本文選題：氯乙烯 + 腫瘤標(biāo)志物�。� 參考：《衛(wèi)生研究》2017年06期

【摘要】：目的研究氯乙烯職業(yè)接觸人群血清腫瘤標(biāo)志物水平的變化,探討不同腫瘤標(biāo)志物的影響因素。方法選擇唐山市某氯堿廠氯乙烯生產(chǎn)車間所有接觸工人223人(接觸組),無(wú)職業(yè)氯乙烯接觸的其他單位行政辦公人員149人(對(duì)照組),監(jiān)測(cè)車間空氣氯乙烯濃度,測(cè)定亞硫基二乙酸,檢測(cè)血清中11項(xiàng)腫瘤標(biāo)志物含量。結(jié)果接觸組血清中的癌胚抗原(carcino-embryonic antigen,CEA)、甲胎蛋白(alphafetoprotein,AFP)、糖鏈抗原CA-199和CA72-4含量隨著接觸工齡的增加而增加,神經(jīng)元特異性烯醇化酶(neuron-specific enolase,NSE)含量隨著接觸工齡的增加而降低,但這5項(xiàng)腫瘤標(biāo)志物與接觸工齡均無(wú)相關(guān)性,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)單因素分析發(fā)現(xiàn),接觸組亞硫基二乙酸水平高于對(duì)照組(Z=-16.178,P0.001)。單因素分析結(jié)果顯示,性別對(duì)CEA、AFP及NSE三項(xiàng)指標(biāo)的含量均有影響(Z值分別為-4.815、-2.052和-4.535,P0.05),而吸煙僅對(duì)CA-199產(chǎn)生影響(Z=-2.016,P0.05),氯乙烯的接觸對(duì)AFP和NSE有影響(Z=-3.763和-2.140,P0.05)。多因素分析顯示,與男性相比,女性體內(nèi)的CEA與NSE含量降低(t值分別為-3.696和-5.722,P0.05);氯乙烯接觸是NSE的影響因素,與對(duì)照組相比其含量升高(t=2.061,P0.05)。結(jié)論在目前的接觸濃度下,接觸氯乙烯可引起血清腫瘤標(biāo)志物水平的變化。隨著工人接觸有害因素的時(shí)間增加,腫瘤標(biāo)志物水平發(fā)生改變,機(jī)體發(fā)生腫瘤的可能性增加。亞硫基二乙酸水平與某些標(biāo)志物可能存在一定的相關(guān)關(guān)系。不同腫瘤標(biāo)志物的影響因素有所差異。
[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.
【作者單位】： 華北理工大學(xué)公共衛(wèi)生學(xué)院;唐山市南堡開(kāi)發(fā)區(qū)醫(yī)院;中國(guó)疾病預(yù)防控制中心職業(yè)衛(wèi)生與中毒控制所;華北理工大學(xué)臨床學(xué)院;
【基金】：“十二五”國(guó)家科技支撐項(xiàng)目(No.2014BAI12B02)
【分類號(hào)】：R135

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