Szymańska-Chabowska Anna, Antonowicz-Juchniewicz Jolanta, Andrzejak Ryszard
Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Wrocław, Poland.
Int J Occup Med Environ Health. 2007;20(3):229-39. doi: 10.2478/v10001-007-0026-0.
Molecular epidemiology studies have lately been focused on occupational cancer associated with exposure to chemical carcinogens in work environment. Measuring serum levels of tumour markers ie. the substances produced in transformed cells, is a modern method used in the prevention or early detection of cancer. A two-year observation study was constructed to investigate the relationship between arsenic, lead, and cadmium concentrations and the levels of cancer markers: TPA (tissue polipeptide antigen), TPS (tissue polipeptide specific antigen), and CYFRA 21-1 in 69 male workers occupationally exposed to As and Pb, and environmentally exposed to Cd via tobacco smoking.
Significant correlations were found between CEA and blood Cd concentrations or between CEA and period of work under exposure. Multiple regression tests revealed also relationships between some cancer markers and the work period, and thereby the lifetime exposure to heavy metals. Duration of work under exposure significantly influenced TPA and TPS concentrations in these models. All the metals examined were found to have influence on the concentration of cancer markers, except for CYFRA 21-1, but the direction of this influence varied. Lead (especially FEP level) and cadmium were also among the metals affecting TPA concentration profile, although the multiple regression ratio for Cd-TPA correlation was negative.
The strong positive correlation between blood concentrations of Cd and CEA, the marker of abnormal cellular differentiation, may reflect neoplastic transformation of normal cells stimulated by some carcinogens (e.g. cadmium). All the examined carcinogenic, or potentially carcinogenic metals (As, Cd, Pb) belong to the group of factors having impact on serum TPS and/or TPA concentrations in exposed workers. No correlation was found between CYFRA 21-1 and any metal studied but it is plausible that changes in the concentration level of this marker might be revealed after a longer observation period.
分子流行病学研究近来聚焦于与工作环境中接触化学致癌物相关的职业性癌症。检测血清肿瘤标志物水平,即转化细胞产生的物质,是用于癌症预防或早期检测的一种现代方法。开展了一项为期两年的观察性研究,以调查69名职业性接触砷和铅且通过吸烟环境接触镉的男性工人中,砷、铅和镉浓度与癌症标志物水平(组织多肽抗原(TPA)、组织多肽特异性抗原(TPS)和细胞角蛋白19片段(CYFRA 21-1))之间的关系。
癌胚抗原(CEA)与血液镉浓度之间,以及CEA与接触工作时长之间存在显著相关性。多元回归测试还揭示了一些癌症标志物与工作时长之间的关系,进而与重金属的终生接触量之间的关系。在这些模型中,接触工作时长对TPA和TPS浓度有显著影响。除CYFRA 21-1外,所有检测的金属均对癌症标志物浓度有影响,但这种影响的方向各不相同。铅(尤其是游离原卟啉水平)和镉也在影响TPA浓度分布的金属之列,尽管镉与TPA相关性的多元回归系数为负。
镉血浓度与异常细胞分化标志物CEA之间的强正相关,可能反映了某些致癌物(如镉)刺激下正常细胞的肿瘤转化。所有检测的致癌或潜在致癌金属(砷、镉、铅)均属于对接触工人血清TPS和/或TPA浓度有影响的因素组。未发现CYFRA 21-1与任何研究的金属之间存在相关性,但经过更长观察期后,该标志物浓度水平的变化可能会显现出来,这是合理的。