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Klinische Wochenschrift

, Volume 63, Issue 7, pp 325–331 | Cite as

Das Vinylchlorid-induzierte hepatozelluläre Karzinom

  • A. Dietz
  • G. Langbein
  • W. Permanetter
Originalien

Abkürzungen

HAS

Hämangiosarkom

HZK

Hepatozelluläres Karzinom

PVC

Polyvinylchlorid

VC

Vinylchlorid

Vinylchloride-induced hepato-cellular carcinoma

Summary

On the occasion of a hitherto unique observation of three hepatocellular carcinomas in workers of the same industrial plant within 7 years following long-term exposure to vinylchloride, the characteristics are discussed of a chemical carcinogenesis leading to two different malignant tumours: haemangiosarcoma and hepatocellular carcinoma. This carcinogenic sequence has been predicted by animal studies. It is not known why the transformation of hepatocytes into carcinoma is far rarer than of sinusoidal cells into sarcoma. Whereas the hepatocellular carcinoma predominantly develops in association with cirrhosis, vinyl chloride is able to cause cancer directly without other known co-carcinogenic agents. This hepatic carcinogenicity is dose-dependent. After the introduction of industrial prevention measures, a new initiation of the tumour is improbable. Nevertheless, because of its long latency period, estimated between 5 and 20 years, clinical manifestations are still possible. An early diagnosis by sonography and computertomography, possibly combined with puncture, in exposed persons or those formerly at high risk is conceivable, while laboratory data, even tumour markers are unreliable. Its fulminant course does not differ from that of other hepatocellular carcinomas and has until now hindered successful treatment.

