158 Occupational exposure to carcinogens in different subtypes of SinoNasal Cancer. Results from 100 consecutive hospital based cases in Italy
基于意大利100例连续住院鼻窦癌患者，发现职业暴露在腺癌中占83%，在其他亚型中占19%，木尘和皮革尘是腺癌的主要风险因素，而甲醛和铬对其他亚型更重要。
<h3>Objective</h3> Sino-nasal cancer (SNC) is a rare and potentially fatal disease with a high occupational attributable fraction, being wood, leather dust, metals and solvents well recognised carcinogenic agents. The importance of occupational exposure varies across different histological subtypes and is disputed for tumors different from adenocarcinoma (AC). We quantified the etiological role of occupational exposure in a large hospital based cohort. <h3>Methods</h3> We systematically evaluate 100 consecutive SNC cases after surgical treatment in Varese Hospital (Feb-2010/Oct-2012) through a standardised and validated questionnaire developed with the National Registry for SNC cases. <h3>Results</h3> We evaluated 62 AC, 22 squamous-cell-carcinoma, 16 other (29% women). Mean age at diagnosis was 63. Aprevious occupational exposure was recognised for 59% of cases. The proportion of occupational cases was sensibly higher for AC (83%) than for all other histotypes (19%). For AC the recognized risk factors in the great majority of cases were leather and wood dusts (46% both). Conversely, for others histotypes different and less common exposures, such as chromium and formaldehyde, resulted more important. In particular we recognised 3 professional cases previously in the photolithographic industry. Mean latency period, 50 years (min 20-max 72), and mean duration of exposure = 26y (min 4-max 54) were similar across histotypes. <h3>Conclusions</h3> Occupational exposure plays a key role in the etiopathogenesis of SNC, not only for AC (with wood and leather dust that confirmed their impact in term of public health) but also for other histotypes with formaldehyde and chromium as important and often misrecognised occupational factors.