Ameille J, Brochard P, Letourneux M, Paris C, Pairon J-C
Unité de pathologie professionnelle, hôpital Raymond-Poincaré, AP-HP, 104, Garches, France.
Rev Mal Respir. 2011 Jun;28(6):e11-7. doi: 10.1016/j.rmr.2011.04.008.
The relationships between benign asbestos-related diseases (asbestosis and pleural plaques) and thoracic cancers are still debated. The aim of this paper was to review the epidemiological data relevant to this issue.
Published studies show a significant relationship between occupational exposure to asbestos and lung cancer risk, even in the absence of abnormalities consistent with asbestosis on the postero-anterior chest x-ray. For a given cumulative asbestos exposure, the presence of radiographic evidence of asbestosis is associated with an increased risk of lung cancer. Among asbestos-exposed individuals, those having radiographic evidence of pleural plaques are at increased risk for lung cancer and pleural mesothelioma, compared to the general population. However, there is no evidence that pleural plaque confers an increased risk of lung cancer or pleural mesothelioma within a population of individuals having the same cumulative asbestos exposure.
The studies identified for this review relied only on chest radiograph data. Studies involving accurate evaluations of asbestos exposure and computed tomography of the chest are needed.
Currently available data indicate that patient follow-up modalities should be dictated solely by the estimated cumulative asbestos exposure and not by the existence of pleural plaques.
良性石棉相关疾病（石棉肺和胸膜斑）与胸段癌症之间的关系仍存在争议。本文旨在回顾与此问题相关的流行病学数据。
已发表的研究表明，职业性接触石棉与肺癌风险之间存在显著关联，即使在后前位胸部X光片上没有与石棉肺相符的异常表现。对于给定的累积石棉接触量，存在石棉肺的影像学证据与肺癌风险增加相关。在接触石棉的个体中，与普通人群相比，有胸膜斑影像学证据的个体患肺癌和胸膜间皮瘤的风险增加。然而，没有证据表明在累积石棉接触量相同的个体人群中，胸膜斑会增加肺癌或胸膜间皮瘤的风险。
本次综述所纳入的研究仅依赖胸部X光片数据。需要开展涉及石棉接触精确评估和胸部计算机断层扫描的研究。
目前可得的数据表明，患者的随访方式应仅由估计的累积石棉接触量决定，而非由胸膜斑的存在与否决定。
