Vineis P
Dipartimento di Scienze Biomediche e Oncologia Umana, Ospedale Maggiore e Università di Torino, Italy.
Cancer Epidemiol Biomarkers Prev. 1992 Jan-Feb;1(2):149-53.
Epidemiological studies have clearly shown that smokers have an increased risk of bladder cancer. Chemical, biochemical, and molecular investigations indicate that such risk might be due to aromatic amines which are present in tobacco smoke. In particular, collaborative studies have shown that smokers have increased levels of hemoglobin-4-aminobiphenyl adducts in their blood and that these levels show a dose-response relationship and an association with the most carcinogenic variety of tobacco, air-cured or black tobacco. Adduct concentrations were also modulated by the genetically based slow acetylator phenotype. In addition, investigations in dogs and humans have described a DNA adduct in bladder biopsies and in exfoliated bladder cells that is a derivative of 4-aminobiphenyl. This paper summarizes the epidemiological, biochemical, and molecular evidence concerning the possible mechanisms of bladder cancer induction in smokers and in occupationally exposed workers. The case of bladder cancer is an example of integration between epidemiological studies, mathematical modeling, and laboratory investigations aiming at the elucidation of mechanisms of carcinogenesis.
流行病学研究已明确表明，吸烟者患膀胱癌的风险会增加。化学、生物化学及分子学研究表明，这种风险可能归因于烟草烟雾中存在的芳香胺。特别是，合作研究显示吸烟者血液中的血红蛋白-4-氨基联苯加合物水平升高，且这些水平呈现剂量反应关系，并与最具致癌性的烟草品种（晾晒烟或黑烟草）相关。加合物浓度也受基于遗传的慢乙酰化酶表型调节。此外，对犬类和人类的研究描述了膀胱活检组织和脱落的膀胱细胞中的一种DNA加合物，它是4-氨基联苯的衍生物。本文总结了有关吸烟者和职业暴露工人膀胱癌诱发可能机制的流行病学、生物化学及分子学证据。膀胱癌的案例是旨在阐明致癌机制的流行病学研究、数学建模和实验室研究相结合的一个实例。
