoshita A, Kaneko M, et al. Increased oxidative stress with gene alteration in urinary bladder urothelium after the Chernobyl accident. Int J Cancer 2000;86:790-8.  Back to cited text no. 5
    
6.
Yamashita S, Carr Z, Repacholi M. Long-term health implications of the Chernobyl accident and relevant projects of the World Health Organization. Health Phys 2007;93:538-41.  Back to cited text no. 6
    




 

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