Key words

Vinylchloride Hepatocellular carcinoma Haemangiosarcoma Carcinogenesis 

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Literatur

  1. 1.
    Adamson RH (1972) Longterm administration of carcinogenic agents to primates. In: Goldsmith EJ, Moor-Jankowski J (eds) Medical Primatology. S Karger, Basel, pp 216–255Google Scholar
  2. 2.
    Arnold W (1984) Klinische und serologische Befunde beim primären Leberzellkarzinom. Dtsch med Wschr 109:460–462Google Scholar
  3. 3.
    Beasley RP, Hwang LY, Lin CC, Chien CS (1981) Hepatocellular carcinoma and hepatitis B virus. Lancet II:1129–1133Google Scholar
  4. 4.
    Büngeler W, Eder M (1960) Das primäre Leberkarzinom. Dtsch Med Wschr 22:959–965Google Scholar
  5. 5.
    Chatelain A, Motillon P (1967) Un syndrome d'acro-osteolyse d'origine professionelle et de constatation nouvelle en France. J Radiol Electrol 48:277–280Google Scholar
  6. 6.
    Cordier JM, Fievez C, Lefevre MJ, Sevrin A (1966) Acroosteolyse et lesions cutanées associées chez deux ouvriers affectés a nettoyage d'autoclaves. Cah Med Travail 4:3–39Google Scholar
  7. 7.
    Creech JL, Johnson MN (1974) Angiosarcoma of Liver in the Manufacture of Polyvinylchloride. J Occup Med 16:150–151Google Scholar
  8. 8.
    Falk H, Creech JL Jr, Heath CW Jr, Johnson MN, Key MM (1974) Hepatic disease among workers at a vinyl chloride polymerization plant. J Amer med Ass 230:59–63Google Scholar
  9. 9.
    Feron VJ, Spit BJ, Immel HR, Kroes R (1979) One-Year Time-Sequence Inhalation Toxicity Study of Vinyl Chloride in Rats. III. Morphological Changes in The Liver. Toxicology 13:143–154Google Scholar
  10. 10.
    Fox AJ, Collier PF (1977) Mortality experience of workers exposed to vinylchloride monomer in the manufacture of polyvinylchloride in Great Britain. Brit J Industr Med 34:1–10Google Scholar
  11. 11.
    Gokel JM, Liebezeit E, Eder M (1976) Hemangiosarcoma and Hepatocellular Carcinoma of the Liver Following Vinyl Chloride Exposure. Virchows Arch A Path Anat and Histol 372:195–203Google Scholar
  12. 12.
    Harris DK, Adams WGF (1967) Acroosteolysis occurring in men engaged in the polymerization of vinylchloride. Brit med J 3:712–714Google Scholar
  13. 13.
    Heath CW, Falk H, Creech HL (1975) Characteristics of cases of angiosarcoma of the liver among vinylchloride workers in the United States. Ann NY Acad Sci 246:231–236Google Scholar
  14. 14.
    Jahresbericht der Gewerbeaufsicht des Landes Nordrhein-Westf (1978) 4. Erkrankungen durch Vinylchlorid. S. 347–352Google Scholar
  15. 15.
    Koischowitz D, Lelbach WK, Lackner K, Hermanutz D (1981) Das vinylchloridinduzierte Leberangiosarkom und hepatozelluläre Karzinom. Fortschr Röntgenstr 134/3:283–290Google Scholar
  16. 16.
    Koshy R, Hofschneider PH (1981) Presence of hepatitis B DNA sequences integrated in the DNA of hepatocarcinoma and cirrhosis tissues. In: Mapas P, Guesry P (eds) Hepatitis B Vaccine, INSERM Symp 18. Elsevier/North-Holland, Biomed Press, p 195Google Scholar
  17. 17.
    Langbein G, Permanetter W, Dietz A (1983) Hepatozelluläres Karzinom nach Vinylchloridexposition. Dtsch med Wschr 108:741–745Google Scholar
  18. 18.
    Lange CE, Jühe S, Veltmann G (1974) Über das Auftreten von Angiosarkomen der Leber bei zwei Arbeitern der PVC-herstellenden Industrie. Dtsch med Wschr 99:1598–1599Google Scholar
  19. 19.
    Lee FI, Harry DS (1974) Angiosarcoma of the Liver in a Vinyl-Chloride Worker. Lancet 1316–1318Google Scholar
  20. 20.
    Lelbach WK, Marsteller HJ (1981) Vinyl Chloride-Associated Disease. Adv Int Med and Ped. Springer, Berlin Heidelberg pp 1–110Google Scholar
  21. 21.
    Maltoni C, Lefemine G (1974) La potenzialità dei Saggi sperimentali nella predizione dei rischi oncogeni ambientali. Un esempio: Il cloruro di vinile. Academia Nazionale dei Lincei. Estratto dei Rendiconti della Classe di Scienze fisiche, matematiche e naturali. Ser VIII, vol LVI 3:1–11Google Scholar
  22. 22.
    Maltoni C (1976) Carcinogenicity of vinyl chloride: current results, experimental evidence. Exc Med Amsterdam 375:216–237Google Scholar
  23. 23.
