职业放射工作人员男性乳腺癌病因概率的初步研究  

A preliminary study on the probability of causation of male breast cancer for occupational radiation workers

作　　者：苏垠平[1] 孙志娟 樊芳[3] 孙全富[1] Su Yinping;Sun Zhijuan;Fan Fang;Sun Quanfu(Key Laboratory of Radiological Protection and Nuclear Emergency,China CDC,National Institute for Radiological Protection,Chinese Center for Disease Control and Prevention,Beijing 100088,China;Thoracic Surgery Department,University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,China;Yunnan Center for Disease Control and Prevention,Kunming 650034,China)

机构地区：[1]中国疾病预防控制中心辐射防护与核安全医学所,辐射防护与核应急中国疾病预防控制中心重点实验室,北京100088 [2]香港大学深圳医院胸外科,深圳518053 [3]云南省疾病预防控制中心,昆明650034

出　　处：《中华放射医学与防护杂志》2022年第3期215-218,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的探讨男性乳腺癌的病因概率的计算方法,为我国职业放射工作人员男性乳腺癌的病因判定提供理论基础。方法利用日本原爆幸存者拟合得到的男性乳腺癌超额相对危险(ERR)模型与美国电离辐射生物效应委员会(BEIR)VII提供的女性乳腺癌超额绝对危险(EAR)模型两种方法,对既往1例被诊断为男性乳腺癌病例进行乳腺剂量及其病因概率的计算。结果通过男性乳腺癌ERR模型计算病因概率(PC)均值为94.6%,95%PC上限为98.3%。女性乳腺癌EAR模型与女性乳腺癌发病基线,PC均值为70.3%,95%PC上限为153.3%,而采用男性乳腺癌发病率基线则PC均值为99.2%。通过以上两种方法均可判定该男性所患乳腺癌是由职业性放射性暴露所致。结论采用女性乳腺癌EAR模型和女性乳腺癌发病率基线计算95%PC上限高于男性乳腺癌ERR模型,但对于女性乳腺癌EAR模型估算病因概率的不确定度还需进一步研究,同时建议将职业放射工作人员男性乳腺癌列入我国职业性放射性肿瘤名单,对职业性放射性肿瘤名单补充完善,使其更加科学合理,以满足潜在的索赔需求。Objective To explore the probability of causation method ology of male breast cancer and to provide theoretical basis for the diagnosis of occupational radiogenic male breast cancer in China.Methods Using the male excess relative risk model(EAR)fitted from the Japanese atomic bomb survivors and the female excess absolute risk model(ERR)provided by the Biological Effect of Ionizing Radiation CommitteeⅦ(BEIRVII),the breast dose and the probability of causation of the previous case of male breast cancer were calculated.Results The average probability of causation(PC)calculated by male ERR model was 94.6%,and the upper limit of 95%PC was 98.3%.Using female EAR model and female breast cancer incidence,the average PC was 70.3%,and the upper limit of 95%PC was 153.3%.when male breast cancer incidence was used,the average PC was 99.2%.By both methods,the male breast cancer patient could be determined to be caused by occupational radiation exposure.Conclusions The upper limit of 95%PC calculated by female EAR model and female breast cancer incidence was higher than that by male ERR model.The uncertainty of probability of causation for female EAR model still need further research.Occupational radiogenic male breast was proposed to listed in occupational radiogenic neoplasms,which will make the list more perfect and scientific and reasonable to meet potential claims.

关 键 词：男性乳腺癌 电离辐射 职业性放射性肿瘤 病因概率 

分 类 号：R148[医药卫生—公共卫生与预防医学]