Rockoff S D, Schwartz A
Department of Radiology, George Washington University Medical Center, Washington, DC 20037.
Chest. 1988 May;93(5):1088-91. doi: 10.1378/chest.93.5.1088.
We analyzed the limitations of the International Labor Organization (ILO) classification of chest roentgenograms in predicting the presence of histologically determined early asbestosis. The ILO system is arbitrary, without histologic correlates, and does not consider the asbestos exposure history or clinical and laboratory information. We present data from the literature and our own work which demonstrate that the application of the ILO classification to an asbestos-exposed individual can result in a 10 to 20 percent probability of a "normal" roentgenographic interpretation in the presence of significant asbestosis at the histologic level, leading to an inappropriate conclusion regarding the presence of asbestosis. In view of the data and statistical analysis presented, we suggest that sole reliance upon the ILO classified chest roentgenogram for determination of the presence of early pulmonary asbestosis in individual cases is inappropriate.
我们分析了国际劳工组织（ILO）胸部X线片分类在预测组织学确诊的早期石棉肺存在方面的局限性。ILO系统是任意性的，与组织学无相关性，且未考虑石棉接触史或临床及实验室信息。我们展示了来自文献及我们自己工作的数据，这些数据表明，将ILO分类应用于石棉接触个体时，在组织学层面存在显著石棉肺的情况下，“正常”X线解读的概率可达10%至20%，从而导致关于石棉肺存在与否的不当结论。鉴于所呈现的数据和统计分析，我们建议仅依靠ILO分类的胸部X线片来确定个别病例中早期肺石棉肺的存在是不合适的。
