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恶性间皮瘤病例中长石棉纤维在外周上叶的蓄积。

Accumulation of long asbestos fibers in the peripheral upper lobe in cases of malignant mesothelioma.

作者信息

Churg A, Wiggs B

出版信息

Am J Ind Med. 1987;11(5):563-9. doi: 10.1002/ajim.4700110508.

Abstract

Animal studies suggest that mesothelioma is most effectively induced by fibers longer than 8 mu. However, studies of asbestos fibers recovered from human lungs in cases of mesothelioma indicate that, at least in large-scale samples, relatively few fibers meet this size criterion, perhaps implying that the animal data do not apply to man. Since asbestos concentration in lung is known to be extremely inhomogeneous, it is also possible that long fibers may selectively accumulate in specific sites, such as under the pleura. To examine this possibility, we selected ten cases of mesothelioma that contained relatively large amounts of amosite asbestos and extracted fibers from an 0.5-cm-thick strip of subpleural tissue and an area 3-cm deep to the subpleural sample for upper and lower lobes. Amosite fibers were identified and sized by electron microscopic techniques. Fibers in the peripheral upper lobe were significantly longer, broader, and of higher aspect ratio than those in the central upper lobe. The lower lobe showed a reverse pattern, with longer fibers and broader fibers in the central sample. These data indicate that the two lobes behave differently in regard to fiber size, with selective accumulation of long fibers in the peripheral upper lobe, but not in the peripheral lower lobe. Whether these differences reflect differences in initial deposition of fibers within the lung, or, more likely, specific redistribution of fibers, is unclear, but in either case, accumulation of long fibers immediately under the upper lobe pleura may be important in the genesis of mesothelioma.

摘要

动物研究表明,长度超过8微米的纤维最易诱发间皮瘤。然而,对间皮瘤患者肺部回收的石棉纤维的研究表明,至少在大规模样本中,符合这一尺寸标准的纤维相对较少,这或许意味着动物实验数据并不适用于人类。由于已知肺部的石棉浓度极不均匀,长纤维也有可能选择性地积聚在特定部位,如胸膜下方。为了探究这种可能性,我们选取了10例含有相对大量铁石棉的间皮瘤病例,从厚度为0.5厘米的胸膜下组织条带以及上叶和下叶胸膜下样本下方3厘米深处的区域提取纤维。通过电子显微镜技术鉴定并测量铁石棉纤维的尺寸。上叶周边的纤维比上叶中央的纤维明显更长、更宽,且长宽比更高。下叶呈现相反的模式,中央样本中的纤维更长、更宽。这些数据表明,两叶在纤维尺寸方面表现不同,长纤维选择性地积聚在上叶周边,而非下叶周边。尚不清楚这些差异是反映了肺部纤维初始沉积的差异,还是更有可能反映了纤维的特定重新分布,但无论哪种情况,上叶胸膜正下方长纤维的积聚可能在间皮瘤的发生中起重要作用。

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