Salvatore Arena1, Adele Latina2, Roberto Baratta2, Giuseppe Burgio2, Damiano Gullo2, Salvatore Benvenga3. 1. A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina salvoarena72@hotmail.com. 2. A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina. 3. A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina A.S.P. 8 SiracusaDepartment of Internal Medicine, Section of Endocrinology and Metabolic Diseases, Umberto I Hospital, Siracusa, ItalyDepartment of Clinical and Experimental MedicineUniversity of Messina, ItalyEndocrinology DivisionDepartment of Clinical and Molecular Biomedicine, University of Catania, Garibaldi-Nesima Hospital, Catania, ItalyA.R.P.A. Sicilia (Agenzia Regionale per la Protezione Ambientale) District of SiracusaItalyMaster Program in ChildhoodAdolescent and Women's Endocrine Health, University of MessinaInterdepartmental Program in Molecular and Clinical Endocrinology & Women's Endocrine HealthUniversity Hospital of Messina, Messina.
Abstract
INTRODUCTION: In genetically predisposed individuals, exogenous factors (including pollution) influence the development of Hashimoto's thyroiditis/chronic lymphocytic thyroiditis (CLT). CLT may also be a risk factor for associated thyroid cancer. Few data are available on the role of pollution from petrochemical complexes, one of which is located in the Siracusa province (South-Eastern Sicily), in the pathogenesis of CLT. AIMS: i) To study the frequency of CLT in fine-needle aspiration cytology (FNAC)-interrogated thyroid nodules from patients who were stably resident in their zones, comparing it in patients living in the petrochemical complex area (zone A) with that of patients from a control area (zone B). ii) To study the frequency of CLT in the FNAC categories of malignancy risk, comparing the two zones. PATIENTS AND METHODS: We retrospectively evaluated cytologically adequate slides of 1323 nodules in 1013 outpatients who underwent ultrasound-guided FNAC from 2006 to 2012. We stratified by area of residence, gender, and FNAC categories of malignancy risk. RESULTS: CLT was detected with significantly greater frequency in either patients or nodules from zone A compared with zone B (32.0% vs 23.1%, P=0.002 or 28.2% vs 18.8%, P=0.0001), with a female preponderance (F=35.2% vs M=21.1% or 30.4% vs 20.4%, zone A and F=26.5% vs 12.3% or 21.6% vs 9.5%, zone B). Regardless of zone, CLT was approximately twofold more frequent in the suspiciously malignant+malignant classes (TH4+THY5=47.6%, zone A and 32.4%, zone B) compared with the benign+intermediate classes (THY2+THY3=27.3%, zone A and 18.2%, zone B), but with a clear stepwise THY2 through THY5 increase only in zone A (THY2=25.3%, THY5=66.7%; THY2=18.6%, THY5=28.6% in zone B). CONCLUSIONS: The petrochemical complex-related pollution is an environmental factor involved in the development of CLT and, likely, in the CLT association with thyroid neoplasms.
INTRODUCTION: In genetically predisposed individuals, exogenous factors (including pollution) influence the development of Hashimoto's thyroiditis/chronic lymphocytic thyroiditis (CLT). CLT may also be a risk factor for associated thyroid cancer. Few data are available on the role of pollution from petrochemical complexes, one of which is located in the Siracusa province (South-Eastern Sicily), in the pathogenesis of CLT. AIMS: i) To study the frequency of CLT in fine-needle aspiration cytology (FNAC)-interrogated thyroid nodules from patients who were stably resident in their zones, comparing it in patients living in the petrochemical complex area (zone A) with that of patients from a control area (zone B). ii) To study the frequency of CLT in the FNAC categories of malignancy risk, comparing the two zones. PATIENTS AND METHODS: We retrospectively evaluated cytologically adequate slides of 1323 nodules in 1013 outpatients who underwent ultrasound-guided FNAC from 2006 to 2012. We stratified by area of residence, gender, and FNAC categories of malignancy risk. RESULTS: CLT was detected with significantly greater frequency in either patients or nodules from zone A compared with zone B (32.0% vs 23.1%, P=0.002 or 28.2% vs 18.8%, P=0.0001), with a female preponderance (F=35.2% vs M=21.1% or 30.4% vs 20.4%, zone A and F=26.5% vs 12.3% or 21.6% vs 9.5%, zone B). Regardless of zone, CLT was approximately twofold more frequent in the suspiciously malignant+malignant classes (TH4+THY5=47.6%, zone A and 32.4%, zone B) compared with the benign+intermediate classes (THY2+THY3=27.3%, zone A and 18.2%, zone B), but with a clear stepwise THY2 through THY5 increase only in zone A (THY2=25.3%, THY5=66.7%; THY2=18.6%, THY5=28.6% in zone B). CONCLUSIONS: The petrochemical complex-related pollution is an environmental factor involved in the development of CLT and, likely, in the CLT association with thyroid neoplasms.
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