炼镍工人中呼吸道癌发病率较高。镍的致癌作用曾用动物实验作过详细研究,将镍的微粒或尘埃及其化合物注射或种植到动物后,均诱发了癌。本文是作者们在十年中预防,诊断和治疗与镍有关的呼吸道癌的经验。 Torjussen等的实验证明,炼镍工人的鼻粘膜病理变化是一种由正常呼吸道粘膜到非典型病变、表皮内癌和浸润癌的鳞状化生过程。挪威一家中心医院给91名沾染镍的病人做了活检,取材部位是有明显干燥结痂的中鼻甲前端鼻侧壁和半月裂,只有轻微变化的鼻前庭、鼻中隔和下鼻甲等处。该组病例中72例无症状、X线看来也正常者,都有不同程度的非典型病变,且1例已是浸润癌;有症状和X线改变的19例,都有严重的非典型病变,3例有鳞癌。此外,活检还证明,沾染了非水溶性镍尘埃者的呼吸道组织内,镍沉着 Nickel workers have a higher incidence of respiratory cancer. The carcinogenic effect of nickel has been studied in animal experiments. After injecting or growing nickel particles or dust and its compounds into animals, cancer has been induced. This article is the author’s experience in the prevention, diagnosis, and treatment of nickel-related respiratory cancer in the past decade. Torjussen et al.’s experiments demonstrated that the pathological changes of the nasal mucosa of nickel-manufacturers are scaly metaplasia from normal respiratory mucosa to atypical lesions, intraepidermal carcinoma, and invasive carcinoma. A central hospital in Norway gave a biopsy to 91 patients contaminated with nickel. The samples were taken from the anterior nasal wall and mid-lunar fissure of the middle turbinate with obvious dry crust, with only slight changes in the nasal vestibule, nasal septum, and inferior turbinate. In this group of patients, 72 cases were asymptomatic, and X-rays also appeared normal, with varying degrees of atypical lesions, and 1 case had invasive carcinoma; 19 cases with symptoms and X-ray changes were severely atypical Lesions, 3 cases have squamous cell carcinoma. In addition, the biopsy also proved that nickel deposits were found in the respiratory tissues contaminated with water-insoluble nickel dust.