云南省宣威地区非吸烟女性肺癌与C1烟煤中二氧化硅的关系  

Relationship between high incidence of lung cancer among non-smoking women and silica in C1 bituminous coal in Xuanwei, Yunnan Province, China

作　　者：李光剑[1] 黄云超[1] 田林玮[3] 刘拥军[4] 郭律 肖义泽[6] 侯文俊 杨堃 陈颖[1] 赵光强[1] 雷玉洁[1] 

机构地区：[1]昆明医科大学第三附属医院(云南省肿瘤医院)胸心外科,650118 [2]第一附属医院麻醉科 [3]香港中文大学公共卫生学院 [4]云南大学现代分析测试中心 [5]昆明贵研催化有限公司技术部 [6]云南省疾病预防控制中心 [7]云南宣威市第一人民医院胸外科

出　　处：《中华劳动卫生职业病杂志》2013年第1期30-36,共7页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：国家自然科学基金重点项目（U1202224）;云南省社会发展科技计划一国际合作专项基金（2008CA030）;云南省科技应用基础研究面上项目（2009CD089）

摘　　要：目的测定宣威肺癌高发地区使用的C1烟煤及燃烧产物中二氧化硅含量，研究云南省宣威地区女性肺癌高发与C1烟煤中自然产出的二氧化硅的关系。方法选取宣威肺癌高发区使用的C1烟煤，以宣威肺癌低发地区开采和使用超过10年的C2＋1、K7、M30烟煤为对照。从昆明医科大学第三附属医院（云南省肿瘤医院）病理科调取宣威地区（当地出生并居住生活3代以上）的非吸烟女性非小细胞肺癌患者手术后的14份病理组织。（1）氟硅酸钾容量滴定法分别测定20份实验组和对照组原煤和燃烧后的底灰中的二氧化硅含量；（2）扫描电镜（SEM）观察C1烟煤和燃烧后底灰中的二氧化硅颗粒物形态，用配带的能谱仪（SEN—EDX）分析其显微组分的依存关系，透射电镜（TEM）观察底灰中、煤烟尘和宣威女性肺癌组织中的二氧化硅颗粒物形态，用配带的能谱仪（TEM-EDX）分析其显微组分的依存关系；（3）物理法分离煤烟尘和底灰中的二氧化硅颗粒物并进行表征。结果（1）C1烟煤和底灰中的二氧化硅含量明显高于C2＋1、K7、M30烟煤，差异有统计学意义（P〈0．05）。（2）C1烟煤底灰中含有较多的二氧化硅颗粒物，多数以微米级别存在。（3）在c1烟煤燃烧后的煤烟尘和宣威女性肺癌癌组织中均发现有二氧化硅颗粒物存在。（4）底灰中的二氧化硅颗粒物粒径主要分布在120-500nm之间，形态各异，大小不一，赋存有铁、铝、钙和钾等元素；煤烟尘中的二氧化硅颗粒物多呈纳米级别，颗粒物直径多分布在37～80nm之间，形态各异，部分成纤维状，表面不光滑，含有铁、钾、钙、铝和硫等元素。结论宣威地区富含二氧化硅的C1烟煤与肺癌死亡率空间分布上吻合，燃烧产物（煤烟尘和底灰）和肺癌组织中均有二氧化硅颗粒物富集，颗粒物形态和显微组分上具有继承性。宣威地区C1Objective To measure the content of silica in C1 bituminous coal and its combustion products in the high-incidence area of lung cancer in Xuanwei, Yunnan Province, China and to investigate the relationship between high incidence of lung cancer among non-smoking women and silica produced naturally in C1 bituminous coal in Xuan Wei. Methods The C1 bituminous coal widely used in the high-incidence area of lung cancer in Xuanwei was selected as experiment group, while the C2＋1, K7, and M30 bituminous coal that was mined and used in the low-incidence area of lung cancer in Xuanwei for more than 10 years were selected as control group. Fourteen paraffin-embedded cancer tissue samples from the non-smoking women with non- small cell lung cancer who were born in Xuanwei and were at least the 3rd generation of the family living there were collected from the department of pathology, the ahird affiliated hospital of kunming medical university （tumor hospital of yunnan province）. Titrimetric potassium silicofluoride method was used to measure thecontent of silica in raw coal and its bottom ashes in 20 samples from the experimental group and control group. Scanning electron microscopy （SEM） was used to observe the morphology of silica particles in C1 bituminous coal and its bottom ashes, and scanning electron microscopy coupled with energy dispersive X-ray analyzer （SEM-EDX） was used to analyze the microscopic composition. Transmission electron microscope （TEM） was used to observe the morphology of silica particles in the bottom ashes and coal soot of C 1 bituminous coal as well as the lung cancer tissue from the non-smoking women in Xuanwei, and transmission electron microscope coupled with energy dispersive X-ray analyzer （TEM-EDX） was used to analyze the microscopic composition. The silica particles were separated from the coal soot and bottom ashes and characterized by physical method. Results The silica content in C1 bituminous coal and its bottom ashes was significantly higher than that in C2＋ 1,

关 键 词：云南 肺肿瘤 煤 二氧化硅 

分 类 号：R734.2[医药卫生—肿瘤]