石棉暴露工人支气管肺泡灌洗液的细胞学分析。
Cytological analysis of bronchoalveolar lavage fluid in asbestos-exposed workers.
机构信息
Department of Medical Biotechnology, University of Siena, Unit of Occupational Health, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.
出版信息
Med Lav. 2020 Oct 31;111(5):379-387. doi: 10.23749/mdl.v111i5.9170.
BACKGROUND
Asbestos-related lung diseases are a group of heterogeneous disorders with different pathogenesis and prognosis. Very few studies investigated the BALF cell profile of asbestos exposed workers. The existence of a relationship between bronchoalveolar lavage fluid (BALF) cellular pattern and specific diagnosis and/or asbestos exposure biomarkers would allow the identification of effect biomarkers useful in the follow up of asbestos-exposed workers and in the diagnosis of asbestos-related diseases.
OBJECTIVES
To assess BALF cell profile in formerly asbestos-exposed workers and its relationship with asbestos fibre (amphibole and chrysotile) and asbestos body (AB) concentrations.
METHODS
113 male workers formerly exposed to asbestos underwent bronchoscopy with bronchoalveolar lavage and were retrospectively enrolled. 35 of them were affected by pleural plaques and 10 were affected by asbestosis. Pulmonary functional tests (PFT), BALF cellular pattern, BALF mineralogical analysis with asbestos fibres and AB counting were performed in each patient. A statistical analysis with a multivariate linear regression model was adopted.
RESULTS
From the statistical analysis of data a direct correlation between pack-years and BALF macrophages was found. Inversely correlation between pack-years and BALF lymphocytes was detected. There was not relationship among BALF cellular pattern, PFT values, specific diagnosis, BALF AB count or BALF asbestos fibre concentration.
DISCUSSION
BALF cellular pattern does not seem to be related to asbestos exposure biomarkers like AB and asbestos fibre concentration in BALF. Instead, smoke habit can induce an increase in BALF macrophages and a decrease of BALF lymphocytes count.
背景
石棉相关肺部疾病是一组具有不同发病机制和预后的异质性疾病。很少有研究调查过暴露于石棉的工人的 BALF 细胞特征。BALF 细胞模式与特定诊断和/或石棉暴露生物标志物之间的关系的存在将允许识别有用的效应生物标志物，这些生物标志物可用于随访暴露于石棉的工人和诊断石棉相关疾病。
目的
评估曾暴露于石棉的工人的 BALF 细胞特征及其与石棉纤维（角闪石和温石棉）和石棉体（AB）浓度的关系。
方法
113 名男性曾暴露于石棉的工人接受支气管镜检查和支气管肺泡灌洗，并进行回顾性登记。其中 35 人患有胸膜斑，10 人患有石棉肺。对每位患者进行肺功能测试（PFT）、BALF 细胞模式、BALF 矿物学分析（包括石棉纤维和 AB 计数）。采用多元线性回归模型进行统计分析。
结果
从数据分析中得出，吸烟年限与 BALF 巨噬细胞呈直接相关。吸烟年限与 BALF 淋巴细胞呈负相关。BALF 细胞模式、PFT 值、特定诊断、BALF AB 计数或 BALF 石棉纤维浓度之间没有关系。
讨论
BALF 细胞模式似乎与 AB 和 BALF 中的石棉纤维浓度等石棉暴露生物标志物无关。相反，吸烟习惯可能会导致 BALF 巨噬细胞增加和 BALF 淋巴细胞计数减少。
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