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髓系白血病和骨髓增生异常综合征:一项病例对照研究中的化学物质暴露、组织学亚型和细胞遗传学

Myeloid leukemias and myelodysplastic syndromes: chemical exposure, histologic subtype and cytogenetics in a case-control study.

作者信息

Ciccone G, Mirabelli D, Levis A, Gavarotti P, Rege-Cambrin G, Davico L, Vineis P

机构信息

Unit of Cancer Epidemiology, Main Hospital, Torino, Italy.

出版信息

Cancer Genet Cytogenet. 1993 Jul 15;68(2):135-9. doi: 10.1016/0165-4608(93)90010-j.

Abstract

We conducted a case control study of 50 acute myeloid leukemias (AML), 17 chronic myeloid leukemias (CML), 19 myelodysplastic syndromes (MDS), and 246 controls. The cases were classified according to the French-American-British (FAB) classification, and chromosome aberrations were recorded according to the International System for Human Cytogenetic Nomenclature. Exposure to suspected leukemogenic agents was assessed blindly by an industrial hygienist. Increased risks were noted for mechanics, welders, electricians, and drivers among men and among farmers and textile workers among women. Increased SMRs for leukemias in a census-based cohort study conducted in the same area (Torino) were previously reported for electricians and drivers among men and for textile workers among women. We detected nonstatistically significant increased relative risks for exposure to benzene (odds ratio, OR = 1.7), petrol refining products (1.9), polycyclic aromatic hydrocarbons (1.7), and electromagnetic fields (1.6) in men; in women, a statistically significant association with exposure to pesticides was detected [OR = 4.4; 95% confidence interval (CI) 1.7-11.5]. Although exposure to pesticides was confined to AML, MDS cases included a high proportion of subjects exposed to benzene and electromagnetic fields. No particular histologic subtype of AML was associated with chemical exposures except for that of pesticides with the M4 category. Chromosome aberrations were not associated with chemical exposures (OR = 1.0), but a nonstatistically significant excess was noted in association with electromagnetic fields (OR = 2.1).

摘要

我们对50例急性髓系白血病(AML)、17例慢性髓系白血病(CML)、19例骨髓增生异常综合征(MDS)患者以及246名对照者进行了病例对照研究。病例按照法美英(FAB)分类法进行分类,染色体畸变依据国际人类细胞遗传学命名系统进行记录。由一名工业卫生学家对接触疑似致白血病因子的情况进行盲法评估。结果发现,男性中的机械工、焊工、电工和司机以及女性中的农民和纺织工人白血病发病风险增加。先前在同一地区(都灵)进行的一项基于人口普查队列研究中,曾报告男性中的电工和司机以及女性中的纺织工人白血病的标准化发病比(SMR)升高。我们检测到男性接触苯(优势比,OR = 1.7)、石油炼制产品(1.9)、多环芳烃(1.7)和电磁场(1.6)的相对风险有非统计学意义的增加;在女性中,检测到与接触农药存在统计学显著关联[OR = 4.4;95%置信区间(CI)1.7 - 11.5]。虽然接触农药的情况仅限于AML,但MDS病例中有很大比例的受试者接触苯和电磁场。除了M4型与农药接触有关外,AML没有特定的组织学亚型与化学物质接触相关。染色体畸变与化学物质接触无关(OR = 1.0),但与电磁场相关有非统计学意义的过量情况(OR = 2.1)。

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