■虽然由于烟草和酒精消费的减少,头颈癌的总体发病率有所下降,在几个工业化国家,HPV阴性口腔鳞状细胞癌(SCC)的发病率正在上升,特别是不吸烟和不饮酒的患者。
■我们记录了一例56岁的从不吸烟患者的牙龈SCC病例,报告其饮酒量低和不寻常的职业溶剂暴露。HPV阴性病变于2018年手术切除,2019年复发手术后4年,患者仍处于完全缓解状态。2021年,该患者被转诊至职业癌症咨询。病人做了18年的丝网印刷机。他报告说,每2-3天吸嘴将有机溶剂(主要是芳烃和酮)从容器转移到较小的容器中,有规律的溶剂进入他的嘴里。
■根据文献,使用口腔虹吸溶剂的频率可能被低估。虽然我们的综述没有发现报告口腔虹吸对口腔的长期影响的研究,目前的证据支持上消化道SCC与职业暴露于有机溶剂和印刷过程呈正相关。在没有主要的非专业因素的情况下,该患者的HPV阴性牙龈SCC可能归因于常规的职业性口服溶剂暴露.虽然现有的证据仍然限于正式建立因果关系,临床医师应调查OSCC患者和溶剂暴露史患者的这一危险工作实践.
UNASSIGNED: While overall head and neck cancer incidence decreases due to reduced tobacco and alcohol consumption, the incidence of HPV negative oral cavity squamous cell carcinoma (SCC) is raising in several industrialized countries, especially in non-smoking and non-drinking patients.
UNASSIGNED: We document a
case of gingiva SCC in a 56 years old never-smoker patient reporting low alcohol consumption and unusual
occupational solvent exposure. The HPV-negative lesion was surgically removed in 2018, and the patient remains in complete remission 4 years after recurrent surgery in 2019. In 2021, the patient was referred to the
occupational cancer consultation. The patient worked as screen printer for 18 years. He reported mouth siphoning every 2-3 days to transfer organic solvents (mainly aromatic hydrocarbons and ketones) from containers into smaller recipients, with regular passage of solvents into his mouth.
UNASSIGNED: According to the literature, the frequency of solvent siphoning using mouth is likely to be underestimated. While our review did not find studies reporting longterm consequences to the oral cavity of mouth siphoning, current evidence supports a positive association of upper aero digestive tract SCC with
occupational exposures to organic solvents and printing processes. In absence of major extraprofessional factors, the HPV-negative gingiva SCC of this patient might be attributable to the regular
occupational oral solvent exposure. While the available evidence remains limited to formally establish a causal relationship, clinicians should investigate this hazardous work practice in patients with OSCC and history of solvent exposures.