Satoh N, Fukuda S, Takizawa M, Furuta Y, Kashiwamura M, Inuyama Y
Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo, Japan.
Rhinology. 1994 Mar;32(1):47-50.
The carcinogenicity of chromium is well established in chromium-induced lung cancer. As of yet, however, there have been only few reports of head-and-neck cancer induced by chromium. We report four cases of carcinoma in the nasal region which seemed to be induced by chromium. All patients have worked at the same chromate factory for 19 to 32 years. The first patient has suffered from squamous cell carcinoma of the left nasal cavity, starting 11 years after his retirement. He received radiotherapy followed by surgery. A malignant fibrous histiocytoma occurred in his left upper gingiva in a previously irradiated region, 7 years after the previous treatment. Surgery and chemotherapy for palliation failed to control the tumour, and he eventually expired. The other three patients underwent lobectomy for lung cancer. In cases 2 and 3, the tumour occurred in the left nasal cavity six and ten years, respectively, each after the lobectomy. In case 4, the tumour arose from the nasopharynx 15 years after the lobectomy. These patients are alive and well without any sign of tumour. The presented cases seem to be induced by long-term exposure to chromium. We conclude that regular physical examination of chromate workers is mandatory for the early detection not only of lung cancer but also of head-and-neck cancer.
铬的致癌性在铬诱发的肺癌中已得到充分证实。然而，迄今为止，仅有少数关于铬诱发头颈癌的报道。我们报告了4例似乎由铬诱发的鼻腔癌病例。所有患者均在同一家铬酸盐工厂工作了19至32年。首例患者在退休11年后罹患左鼻腔鳞状细胞癌。他接受了放疗，随后进行了手术。在先前治疗7年后，他左上颌牙龈先前接受过放疗的区域出现了恶性纤维组织细胞瘤。姑息性手术和化疗未能控制肿瘤，他最终死亡。其他3例患者接受了肺癌肺叶切除术。在第2例和第3例中，肿瘤分别在肺叶切除术后6年和10年出现在左鼻腔。在第4例中，肿瘤在肺叶切除术后15年起源于鼻咽部。这些患者目前健在，无任何肿瘤迹象。所呈现的病例似乎是由长期接触铬诱发的。我们得出结论，对铬酸盐工人进行定期体格检查不仅对早期发现肺癌而且对头颈癌都是必不可少的。
