流式細胞儀在染料廠員工膀胱癌早期偵測之應用
The early screening of bladder cancer by flow cytometry in the benzidine-based dye workers
中文摘要
台灣地區染料製造業的歷史已有三十年以上, 而聯苯胺類染料及其中間 體已被確認易導致膀胱癌,潛伏期平均約為十八至二十五年,且在離開暴露 後仍有病例可能發生,預期從業人員中將會有患者持續出現,若能早期發 現,則其存活率可明顯增加,故從業人員之長期追蹤及疾病早期偵測之工作 相當必要. 本研究為了解染料製造業者泌尿上皮細胞之病變及探討更有 效的膀胱癌早期篩選指標,選定某染料製造所有員工,以流式細胞儀針對泌 尿上皮細胞分析其細胞週期,由此所得之可疑個案進一步作細胞學檢查與 膀胱腫瘤抗原試驗的確認,評估職業暴露對細胞染色體傷害的程度. 在
流式細胞儀細胞週期分析中,染料廠員工的 G0G1 值為 85.43%, 較膀胱癌病 人48.2%為高,卻較健檢老人 86.56%為低.在 S 值方面,膀胱癌病人為最高,健 檢老人10.84%為最低,染料廠員工則為 12.10%,居兩者之中.在進一步的多 因子對數回歸分析中,經調整干擾因子後,部門間與 G0G1 值及 S 值之異常率 均有達到顯著差異,其危險對比值分別為 1.80(95%CI 為
1.25-2.58)與 2.08(95%CI 為 1.34-3.22). 本研究建立了台灣地區第一個 染料造廠員工泌尿上皮細胞活性之基本資料,可供為未來癌變追蹤之參考, 並建議染料製造廠現場工人應列為高危險群,宜作定期追蹤,也其能將此方 法應用於其他類似工業疾病或癌症之早期篩選上,使早期患者能因此改善 預後及延長存活時間.
英文摘要
An increased incidence of cancer of the urinary bladder was first attributed to human occupational exposure to dyes and dye chemicals in 1895.The latent period of bladder cancer was about 18 years,and thiscancer could be happened after leaving the exposure for several years.ASthe synthetic dye industry had been grown about 30 years in Taiwan,itcould be predicted that the bladder cancer would be prevalent subsequentlyin benzidine-based dye workers in the near future.Early screening ofbladder cancer will increase the survival rate of the patients.Both thelong- term follow up and early detection will be important preventive measure to benzidine-based workers. In order to understand the urothelial cell carcinoma in dyemanufacturing workers and
find a efficient marker to screen the early stageof bladder cancer,this study was made to take the workers in a benzidine- based dye manufactory. we used the flow cytometry to analysis theurotherial cell cycle. Cytological examination and bladder tumor antigentest were used to confirm the suspicious cases screened by cell cycleanalysis. The degree of the cell
chromosome damage from theoccupational exposure were determined.
The data base of flow cytometricDNA ploidy of these dye workers''
urothelial cell were set up,and may beadopted to other similar occupational diseases.
