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石棉暴露在肺组织中的诊断。

Asbestos exposure diagnosis in pulmonary tissues.

机构信息

Centre "G. Scansetti", Torino, Italy.

SSD Research Laboratories, Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.

出版信息

Pathologica. 2024 Aug;116(4):207-215. doi: 10.32074/1591-951X-930.

Abstract

The diagnosis of asbestosis requires different criteria depending on whether it is in a clinical or medical/legal setting. In the latter context, only when a "diffuse interstitial fibrosis associated to asbestos bodies (ABs)" is present, it can be said to be asbestosis. Considering the medical/legal setting, the diagnosis must be certain and proven. Unfortunately, it is often difficult to identify ABs by light microscopy (LM), but this does not mean that the diagnosis should be clinically excluded. Other parameters are important, such as working history and/or diagnostic imaging. In addition to LM, normally used for diagnosis, there are other techniques, e.g.: scanning electron microscopy with attached microanalysis microprobe (SEM/EDS), but they require tissue digestion and higher cost. A new approach with micro-Raman spectroscopy and SEM/EDS techniques is able to analyse histological sections without other manipulations that could interfere with analysis of asbestos fibres. In this work, we propose an algorithm for asbestosis diagnosis, especially in the forensic medical field, demonstrating the importance of close collaboration between multiple professionals.

摘要

石棉肺的诊断需要不同的标准,具体取决于它是在临床还是医学/法律环境中。在后一种情况下,只有当存在“与石棉体相关的弥漫性间质纤维化(ABs)”时,才能称之为石棉肺。在医学/法律环境下,诊断必须是确定且经过证实的。不幸的是,通过光学显微镜(LM)通常很难识别 ABs,但这并不意味着应该在临床上排除诊断。其他参数也很重要,例如工作史和/或诊断成像。除了用于诊断的 LM 之外,还有其他技术,例如:带有微分析探针的扫描电子显微镜(SEM/EDS),但它们需要组织消化和更高的成本。一种使用微拉曼光谱和 SEM/EDS 技术的新方法能够分析组织学切片,而无需进行其他可能干扰石棉纤维分析的操作。在这项工作中,我们提出了一种石棉肺诊断算法,特别是在法医领域,证明了多个专业人员密切合作的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e864/11460150/34bd5c4afd29/pathol-2024-04-207-g001.jpg

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