De Vuyst P, Dumortier P, Moulin E, Yourassowsky N, Roomans P, de Francquen P, Yernault J C
Chest Department, Erasme Hospital, Free University of Brussels, Belgium.
Eur Respir J. 1988 Apr;1(4):362-7.
Asbestos body (AB) countings on both bronchoalveolar lavage (BAL) fluids and digested lung tissue samples were performed in one hundred consecutive subjects submitted to a thoracotomy procedure, mostly for lung carcinoma. A good correlation (r = 0.73) was found between the two groups of values for the total group of subjects. When restrictive selection criteria were taken into account, such as lavage homolateral to the analysed lung, performed by the same trained physician, this correlation improved (r = 0.82). Absence of AB's or low AB counts (less than 1 AB/ml) in BAL corresponded in about 70% of cases to concentrations of less than 1,000 AB/gm and in 100% of cases to concentrations less than 10,000 AB/gm. In subjects with BAL containing more than 1 AB/ml, the lung tissues of 85% contained more than 1,000 AB/gm and the tissues of 44% contained more than 10,000 AB/gm. Above 10 AB/ml BAL, all lung tissues contained more than 10,000 AB/gm. Since lung tissue is not readily available in patients undergoing assessment of their asbestos exposure, BAL fluid analysis seems to be a useful tool to evaluate lung AB concentrations. This technique cannot be performed, however, in patients with severe lung impairment which does not allow sufficient recovery of BAL fluid.
对100例连续接受开胸手术(主要是因为肺癌)的患者的支气管肺泡灌洗(BAL)液和消化后的肺组织样本进行了石棉小体(AB)计数。在所有受试者的两组数值之间发现了良好的相关性(r = 0.73)。当考虑到限制性选择标准时,如由同一位经过培训的医生对与分析的肺同侧进行灌洗,这种相关性得到了改善(r = 0.82)。BAL中无AB或AB计数低(低于1个AB/ml)的情况,在约70%的病例中对应肺组织浓度低于1000个AB/gm,在100%的病例中对应浓度低于10000个AB/gm。在BAL中AB含量超过1个AB/ml的受试者中,85%的肺组织AB含量超过1000个AB/gm,44%的组织AB含量超过10000个AB/gm。BAL中AB含量高于10个AB/ml时,所有肺组织AB含量均超过10000个AB/gm。由于在评估石棉暴露的患者中不易获得肺组织,BAL液分析似乎是评估肺AB浓度的一种有用工具。然而,对于严重肺功能受损、无法充分回收BAL液的患者,无法进行这项技术。