Kühne W, Schultz M
Institut für Pathologische Anatomie, Medizinischen Akademie Magdeburg, DDR.
Zentralbl Allg Pathol. 1988;134(8):703-12.
Asbestos had been increasingly used in many applications across numerous industries on account of its particular material properties, including resistance to heat and fire as well as to aggressive chemicals, high mechanical strength, insulation capacity, other physical parameters, and for its low price. World wide asbestos production and processing thus went up from 50 tons to 5.5 million tons per annum, in about 100 years. Widespread application of asbestos as well as of asbestos-containing materials and workpieces together with the understanding that asbestos for its fibrogenicity is capable of causing pulmonary and pleural asbestoses constitute a major challenge for thorough elucidation of related occupational diseases and their relationship with asbestos. This demand is additionally supported in urgency by the cancerogenicity of asbestos potentially leading to malignant diffuse mesotheliomas, bronchial carcinomas, and, obviously, other tumors. In the context of malignant mesotheliomas, emphasis has to be laid on characteristic morphological features, biological behaviours, and asbestos-related aetiology. As bronchial carcinomas have several aetiological backgrounds, answers will have to be found to the questions for which of them may have been fully or partially caused by asbestos and which have not. No differentiation has so far been feasible, in this context, by tumour morphology, including histological typing. After all, when it comes to malignant tumours of other organs, additional epidemiological as well as pathologico-anatomic efforts will have to be made to find out, if and where a given case of tumour growth has coincided with exposure to asbestos.
由于石棉具有特殊的材料特性,包括耐热、防火、耐腐蚀性化学物质、高机械强度、绝缘能力及其他物理参数,且价格低廉,因此在众多行业的许多应用中被越来越多地使用。在大约100年的时间里,全球石棉的生产和加工量从每年50吨增至550万吨。石棉以及含石棉材料和工件的广泛应用,再加上人们认识到石棉因其纤维生成性会导致肺和胸膜石棉沉着病,这对全面阐明相关职业病及其与石棉的关系构成了重大挑战。石棉的致癌性可能导致恶性弥漫性间皮瘤、支气管癌以及其他肿瘤,这一情况进一步加剧了对阐明相关问题的紧迫性需求。在恶性间皮瘤方面,必须强调其特征性的形态学特征、生物学行为以及与石棉相关的病因。由于支气管癌有多种病因背景,因此必须回答哪些可能完全或部分由石棉引起、哪些并非由石棉引起的问题。在这种情况下,到目前为止,通过肿瘤形态学(包括组织学分型)进行区分是不可行的。毕竟,对于其他器官的恶性肿瘤,还需要进行额外的流行病学以及病理解剖学研究,以确定某一肿瘤生长病例是否以及在何处与接触石棉同时发生。