BACKGROUND The increase in the number of childhood thyroid carcinoma cases in Ukraine after the Chernobyl nuclear accident in 1986 prompted the development of a registry of thyroid carcinoma cases at the Institute of Endocrinology and Metabolism in Kiev. In the current study, the authors report the statistical data and clinicomorphologic features of the cases included in this registry. METHODS To study the incidence, and age and gender distribution of thyroid carcinoma in Ukraine, the authors compiled complete clinical information from cases diagnosed and treated at the Institute of Endocrinology and Metabolism and statistical reports submitted to the registry from 27 regions of Ukraine. Morphologic features of the resected tumors were examined and were included in the database. RESULTS During the 5 years preceding the Chernobyl nuclear accident, a total of 59 cases of thyroid carcinoma were identified in the birth to 18 years age group (25 in children age ≤ 14 years and 34 in adolescents ages 15–18 years). Between 1986 and 1997, the total number of thyroid carcinomas in Ukrainian children and adolescents was 577 (358 children and 219 adolescents). Morphologically, the thyroid tumors overwhelmingly were papillary carcinomas, and the majority of these also showed a follicular and/or solid growth pattern. Lymph node metastases and other extrathyroidal spread were common, thus necessitating total thyroidectomy and lymph node dissections in many patients. CONCLUSIONS Between 1990 and 1997, a significant increase in the incidence of thyroid carcinoma was noted in children and adolescents in Ukraine; the group most affected was comprised of the individuals who were age ≤ 5 years in 1986 (the year of the Chernobyl nuclear accident). The largest number of cases occurred in patients living in areas of thyroid radiation doses of ≥0.50 grays. The morphologic features of those thyroid tumors suggest that they are aggressive tumors with a high frequency of lymph node metastases, venous invasion, and extrathyroidal spread. Cancer 1999;86:149–56. © 1999 American Cancer Society.

Vitamin due to the presence of the receptor (VDR), which is found in almost all nuclear cells is an important regulator in the pathogenesis of many diseases. The question of the causal relationship between vitamin D deficiency and Graves 'disease and the importance of this vitamin for thyroid function in the treatment of Graves' disease deserves special attention. The aim of the study was to investigate the level of 25-(OH) D in the body in Graves' disease and its relationship with thyroid function. We examined 143 patients who were first diagnosed with moderate Graves' disease (GD). All patients studied by us, residents of Ukraine, 67% of them live in Kyiv, 19% in Kyiv region, 14% in other regions of Ukraine. The average age of the subjects was 43.8 ± 0.95, among whom were men 22.4%, women -77.6%. The analysis of immune parameters and thyroid function depending on the age of patients, the content of vitamin D in the serum, and its quartile distribution before treatment. Subsequently, all patients were divided into two groups depending on the therapy. The first group included 73 subjects, whose average age was 44.69 ± 1.39, patients in this group received tyrosol at a dose of 5 -10 mg per day. The second group consisted of 70 patients. whose average age was 42.93 ± 1.29, they took tyrosol at a dose of 5-10 mg per day and vitamin D preparations -2000 MO/day. In patients with Graves' disease. the highest content of 25-(OH) D in serum was observed in the age group of 19-30 years -59.1 nmol/l and a low level of antibodies to the TSH receptor -9.0 mUi/l. A significant decrease in the immune index was observed only in the 3 rd and 4 th quartiles, when the content of 25-(OH) D in the serum reached 47.5 nmol/l and above, i.e. approached a moderate deficit. At a slight increase to 34 nmol/l, such changes were insignificant. After 3 months of treatment, the level of AbrTSH in the serum during treatment with vitamin D was twice lower than when treated with tyrosol alone. After 6 months, compared with the treatment with tyrosol, the effect of treatment was 2 times better. In contrast to TPOAbs in Graves' disease without treatment with vitamin D, where it did not differ depending on the level of 25 (OH) D, in the second group after 6 months of treatment there was a significant decrease in this indicator (p = 0.009). Compared to tyrosol treatment alone, there was a significant increase in TSH levels and a decrease in thyroid volume after 6 months. Data on the dependence of thyroid function on the level of 25 (OH) D were indicative. In each of the quartiles, the level of TSH after treatment with vitamin D was 4-5 times higher than in the group of patients treated only with tyrosol. Convincing data on the positive effect of vitamin D on autoimmune parameters, thyroid function and the need for its inclusion in the treatment of Graves' disease.

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