Pirastu R, Comba P, Reggiani A, Foa V, Masina A, Maltoni C
Department of Animal and Human Biology, University of Rome, La Sapienza, Italy.
Am J Ind Med. 1990;17(2):155-61. doi: 10.1002/ajim.4700170202.
The possible association in humans between nonangiosarcoma primary liver tumors (PLC-non-A), particularly hepatocellular carcinoma (HCC), and exposure to vinyl chloride monomer (VCM) is supported by both experimental and human data. This article presents a review of the information regarding 253 deaths that occurred in seven plants manufacturing VCM/PVC and one plant extruding PVC. The retrieval of clinical and pathological data, in addition to the information from death certificate, is referred to as "best evidence" (BE). BE has been carried out for 63 deaths. A total of 14 primary liver cancer (PLC) were detected: seven were angiosarcoma (PLC-A), and two of the remaining seven were hepatocellular carcinoma (HCC). In our series of 14 PLC cases, there was no significant difference between PLC-A and PLC-non-A as to length of exposure and latency. There was no noticeable difference in terms of job title between ASL and non-ASL cases. The list of longest held jobs shows the presence of various job titles, different from autoclave cleaner, for primary liver cancer, PLC-A and PLC-non-A. In conclusion, our observations show that VCM may have a broader carcinogenicity action on the liver and that exposure lower than that occurring in autoclave cleaning can cause primary liver cancer, both angiosarcoma and nonangiosarcoma.
实验数据和人类数据均支持人类中非血管肉瘤性原发性肝肿瘤（PLC - non - A），尤其是肝细胞癌（HCC）与接触氯乙烯单体（VCM）之间可能存在关联。本文综述了在7家生产VCM/PVC的工厂和1家挤出PVC的工厂中发生的253例死亡事件的相关信息。除死亡证明信息外，临床和病理数据的检索被称为“最佳证据”（BE）。已对63例死亡进行了BE。共检测到14例原发性肝癌（PLC）：7例为血管肉瘤（PLC - A），其余7例中有2例为肝细胞癌（HCC）。在我们的14例PLC病例系列中，PLC - A和PLC - non - A在接触时长和潜伏期方面无显著差异。ASL和非ASL病例在职称方面无明显差异。任职时间最长的工作列表显示，原发性肝癌、PLC - A和PLC - non - A存在各种不同的职称，不同于高压釜清洁工。总之，我们的观察结果表明，VCM可能对肝脏具有更广泛的致癌作用，且低于高压釜清洁工作中的接触水平也可导致原发性肝癌，包括血管肉瘤和非血管肉瘤。
