Bianchi C, Brollo A, Ramani L, Zuch C
Laboratory of Pathological Anatomy, Hospital of Monfalcone, Italy.
Am J Ind Med. 1993 Aug;24(2):149-60. doi: 10.1002/ajim.4700240203.
The Monfalcone area, in northeastern Italy, is a small industrial territory (population about 60,000), with a large shipyard. Between October 1979 and April 1992, ninety-two malignant mesotheliomas were diagnosed at the Monfalcone Hospital. The series included 84 men and 8 women, aged 42 to 89 years (median age 68 years). There were 89 pleural and 3 peritoneal tumors. Seventy patients (69 men and 1 woman) had worked in the shipyards; six were seamen, and four insulators. Five men had been exposed to asbestos in various industries; six women had histories of domestic exposure, and one woman had a history of possible environmental exposure. The latency periods (intervals between first exposure to asbestos and diagnosis of the tumor) ranged from 20 to 65 years (median 52 years). Latency periods among insulators were significantly lower than among shipyard workers, as well as lower than among the other categories (p < 0.01). Lung asbestos bodies were isolated after chemical digestion in 73 cases at necropsy, and in two cases at surgery. In necropsy cases, asbestos body burdens ranged between 100 and 10,000,000 bodies per gram of dried tissue (median 11,000). Pleural plaques were observed at necropsy in 62 out of 73 cases, and in two cases at surgery. In the time period we considered, the annual incidence rates for pleural mesothelioma were very high among male Monfalcone residents, being 189 per 100,000 among people aged 75 years or more. On the basis of occupational data and of objective signs (lung asbestos bodies, pleural plaques), all the cases of the present series but one (that with possible environmental exposure) were considered as asbestos-related. The role of co-factors in the development of asbestos-related mesothelioma is suggested.
意大利东北部的蒙法尔科内地区是一个小型工业区（人口约6万），有一家大型造船厂。1979年10月至1992年4月期间，蒙法尔科内医院诊断出92例恶性间皮瘤。该系列包括84名男性和8名女性，年龄在42至89岁之间（中位年龄68岁）。有89例胸膜肿瘤和3例腹膜肿瘤。70名患者（69名男性和1名女性）曾在造船厂工作；6名是海员，4名是绝缘工。5名男性曾在不同行业接触过石棉；6名女性有家庭接触史，1名女性有可能的环境接触史。潜伏期（首次接触石棉至肿瘤诊断之间的间隔）为20至65年（中位52年）。绝缘工的潜伏期明显低于造船厂工人，也低于其他类别（p<0.01）。尸检时在73例病例以及手术时在2例病例中，经化学消化后分离出肺石棉小体。在尸检病例中，每克干组织中石棉小体负荷量在100至10000000个之间（中位值11000）。73例尸检病例中有62例以及2例手术病例中观察到胸膜斑。在我们所考虑的时间段内，蒙法尔科内男性居民中胸膜间皮瘤的年发病率非常高，75岁及以上人群中每10万人中有189例。根据职业数据和客观体征（肺石棉小体、胸膜斑），本系列中除1例（有可能的环境接触史）外的所有病例均被视为与石棉相关。提示了辅助因素在石棉相关间皮瘤发生中的作用。
