Department of Occupational and Environmental Health, University of Milano, Clinica del Lavoro L Devoto, 20122, Milano, Italy.
Scand J Work Environ Health. 2010 Mar;36(2):163-79. doi: 10.5271/sjweh.2899. Epub 2010 Feb 2.
This paper summarizes the rationale for, possible mechanisms of, and problems related to risk assessment of the association between shift work and cancer. The mechanisms by which circadian disruption may favor the induction and/or promotion of malignant tumors are complex and multifactorial. The multilevel endocrine changes caused by circadian disruption with melatonin suppression through light at night (LAN) lead to the oncogenic targeting of the endocrine-responsive breast in women and possibly the prostate in men. Repeated phase shifting with internal desynchronization may lead to defects in the regulation of the circadian cell cycle, thus favoring uncontrolled growth. Sleep deprivation leads to the suppression of immune surveillance that may permit the establishment and/or growth of malignant clones. The epidemiological studies published so far, although dealing with large cohorts and controlling for several personal confounders, have defined the exposure to shift and/or night work rather loosely and consequently do not allow for the proper assessment of the risk connected with circadian disruption.
本文总结了轮班工作与癌症之间关联的风险评估的基本原理、可能的机制和相关问题。昼夜节律紊乱可能促进恶性肿瘤发生和/或促进其发展的机制复杂且多因素。通过夜间光照（LAN）抑制褪黑素导致的昼夜节律内分泌变化，引起女性内分泌反应性乳房（可能还有男性前列腺）的致癌靶向。反复的相位移动伴内部失同步可能导致昼夜节律细胞周期调节缺陷，从而有利于失控生长。睡眠剥夺导致免疫监视抑制，可能允许恶性克隆的建立和/或生长。迄今为止发表的流行病学研究虽然涉及大量队列并控制了几个个体混杂因素，但对轮班和/或夜班的暴露定义相当宽松，因此无法对与昼夜节律紊乱相关的风险进行适当评估。
