氯乙烯接触工人肿瘤标志物水平  

Tumor markers of workers exposed to vinyl chloride

作　　者：张晓星 张桂云[2] 肖经纬[3] 常志敏 闫玉洁 薛玲 刘楠 李斌[3] 关维俊 Zhang Xiaoxing;Zhang Guiyun;Xiao Jingwei;Chang Zhimin;Yan Yujie;Xue Ling;Liu Nan;Li Bin;Guan Weijun(School of Public Health, North China University of Science and Technology, Tangshan 063000,Chin)

机构地区：[1]华北理工大学公共卫生学院,唐山063000 [2]唐山市南堡开发区医院 [3]中国疾病预防控制中心职业卫生与中毒控制所 [4]华北理工大学临床学院

出　　处：《卫生研究》2017年第6期950-955,共6页Journal of Hygiene Research

基　　金："十二五"国家科技支撑项目(No.2014BAI12B02)

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(P>0.05)。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,P<0.001)。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,P<0.05),而吸烟仅对CA-199产生影响(Z=-2.016,P<0.05),氯乙烯的接触对AFP和NSE有影响(Z=-3.763和-2.140,P<0.05)。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,P<0.05);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,P<0.05)。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。Objective To detect the changes of serum tumor markers of vinyl chloride, and find the influencing factors of tumor markers. Methods Two hundred and twenty-three workers exposed to vinyl chloride from a chlor alkali plant and one hundred and forty-nine workers without occupational exposure to vinyl chloride were recruited into this study. Detected 11 tumor markers in serum of the objective . Results The contents of carcino-embryonic antigen （CEA）, alpha-fetoprotein （AFP）, CA-199 and CA72-4 in exposed group increased with the length of service, while the content of neuron-specific enolase （NSE） decreased with the length of service, but there was no correlation between contents of tumor markers and the length of service, which had no statistical significance （P 〉 0.05）. By univariate analysis, the difference between the exposed group and the control group in the level of thiodiglycolic acid had statistical significance （Z = - 16. 178, P 〈0. 001）. By univariate analysis, gender had effect on CEA, AFP and NSE （Z = -4. 815, -2.052 and -4.535,P 〈0.05）, smoking had effect on CA-199 （Z = -2. 016,P 〈0.05）, vinyl chloride exposure had effect on AFP and NSE （Z = -3. 763 and - 2. 140, P 〈 0.05）. By multivariate analysis, CEA and NSE of women were lower than those of men （ t = - 3. 696 and - 5. 722, P 〈 0.05 ）. That vinyl chloride exposure was a factor in NSE and NSE of the exposed group were higher than the control group（t = 2. 061 ,P 〈 0.05）. Conclusion Under the current exposure concentration, exposure to vinyl chloride can change the contents of tumor markers. As the time of exposure to harmful factors increases, the level of tumor markers changes, and the possibility of tumor increases. The level of thiodiglycolic acid may be related to some tumor markers. The influencing factors of different tumor markers are different.

关 键 词：氯乙烯 肿瘤标志物 职业接触 

分 类 号：R135[医药卫生—劳动卫生] R730.2[医药卫生—公共卫生与预防医学]