    Maltoni C (1977) Recent findings on the carcinogenicity of chlorinated olefins. Environ Health Perspect 21:1–5Google Scholar
  24. 24.
    Marin A, Strauss J, Michels R, Benoit JP, Baltie R, Pierre C (1967) Acro-ostéolyse d'origine professionelle. Rev Rheum Med Osteoartic 34:340–351Google Scholar
  25. 25.
    Marosi L, Ferenci P, Dragosics B, Kiss F (1983) Leberzirrhose und primäres Leberkarzinom. 89 Tg Dtsch Ges Inn MedGoogle Scholar
  26. 26.
    Pichlmayr R, Brölsch Ch (1983) Lebertransplantation: Entwicklungsstand und Tendenzen. Med Klin 78:744–752Google Scholar
  27. 27.
    Popper H (1977) The increasing Importance of Liver Tumors. In: Remmer H, Bolt HM, Bannasch P, Popper H (eds) Proc 25th Falk Symp. MTP Press, pp 3–10Google Scholar
  28. 28.
    Popper H, Thomas LB, Schaffner F, Maltoni C, Selikoff IJ (1978a) Interaction between sinusoidal cells and hepatocytes in human and experimental angiosarcoma induced by experimental factors. In: Wisse E, Knock DL (eds) Proc Int Kupffer Cell Symp. Elsevir, North HollandGoogle Scholar
  29. 29.
    Popper H, Thomas LB, Telles NC, Falk H, Selikoff IJ (1978b) Development of hepatic angiosarcoma in man, induced by vinyl chloride, thorotrast and arsenic. Am J Pathol 92:349–376Google Scholar
  30. 30.
    Popper H, Maltoni C, Selikoff IJ (1981) Vinyl chloride-induced hepatic lesions in man and rodents. A comparison. Liver 1:7–20Google Scholar
  31. 31.
    Preussmann R (1977) Hepatocarcinogens as Potential Risk for Human Liver Cancer. In: Remmer H, Bolt HM, Bannasch P, Popper H (eds) Proc 25th Falk Symp. MTP Press Ltd, pp 11–29Google Scholar
  32. 32.
    Schaffner F (1977) Effect of Long-term Vinyl Chloride Exposure in Mouse Liver Structure. In: Remmer H, Bolt HM, Bannasch P, Popper H (eds) Proc 25th Falk Symp. MTP Press Ltd, pp 189–199Google Scholar
  33. 33.
    Schmid M (1976) Umwelteinflüsse auf Leber und Magen-Darm-trakt. Schweiz Med Wochenschr 106:289–295Google Scholar
  34. 34.
    Schmid M (1984) Leberkrebs — Hepatokarzinogenese. 90 Tg Dtsch Ges Inn MedGoogle Scholar
  35. 35.
    Suciu J, Drejman I, Valaskai M (1963) Contributii la studiul imbolnavirilor produse de clorura de vinil. Med interna (Buc.) 15:967–978Google Scholar
  36. 36.
    Szadkowski D, Lehnert G (1982) Vinylchlorid als Krankheitsursache. Eine Bibliographie. Verb Kunststofferzeugende Industrie, Frankfurt/MainGoogle Scholar
  37. 37.
    Tamburro CH, Creech JL, Makk L, Whelan JG (1978) Alcohol and vinyl chloride: A causal relationship in the development of primary hepatocellular carcinoma. Meeting of the Intern Ass for the Study of the Liver. Fuengirola, SpanienGoogle Scholar
  38. 38.
    Teschke R (1983) Leberschäden durch Arzneimittel. Dtsch med Wochenschr 108:190–194Google Scholar
  39. 39.
    Thomas LB, Popper H, Berk PD, Selikoff IJ, Falk H (1975) Vinyl-chloride-induced liver disease. From idiopathic portal hypertension (Banti's Syndrom) to angiosarcomas. New Engl J Med 2921:17–22Google Scholar
  40. 40.
    Tribukh SL, Tikhomirova NP, Levina SV, Kozlov LA (1949) Working conditions and measures for their sanitation in the production and utilization vinylchloride plastics. Arg Saint 10:38–45Google Scholar
  41. 41.
    Viola PL, Bigotti A, Caputo A (1971) Oncogenic Response of Rat Skin, Lungs and Bones to Vinyl Chloride. Cancer Res 31:516–522Google Scholar
  42. 42.
    Weiss W, Hanak H (1977) Primary Liver Carcinoma in Austria In: Remmer H, Bolt HM, Bannasch P, Popper H (eds) Proc 25th Falk Symp MTP Press, pp 145–148Google Scholar
  43. 43.
    Wildgrube HJ (1983) Diagnostische und prognostische Aspekte der akuten Virushepatitis. Klinikarzt 12:539–558Google Scholar
  44. 44.
    Wilson RH, McCormick WE, Tatum CF, Creech JL (1967) Occupational acroosteolysis. Report of 31 cases. J Amer Med Ass 201:577–581Google Scholar

Copyright information

© Springer-Verlag GmbH & Co. KG 1985

Authors and Affiliations

  • A. Dietz
    • 1
  • G. Langbein
    • 1
  • W. Permanetter
    • 2
  1. 1.Innere Abteilung des Städtischen KrankenhausesRadolfzell
  2. 2.Pathologisches Institut der UniversitätMünchen

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