环境因素的宫内暴露与生后致癌的研究进展及预防策略

Research progress and preventive strategy on postnatal carcinogenesis associated with prenatal exposure of environmental factors

恶性肿瘤是危害人类生命与健康的最严重疾病。近些年,恶性肿瘤发病率的明显变化特点之一就是年轻化趋势,其中儿童和青少年癌症的发病率上升较快,已引起各国学者的广泛关注。一些学者认为,这可能主要与母亲在怀孕期,甚至怀孕前期对各种致癌性环境因素暴露有密切的因果关系。人群流行病学调查或动物试验结果显示,在孕期胎儿或胎仔宫内暴露于射线、烟雾、一些药物、酒精、农药、有机溶剂、重金属、某些病毒感染等环境危险因素,与生后诱发肿瘤有相关性。尽管许多环境危险因素的宫内暴露致癌作用还缺乏相应的人类资料和确切依据,但随着社会经济的发展,人类接触各种环境危险因素的机会越来越多,由于一些环境因素的宫内和孕前暴露而导致其子女诱发肿瘤的潜在风险还在不断增加。因此,当务之急是大力开展环境因素的宫内暴露与子女诱发肿瘤相关的病因学研究,不断发现新的环境危险因素。同时,鉴于胎儿对各种环境致癌因素作用的高敏感性,在怀孕前期和孕期阶段,积极采取有效措施消除其环境危险因素,对降低儿童乃至全民肿瘤发病率具有重要意义。

Malignant tumor is the severe disease threatening human life and health. Recently, the evident change characteristic in malignant tumor incidence is the trend of rejuvenation. Because caner incidences of children and adolescents have increased rapidly, it has been widely concerned by researches in many countries. Some scholars think the increased caner incidences may be associated with exposures of pregnant women to various carcinogenic environmental factors during gestation and even the preconceptional period. The results of epidemiological investigation or animal experiments showed that there was correlation between caner development in offspring and exposures of them to radiation, smog, some medicine, alcohol, pesticide, organic solvent, heavy metals and some virus etc. in utero. Although there is still lack of relevant human data and definite evidences, the potential risk factors leading to caner development in the offspring due to exposures during the gestation and preconceptional period also increase continuously. Therefore, it is urgent affairs to study on etiology related caner development in the offspring and take effective measures to eliminate these risks during the gestation and preconceptional period, possessing a great meaning for reducing tumor incidence of children and even all people.