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目的研究氯乙烯职业接触人群血清肿瘤标志物水平的变化,探讨不同肿瘤标志物的影响因素。方法选择唐山市某氯碱厂氯乙烯生产车间所有接触工人223人(接触组),无职业氯乙烯接触的其他单位行政办公人员149人(对照组),监测车间空气氯乙烯浓度,测定亚硫基二乙酸,检测血清中11项肿瘤标志物含量。结果接触组血清中的癌胚抗原(carcino-embryonic antigen,CEA)、甲胎蛋白(alphafetoprotein,AFP)、糖链抗原CA-199和CA72-4含量随着接触工龄的增加而增加,神经元特异性烯醇化酶(neuron-specific enolase,NSE)含量随着接触工龄的增加而降低,但这5项肿瘤标志物与接触工龄均无相关性,差异无统计学意义(P>0.05)。经单因素分析发现,接触组亚硫基二乙酸水平高于对照组(Z=-16.178,P<0.001)。单因素分析结果显示,性别对CEA、AFP及NSE三项指标的含量均有影响(Z值分别为-4.815、-2.052和-4.535,P<0.05),而吸烟仅对CA-199产生影响(Z=-2.016,P<0.05),氯乙烯的接触对AFP和NSE有影响(Z=-3.763和-2.140,P<0.05)。多因素分析显示,与男性相比,女性体内的CEA与NSE含量降低(t值分别为-3.696和-5.722,P<0.05);氯乙烯接触是NSE的影响因素,与对照组相比其含量升高(t=2.061,P<0.05)。结论在目前的接触浓度下,接触氯乙烯可引起血清肿瘤标志物水平的变化。随着工人接触有害因素的时间增加,肿瘤标志物水平发生改变,机体发生肿瘤的可能性增加。亚硫基二乙酸水平与某些标志物可能存在一定的相关关系。不同肿瘤标志物的影响因素有所差异。
Objective To investigate the changes of serum tumor markers in VCV occupational exposure groups and to explore the influencing factors of different tumor markers. Methods A total of 223 exposed workers (contact group) and 149 persons (control group) from other units without occupational vinyl chloride exposure in a chlor-alkali workshop in a chlor-alkali plant in Tangshan City were selected to monitor the concentration of vinyl chloride in the air of the workshop. Diacetic acid, detection of serum tumor markers in 11 content. Results The levels of carcinoembryonic antigen (CEA), alphafetoprotein (AFP), carbohydrate antigen CA-199 and CA72-4 in the serum of contact group increased with the increase of working age, and neuron-specific The content of neuron-specific enolase (NSE) decreased with the increase of working age, but there was no correlation between the five tumor markers and the length of service. There was no significant difference (P> 0.05). Univariate analysis showed that the level of thiodiacetic acid in the exposed group was higher than that in the control group (Z = -16.178, P <0.001). Univariate analysis showed that gender had effects on the levels of CEA, AFP and NSE (Z values were -4.815, -2.052 and -4.535 respectively, P <0.05), whereas smoking only affected CA-199 Z = -2.016, P <0.05). Exposure to vinyl chloride had effects on AFP and NSE (Z = -3.763 and -2.140, P <0.05). Multivariate analysis showed that women had lower CEA and NSE levels compared with men (t = -3.696 and -5.722, respectively, P <0.05); exposure to vinyl chloride was a contributing factor to NSE, compared with controls Increased (t = 2.061, P <0.05). Conclusions Exposure to vinyl chloride can cause changes in serum tumor marker levels at the current contact concentrations. As workers become exposed to harmful elements for an extended period of time, the level of their tumor markers changes and their chance of developing tumors increases. Thiodiacetic acid levels and some markers may be related to some degree. The impact of different tumor markers vary.