Dubosq Francis, Linke Clemens, Cardot Vincent, Meria Paul, Desgrandchamps François, Teillac Pierre
Service d'Urologie, Hôpital Saint-Louis, Paris, France.
Prog Urol. 2005 Jun;15(3):525-8.
The authors report the case of a 51-year-old man with a history of trichloroethylene (TCE) poisoning. He was treated by radical nephrectomy after discovery ofa right renal mass corresponding to renal cell carcinoma. The objective of this study is to discuss the role of TCE abuse as a renal carcinogen. TCE is an excellent solvent used to degrease metal parts. It can enter the body by inhalation, ingestion or cutaneous contact, but the respiratory tract is the main route of absorption of TCE. Many epidemiological studies have been conducted on workers exposed to TCE, but they have not been able to clearly establish a link between exposure by inhalation to TCE and cancer. The International Agency for Research on Cancer has accumulated sufficient evidence to consider TCE to be carcinogenic to animals and considers that TCE is probably carcinogenic to humans. Toxic metabolites derived from TCE induce chronic renal tubular lesions and may exert a genotoxic effect on the proximal convoluted tubule. The initial genotoxic effect appears to be related to mutations of the VHL suppressor gene. The chronic toxic effects and the possible role of TCE in the development of cancer have not been specifically studied in the context of TCE abuse behaviour. To our knowledge, this is the first case of renal cell carcinoma reported in a TCE addict.
作者报告了一例有三氯乙烯（TCE）中毒病史的51岁男性病例。在发现一个与肾细胞癌相符的右肾肿块后，他接受了根治性肾切除术。本研究的目的是探讨TCE滥用作为一种肾致癌物的作用。TCE是一种用于金属部件脱脂的优良溶剂。它可通过吸入、摄入或皮肤接触进入人体，但呼吸道是TCE的主要吸收途径。已经对接触TCE的工人进行了许多流行病学研究，但未能明确证实吸入TCE与癌症之间的联系。国际癌症研究机构已积累了足够的证据，认为TCE对动物具有致癌性，并认为TCE可能对人类具有致癌性。TCE衍生的有毒代谢产物会导致慢性肾小管病变，并可能对近端曲管产生遗传毒性作用。最初的遗传毒性作用似乎与VHL抑癌基因的突变有关。TCE的慢性毒性作用及其在癌症发生中的可能作用尚未在TCE滥用行为的背景下进行专门研究。据我们所知，这是首例在TCE成瘾者中报告的肾细胞癌病例。
