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在美國(guó),，過(guò)去頻繁接受牙科X光檢測(cè)的人們?cè)谀X癌早期診斷中風(fēng)險(xiǎn)明顯增加，近日刊登在雜志Cancer上的一篇研究報(bào)告中報(bào)道了這一結(jié)果,，盡管牙科X光在很多時(shí)候很有必要,，但是研究者的研究發(fā)現(xiàn)提示了適度的X光檢測(cè)對(duì)于個(gè)體來(lái)說(shuō)還是很有必要的。
電離輻射是引起腦膜瘤最主要的環(huán)境危險(xiǎn)因子,，而腦膜瘤在美國(guó)是最為頻繁的腦癌初期的診斷,。牙科X射線是主要的電離輻射來(lái)源。為了測(cè)定牙科X射線與腦膜瘤風(fēng)險(xiǎn)之間的關(guān)系,，來(lái)自耶魯大學(xué)的研究者Elizabeth Claus從2006年5月至2011年4月期間收集了年齡段為20-79之間的1433個(gè)進(jìn)行疾病診斷的病人的相關(guān)信息,，對(duì)照組為1350個(gè)沒(méi)有經(jīng)過(guò)腦膜瘤診斷的相似的人群,。
結(jié)果顯示，患有腦膜炎的病人進(jìn)行牙科X射線檢測(cè)治療的次數(shù)是對(duì)照組兩倍以上,，而且每個(gè)月進(jìn)行牙科X檢測(cè)的病人或者更為頻繁的檢測(cè)的病人相比對(duì)照更容易患上腦膜瘤,。腦膜瘤增加的風(fēng)險(xiǎn)也和曲面體層X(jué)線機(jī)測(cè)試相關(guān)（這種測(cè)試就是對(duì)所有牙齒進(jìn)行體外顯影）。在早年結(jié)構(gòu)過(guò)這樣的檢測(cè)或者更為頻繁檢測(cè)的病人更容易患上腦膜瘤,，每年接受過(guò)多次這種檢測(cè)的病人患上腦膜瘤的風(fēng)險(xiǎn)是對(duì)照組的2.7-3倍,。
研究者指出，相比過(guò)去,，如今的牙科醫(yī)生接受的輻射很少了,。按照美國(guó)牙科協(xié)會(huì)的指導(dǎo)原則，兒童1-2年只需接受一次X射線檢測(cè),，青少年1.5-3年接受一次檢測(cè),，成年而每隔2-3年需要進(jìn)行一次檢測(cè)。早在2006年,，牙科協(xié)會(huì)就指出了牙科X射線檢測(cè)必須安全可靠,，尤其是不能對(duì)病人產(chǎn)生負(fù)面影響，相信研究者的這項(xiàng)研究會(huì)給牙科的檢測(cè)提供新的視野和建議,。（生物谷：T.Shen編譯）
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doi:10.1002/cncr.26625
PMC:
PMID:
Dental x-rays and risk of meningioma
Elizabeth B. Claus MD, PhD1,2,§,*, Lisa Calvocoressi PhD1, Melissa L. Bondy PhD3, Joellen M. Schildkraut PhD4, Joseph L. Wiemels PhD5, Margaret Wrensch PhD5,6
BACKGROUND: Ionizing radiation is a consistently identified and potentially modifiable risk factor for meningioma, which is the most frequently reported primary brain tumor in the United States. The objective of this study was to examine the association between dental x-rays—the most common artificial source of ionizing radiation—and the risk of intracranial meningioma.
METHODS: This population-based case-control study included 1433 patients who had intracranial meningioma diagnosed at ages 20 to 79 years and were residents of the states of Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 counties in Houston, Texas between May 1, 2006 and April 28, 2011 (cases). A control group of 1350 individuals was frequency matched on age, sex, and geography (controls). The main outcome measure for the study was the association between a diagnosis of intracranial meningioma and self-reported bitewing, full-mouth, and panorex dental x-rays.
RESULTS: Over a lifetime, cases were more than twice as likely as controls (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.4-2.9) to report having ever had a bitewing examination. Regardless of the age at which the films were obtained, individuals who reported receiving bitewing films on a yearly basis or with greater frequency had an elevated risk for ages <10 years (OR, 1.4; 95% CI, 1.0-1.8), ages 10 to 19 years (OR, 1.6; 95% CI, 1.2-2.0), ages 20 to 49 years (OR, 1.9; 95% CI, 1.4-2.6), and ages ≥40 years (OR, 1.5; 95% CI, 1.1-2.0). An increased risk of meningioma also was associated with panorex films taken at a young age or on a yearly basis or with greater frequency, and individuals who reported receiving such films at ages <10 years had a 4.9 times increased risk (95% CI, 1.8-13.2) of meningioma. No association was appreciated for tumor location above or below the tentorium.
CONCLUSIONS: Exposure to some dental x-rays performed in the past, when radiation exposure was greater than in the current era, appears to be associated with an increased risk of intracranial meningioma. As with all sources of artificial ionizing radiation, considered use of this modifiable risk factor may be of benefit to patients.
