氯乙烯接触工人肿瘤标志物水平

发布时间：2018-07-02 21:12

本文选题：氯乙烯 + 肿瘤标志物　；参考：《卫生研究》2017年06期

【摘要】：目的研究氯乙烯职业接触人群血清肿瘤标志物水平的变化,探讨不同肿瘤标志物的影响因素。方法选择唐山市某氯碱厂氯乙烯生产车间所有接触工人223人(接触组),无职业氯乙烯接触的其他单位行政办公人员149人(对照组),监测车间空气氯乙烯浓度,测定亚硫基二乙酸,检测血清中11项肿瘤标志物含量。结果接触组血清中的癌胚抗原(carcino-embryonic antigen,CEA)、甲胎蛋白(alphafetoprotein,AFP)、糖链抗原CA-199和CA72-4含量随着接触工龄的增加而增加,神经元特异性烯醇化酶(neuron-specific enolase,NSE)含量随着接触工龄的增加而降低,但这5项肿瘤标志物与接触工龄均无相关性,差异无统计学意义(P0.05)。经单因素分析发现,接触组亚硫基二乙酸水平高于对照组(Z=-16.178,P0.001)。单因素分析结果显示,性别对CEA、AFP及NSE三项指标的含量均有影响(Z值分别为-4.815、-2.052和-4.535,P0.05),而吸烟仅对CA-199产生影响(Z=-2.016,P0.05),氯乙烯的接触对AFP和NSE有影响(Z=-3.763和-2.140,P0.05)。多因素分析显示,与男性相比,女性体内的CEA与NSE含量降低(t值分别为-3.696和-5.722,P0.05);氯乙烯接触是NSE的影响因素,与对照组相比其含量升高(t=2.061,P0.05)。结论在目前的接触浓度下,接触氯乙烯可引起血清肿瘤标志物水平的变化。随着工人接触有害因素的时间增加,肿瘤标志物水平发生改变,机体发生肿瘤的可能性增加。亚硫基二乙酸水平与某些标志物可能存在一定的相关关系。不同肿瘤标志物的影响因素有所差异。
[Abstract]:Objective to study the changes of serum tumor markers in workers exposed to vinyl chloride and to explore the influencing factors of different tumor markers. Methods 223 exposed workers (exposure group) and 149 administrative staff (control group) in chloroethylene production workshop of a chlor-alkali plant in Tangshan City were selected to monitor the concentration of vinyl chloride in the air. The contents of 11 tumor markers in serum were determined. Results the levels of carcino-embryonic antigens, alphafetoprotein, carbohydrate antigen CA-199 and CA72-4 in serum of exposed group increased with the increase of exposure time, and the contents of neuron-specific enolase decreased with the increase of exposure time. However, there was no correlation between the five tumor markers and exposure time, and the difference was not statistically significant (P0.05). Univariate analysis showed that the level of thiodiacetic acid in the exposed group was higher than that in the control group (P 0.001). The results of univariate analysis showed that sex had an effect on the contents of AFP and NSE (Z = -4.815- 2.052 and -4.535), while smoking only had an effect on CA-199 (P 0.05), and exposure to vinyl chloride had an effect on AFP and NSE (Z-3.763 and -2.1400.05). Multivariate analysis showed that the levels of CEA and NSE in women were significantly lower than those in men (t = -3.696 and -5.722%, respectively), and exposure to vinyl chloride was the influencing factor of NSE, which was higher than that in control group (t = 2.061, P 0.05). Conclusion exposure to vinyl chloride can cause changes in serum tumor markers at current exposure concentrations. With the time of exposure to harmful factors increased, tumor markers changed, and the possibility of tumorigenesis increased. The level of thiodiacetic acid may be related to some markers. The influencing factors of different tumor markers were different.
【作者单位】：华北理工大学公共卫生学院;唐山市南堡开发区医院;中国疾病预防控制中心职业卫生与中毒控制所;华北理工大学临床学院;
【基金】：“十二五”国家科技支撑项目(No.2014BAI12B02)
【分类号】：R135

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