摘要
目的总结分析广东省新发职业性肺部肿瘤的诊断思路。方法依照《中华人民共和国职业病防治法》和GBZ 94—2002《职业性肿瘤诊断标准》,对2010—2011年广东省6种新发职业性肺部肿瘤的诊断要点进行分析。结果 2010—2011年广东省诊断6种新发职业性肺部肿瘤共9例,包括:职业性焦炉工人肺癌3例,职业性石棉所致肺癌2例,职业性石棉所致间皮瘤、职业性砷所致肺癌、职业性铬酸盐所致肺癌、职业性沥青所致肺癌各1例。诊断过程中,依据综合分析和归因诊断的原则,综合分析职业史、职业病危害接触史、临床资料和辅助检查结果等资料,在明确患者所罹患恶性肿瘤为原发性肿瘤的前提下,不局限于某特殊行业人员,重点对患者的职业性致癌物接触史进行追踪、追溯和确认,参考国际劳工组织职业性肿瘤名单和文献报道,明确诊断。结论职业性肿瘤诊断过程中应注重职业性致癌物接触史的确认,重点是明确有否相应职业性致癌物接触、接触途径、接触时间和潜隐伏期。
Objective To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.Methods According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. Results There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. Conclusion During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.
作者
郑倩玲
夏丽华
胡世杰
陈嘉斌
华明
梁伟辉
陈建忠
曾飞飞
李晓艺
叶丽君
ZHENG Qianling;XIA Lihua;HU Shijie;CHEN Jiabin;HUA Ming;LIANG Weihui;CHEN Jianzhong;ZENG Feifei;LI Xiaoyi;YE Lijun(Guangdong Province Hospital for Occupational Disease Prevention and Treatment,Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment,Guangzhou,Guangdong 510300,China)
出处
《中国职业医学》
CAS
北大核心
2019年第6期678-683,共6页
China Occupational Medicine
基金
国家科技支撑计划项目(2014BAI12B01)
国家临床重点专科建设项目(2011-09)
广东省医学科研基金(A2018502)
广东省职业病防治重点实验室(2017B030314152)
广东省化学中毒与核辐射突发事件医学救援应急技术研究中心(2016A020224005).
关键词
职业性肿瘤
致癌物
接触途径
接触时间
潜隐期
Occupational tumor
Carcinogens
Exposure route
Exposure time
Incubation period
作者简介
郑倩玲(1972-),女,公共卫生硕士,主任医师,主要从事职业病防治研究
