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Med Lav. 2019 Oct 29;110(5):353-362. doi: 10.23749/mdl.v110i5.8471.
The relationship between pleural plaques and cumulative asbestos exposure is controversial.
To evaluate the relationship between lung asbestos bodies (AB) and fibres (AF) and plaques presence and extension.
In a necropsy series of shipyard workers with asbestos-related diseases, we measured counts (per g of dry lung tissue) of AB (thousands) and AF>1 µm (millions). Pleural plaques were classified into three extension grades. We fitted univariate and multivariable linear (dependent variables: AB and AF, log10 transformed) and multinomial (dependent variable: plaques grade) regression models.
We analysed 124 subjects, 13 without plaques 20 with grade 1, 69 with grade 2, and 22 with grade 3 plaques. Geometric means (GM) of AB were 10.6, 23.3, 126, and 140 in the four groups respectively (P=0.0001). GMs for AF (mostly amphiboles) were 1.2, 1.4, 7.3, and 12.9 (P=0.0001). AB and AF were strongly correlated (r=0.81). The likelihood of no plaques and grade 1 plaques decreased with increasing AB and AF doses, with a corresponding increase of grade 2 and 3 plaques. Plaque presence and extension was also associated with histologically verified asbestosis (P<0.001).
Our study showed a strong positive relationship between pleural plaque presence and extension and both lung asbestos burden and asbestosis.
胸膜斑与累计石棉暴露之间的关系存在争议。
评估肺内石棉体（AB）和纤维（AF）与胸膜斑存在和扩展的关系。
在一组与石棉相关疾病的造船厂工人尸检系列中，我们测量了 AB（千个）和 AF>1 µm（百万个）的计数（每克干燥肺组织）。胸膜斑分为三个扩展等级。我们拟合了单变量和多变量线性（因变量：AB 和 AF，取对数）和多项（因变量：斑块等级）回归模型。
我们分析了 124 名受试者，其中 13 名无斑块，20 名有 1 级斑块，69 名有 2 级斑块，22 名有 3 级斑块。AB 的几何均数（GM）分别为 10.6、23.3、126 和 140，在四个组中差异有统计学意义（P=0.0001）。AF（主要是角闪石）的 GM 分别为 1.2、1.4、7.3 和 12.9（P=0.0001）。AB 和 AF 之间存在强烈相关性（r=0.81）。无斑块和 1 级斑块的可能性随着 AB 和 AF 剂量的增加而降低，相应的 2 级和 3 级斑块的可能性增加。斑块的存在和扩展也与组织学证实的石棉肺有关（P<0.001）。
我们的研究表明，胸膜斑的存在和扩展与肺内石棉负担和石棉肺之间存在强烈的正相关关系。
