Kohyama N, Kyono H, Yokoyama K, Sera Y
National Institute of Industrial Health, Ministry of Labor, Kawasaki, Japan.
J Electron Microsc (Tokyo). 1993 Oct;42(5):315-27.
To improve diagnostic sensitivity for detecting low-level asbestos exposure (AEx) in patients, a new method was developed using an analytical transmission electron microscope (ATEM) for specimens of transbronchial lung biopsy (TBLB). The TBLB specimens from 28 patients were examined and the results were: 1) In cases with long-term AEx, the present method detected a large amount of asbestos fibers (AF) as well as asbestos bodies (AB) showing a good agreement with the results of light microscope (LM) which detected definite amounts of ferruginous bodies (FB). 2) In cases with short-term or suspected AEx, the LM failed to detect FB in some cases, but an appreciable amount of AF was detected using the present method, and AEx was disclosed through a second close interview. 3) Neither AB nor AF were detected in most of the cases without any dust exposure. Although small amounts of chrysotile fibers were observed in some cases, this might simply reflect the exposure level of urban dwellers. These results show that the ATEM applied to the TBLB specimens promises to confirm low-level AEx in such small specimens even if the patients were unaware of their past AEx.
为提高检测患者低水平石棉暴露（AEx）的诊断敏感性，开发了一种新方法，使用分析型透射电子显微镜（ATEM）对经支气管肺活检（TBLB）标本进行检测。对28例患者的TBLB标本进行了检查，结果如下：1）在长期AEx病例中，本方法检测到大量石棉纤维（AF）以及石棉小体（AB），与光学显微镜（LM）检测到一定数量含铁小体（FB）的结果吻合良好。2）在短期或疑似AEx病例中，LM在某些情况下未能检测到FB，但使用本方法检测到了相当数量的AF，并通过第二次密切访谈揭示了AEx。3）在大多数无任何粉尘暴露的病例中，未检测到AB和AF。虽然在某些情况下观察到少量温石棉纤维，但这可能仅仅反映了城市居民的暴露水平。这些结果表明，应用于TBLB标本的ATEM有望在如此小的标本中确认低水平AEx，即使患者不知道他们过去的AEx情况。
