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间皮瘤或肺癌患者肺部中铁石棉纤维的分布情况。

The distribution of amosite asbestos fibers in the lungs of workers with mesothelioma or carcinoma.

作者信息

Churg A, Wiggs B

机构信息

Department of Pathology, University of British Columbia, Vancouver, Canada.

出版信息

Exp Lung Res. 1989 Sep;15(5):771-83. doi: 10.3109/01902148909062860.

Abstract

We have previously shown that there are differences in the sizes of fibers of amosite asbestos in different parts of the lung in workers with relatively high asbestos exposure and malignant pleural mesothelioma. To determine whether this distribution pattern is specific to cases of mesothelioma, we compared the fiber distribution in the lungs of 20 cases of mesothelioma and 10 cases of carcinoma of the lung. The two test groups were statistically identical in terms of age, and exposure period, and overall both groups had very similar mean fiber concentrations and mean fiber sizes. When individual sampling sites within the lung were considered, neither group showed preferential fiber concentration in any area. However, there were definite differences in the intrapulmonary fiber size distribution both within and between the two groups: Cases of mesothelioma showed accumulation of lung fibers in the peripheral upper lobe with shorter central upper lobe fibers. The lung cancer cases demonstrated a reverse pattern, with shorter fibers in the peripheral compared to central upper lobe, but accumulations of long fibers in the peripheral lower lobe. Fiber surfaces and masses showed similar differences among sample sites. We conclude that (1) there is no evidence for fiber concentration variations in different portions of the lung; (2) there is strong evidence for variations in fiber sizes in different portions of the lung, and these differences are most clearly related to fiber length, surface area, and mass; (3) contrary to data from experimental animals, there are no clear gravitational effects on fiber distribution in humans; and (4) there are reproducible differences in intrapulmonary fiber size distribution between mesothelioma and lung cancer cases. These differences may be a manifestation of individual handling of mineral particles because of structural variations in individual lungs.

摘要

我们之前已经表明,在石棉暴露量相对较高且患有恶性胸膜间皮瘤的工人中,肺不同部位的铁石棉纤维大小存在差异。为了确定这种分布模式是否特定于间皮瘤病例,我们比较了20例间皮瘤患者和10例肺癌患者肺部的纤维分布。两个测试组在年龄、暴露时间方面在统计学上是相同的,并且总体上两组的平均纤维浓度和平均纤维大小非常相似。当考虑肺内的各个采样点时,两组在任何区域均未表现出纤维浓度的偏好。然而,两组内部和之间的肺内纤维大小分布存在明显差异:间皮瘤病例显示肺纤维在上叶周边积聚,上叶中央纤维较短。肺癌病例则呈现相反的模式,周边纤维比上叶中央纤维短,但在下叶周边有长纤维积聚。纤维表面和质量在采样点之间也表现出类似的差异。我们得出以下结论:(1)没有证据表明肺的不同部位存在纤维浓度差异;(2)有强有力的证据表明肺的不同部位存在纤维大小差异,并且这些差异与纤维长度、表面积和质量最为密切相关;(3)与实验动物的数据相反,在人类中没有明显的重力对纤维分布的影响;(4)间皮瘤和肺癌病例的肺内纤维大小分布存在可重复的差异。这些差异可能是由于个体肺部结构差异导致对矿物颗粒的个体处理方式不同的表现。

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