Srebro S H, Roggli V L, Samsa G P
Department of Pathology, Durham Veterans' Administration, North Carolina, USA.
Mod Pathol. 1995 Aug;8(6):614-21.
Most malignant mesothelioma cases are associated with pulmonary asbestos body (AB) counts significantly greater than those of the general population. However, the question remains whether malignant mesothelioma cases associated with "normal" AB counts (i.e., indistinguishable from the general population) represent background incidence levels or are, actually, asbestos related. We performed AB counts (by light microscopy) and mineral fiber analysis (by scanning electron microscopy) in 18 mesothelioma cases with AB counts within our normal range (0 to 20 AB/G wet lung) and in 19 "control" cases. Our study demonstrated that approximately one-third (6 of 18) of the mesothelioma cases have asbestos fiber burdens greater than 95% of the control levels. These results suggest that these six mesothelioma cases may be asbestos related despite AB counts similar to those of the general population. An asbestos etiology was suggested in three additional cases, but too few amphibole fibers were identified in these cases to be certain of a value above background. The remaining nine cases showed no evidence of an asbestos etiology. Electron microscopic analysis of pulmonary mineral fibers may be required to differentiate asbestos-related mesotheliomas from non-asbestos-related cases when AB counts are within the range of background values.
大多数恶性间皮瘤病例与肺部石棉小体（AB）计数显著高于普通人群有关。然而，与“正常”AB计数（即与普通人群无差异）相关的恶性间皮瘤病例是代表背景发病率水平，还是实际上与石棉有关，这个问题仍然存在。我们对18例AB计数在正常范围内（0至20个AB/克湿肺）的间皮瘤病例和19例“对照”病例进行了AB计数（通过光学显微镜）和矿物纤维分析（通过扫描电子显微镜）。我们的研究表明，大约三分之一（18例中的6例）的间皮瘤病例的石棉纤维负荷高于95%的对照水平。这些结果表明，尽管这6例间皮瘤病例的AB计数与普通人群相似，但可能与石棉有关。另外3例提示有石棉病因，但在这些病例中鉴定出的闪石纤维太少，无法确定其高于背景值的意义。其余9例未显示石棉病因的证据。当AB计数在背景值范围内时，可能需要对肺部矿物纤维进行电子显微镜分析，以区分与石棉相关的间皮瘤和与非石棉相关的病例。
