Centeno Jose A, Mullick Florabel G, Martinez Leonor, Page Norbert P, Gibb Herman, Longfellow David, Thompson Claudia, Ladich Elena R
Division of Biophysical Toxicology, U.S. Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Environ Health Perspect. 2002 Oct;110 Suppl 5(Suppl 5):883-6. doi: 10.1289/ehp.02110s5883.
Millions now suffer the effects of chronic arseniasis related to environmental arsenic exposure. The biological mechanisms responsible for arsenic-induced toxicity and especially chronic effects, including cancer, are not well known. The U.S. Armed Forces Institute of Pathology (AFIP) is participating in an international research effort to improve this understanding by the development of the International Tissue and Tumor Repository for Chronic Arsenosis (ITTRCA). The ITTRCA obtains, archives, and makes available for research purposes, tissues from subjects exposed to arsenic. We provide here a short overview of arsenic-induced pathology, briefly describe arsenic-induced lesions in the skin and liver, and present five case reports from the ITTRCA. Arsenic-induced skin pathology includes hyperkeratosis, pigmentation changes, Bowen disease, squamous cell carcinoma, and basal cell carcinomas. A unique spectrum of skin lesions, known as arsenical keratosis, is rather characteristic of chronic arseniasis. Bowen disease, or squamous cell carcinoma in situ of the skin, has been well documented as a consequence of arsenical exposure. A spectrum of liver lesions has also been attributed to chronic arseniasis. Of these, hepatocellular carcinoma, angiosarcoma, cirrhosis, and hepatoportal sclerosis have been associated with arsenic exposure. We present case reports that relate to these health conditions, namely, squamous cell carcinoma, basal cell carcinoma, and Bowen disease of the skin and hepatocellular carcinoma and angiosarcoma of the liver. Four patients had been treated with arsenical medications for such conditions as asthma, psoriasis, and syphilis, and one case occurred in a boy chronically exposed to arsenic in drinking water.
如今，数百万人正遭受与环境砷暴露相关的慢性砷中毒影响。砷诱导毒性尤其是包括癌症在内的慢性影响的生物学机制尚不清楚。美国武装部队病理研究所（AFIP）正在参与一项国际研究工作，通过建立慢性砷中毒国际组织和肿瘤储存库（ITTRCA）来增进对此的了解。ITTRCA获取、存档并提供受砷暴露者的组织用于研究目的。我们在此简要概述砷诱导的病理学，简要描述砷在皮肤和肝脏中诱导的病变，并展示来自ITTRCA的五个病例报告。砷诱导的皮肤病理学包括角化过度、色素沉着变化、鲍恩病、鳞状细胞癌和基底细胞癌。一种独特的皮肤病变谱，即砷角化病，是慢性砷中毒的相当典型特征。鲍恩病，即皮肤原位鳞状细胞癌，已被充分证明是砷暴露的后果。一系列肝脏病变也归因于慢性砷中毒。其中，肝细胞癌、血管肉瘤、肝硬化和肝门脉硬化都与砷暴露有关。我们展示了与这些健康状况相关的病例报告，即皮肤的鳞状细胞癌、基底细胞癌和鲍恩病以及肝脏的肝细胞癌和血管肉瘤。四名患者曾因哮喘、银屑病和梅毒等病症接受砷剂治疗，还有一例发生在一名长期饮用含砷饮用水的男孩身上。
