The pathogenesis of radiation-induced thyroid cancer has not yet been elucidated. Gene rearrangements may play an important role in the process. Nikiforova and associates found that radiation-induced tumors had a 4% prevalence of BRAF point mutations and a 58% prevalence of RET/PTC rearrangements, and sporadic papillary thyroid cancers demonstrated a 37% prevalence of BRAF point mutations and only a 20% prevalence of RET/PTC rearrangements.34 Similarly, RET/PTC3 rearrangement was found in aggressive tumors that occurred less than 10 years after the Chernobyl accident.35 Elisei and coauthors also found a prevalence of 38% of RET/PTC rearrangements in adenomas found within radiation-exposed glands, implying that this rearrangement is not restricted to the malignant phenotype but may be a step in the development of malignant transformation of radiation-induced thyroid tumors.36
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