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[木尘所致筛窦腺癌的致癌作用]

[Carcinogenesis of the ethmoidal adenocarcinoma due to wood dust].

作者信息

De Gabory L, Conso F, Barry B, Stoll D

机构信息

CHU Pellegrin, Pôle FX Michelet, Clinique Universitaire d'ORL et Chirurgie Cervico-Faciale, Bordeaux, France.

出版信息

Rev Laryngol Otol Rhinol (Bord). 2009;130(2):93-104.

Abstract

OBJECTIVES

To recognize the mechanisms and the different oncogenic pathways of ethmoid adenocarcinoma (EADC) in woodworkers.

METHODS

A systematic review of the literature and evaluation according to scientific evidences.

RESULTS

Wood dust less than 10 microm settles on the external aspects of the ethmoid sinus that is the middle turbinate, the middle meatus and the olfactory cleft. The risk of developing an EADC is important from the first year. It is impossible to know what determines the latency period. Usually, this period exceeds 30 years and only 10% of patients are younger than 50 years of age. Chromosomal instability of the respiratory mucosa appears to be one of the major phases in the oncogenic process. Certain biomolecular and genetic factors are shared with the adenocarcinoma of the colon but they are not activated with the same importance and in the same context suggesting two distinct mechanisms of evolution. The local anatomo-clinical setting in the nasal cavity and carcinogenic substances in the wood dust play a key specific role in the development of EADC. No oncoproteins or immunohistochemistry features were identified in the process suggesting a cascade of genetic or molecular series of events.

摘要

目的

认识木工筛窦腺癌(EADC)的发病机制及不同致癌途径。

方法

根据科学证据对文献进行系统综述和评估。

结果

小于10微米的木屑沉积在筛窦的外部,即中鼻甲、中鼻道和嗅裂。从第一年起发生EADC的风险就很高。无法知晓是什么决定了潜伏期。通常,这个时期超过30年,只有10%的患者年龄小于50岁。呼吸道黏膜的染色体不稳定性似乎是致癌过程中的主要阶段之一。某些生物分子和遗传因素与结肠癌共有,但它们的激活程度和背景不同,提示两种不同的演变机制。鼻腔的局部解剖临床情况和木屑中的致癌物质在EADC的发生中起关键的特定作用。在此过程中未发现癌蛋白或免疫组化特征,提示存在一系列遗传或分子事件。

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