McConnell J P, Moyer T P, Nixon D E, Schnur P L, Salomao D R, Crotty T B, Weinzweig J, Harris J B, Petty P M
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Am J Clin Pathol. 1997 Feb;107(2):236-46. doi: 10.1093/ajcp/107.2.236.
A method for analysis of silicon in tissue was developed to determine silicon content in breast parenchymal and periprosthetic capsular tissues of patients with silicone or saline implants and to compare levels in tissues from normal (nonaugmented) breasts. It is of interest to determine whether increased silicon content in tissues can be associated with morbidity in patients who have received silicone implants. This manuscript addresses the issues involved in analysis of breast tissue samples for silicon and compares silicon levels with tissue histologic findings and patient morbidity. One hundred sixty tissue samples were obtained for silicon analysis from 72 patients during augmentation, capsulectomy with or without replacement mammoplasty, mastectomy, or biopsy procedures and were frozen in acid-washed polystyrene tubes at 220 degrees C until analysis. Samples were thawed, sectioned to approximately 0.1 g (dry weight), and digested in nitric acid before analysis by inductively coupled plasma emission spectroscopy, monitoring emission intensity at 251.6 nm. Tissue silicon levels (breast parenchymal and periprosthetic capsular tissue) in patients with silicone gel implants were much higher (mean, 9,287 micrograms/g, n = 106) than in patients with saline implants (mean, 196 micrograms/g, n = 37) or nonaugmented breasts (mean, 64 micrograms/g, n = 17). Histologic examination was performed on 54 tissue samples stained with hematoxylin-eosin. Tissue samples were rated as to degree of inflammation and calcification, and amount of giant cells, foamy histiocytes, and vacuoles containing a colorless refractory material. Vacuolization and foamy histiocyte ratings correlated significantly with tissue silicon concentration. No correlations were found between tissue silicon concentration and inflammation, calcification, or giant cell rating. Implant age (number of years an implant was in place before sampling) correlated with capsular tissue silicon concentration in patients with intact implants but not in those with ruptured implants. No difference in tissue silicon concentration was found between patients with or without signs or symptoms of morbidity. Using 0.1 g of tissue, the method was linear to 1,000 micrograms/g, and sensitivity was 3.7 micrograms/g. Precision between runs (mean, 5.1 micrograms/g; coefficient of variance, 13.7%; n = 13) was calculated from multiple analyses of a bovine liver standard (National Bureau of Standards, reference material 1577a). Significant biologic variability (21.4% to 52.5%) was seen in tissues with high silicon levels. Paraffin-embedded, formalin-fixed tissues are not amenable to silicon analysis by this method, because of leaching of silicone from the tissues during preparation. Thus only fresh frozen tissue samples were used.
我们开发了一种分析组织中硅的方法，以测定硅胶或盐水植入物患者的乳腺实质组织和假体周围包膜组织中的硅含量，并比较正常（未隆胸）乳房组织中的硅含量水平。确定组织中硅含量增加是否与接受硅胶植入物的患者的发病率相关是很有意义的。本手稿阐述了乳腺组织样本硅分析中涉及的问题，并将硅水平与组织组织学结果和患者发病率进行了比较。在隆胸、有或无置换乳房成形术的包膜切除术、乳房切除术或活检过程中，从72名患者身上获取了160个组织样本用于硅分析，并在酸洗过的聚苯乙烯管中于 -20℃冷冻，直至分析。样本解冻后，切成约0.1 g（干重），在硝酸中消化，然后通过电感耦合等离子体发射光谱法进行分析，监测251.6 nm处的发射强度。硅胶植入物患者的组织硅水平（乳腺实质组织和假体周围包膜组织）（平均值为9287微克/克，n = 106）远高于盐水植入物患者（平均值为196微克/克，n = 37）或未隆胸患者（平均值为64微克/克，n = 17）。对54个苏木精 - 伊红染色的组织样本进行了组织学检查。对组织样本的炎症程度、钙化程度以及巨细胞、泡沫状组织细胞和含有无色难熔物质的液泡数量进行了评级。空泡化和泡沫状组织细胞评级与组织硅浓度显著相关。未发现组织硅浓度与炎症、钙化或巨细胞评级之间存在相关性。植入物使用年限（采样前植入物在位的年数）与完整植入物患者的包膜组织硅浓度相关，但与破裂植入物患者无关。有或无发病体征或症状的患者之间，组织硅浓度没有差异。使用0.1 g组织，该方法在1000微克/克范围内呈线性，灵敏度为3.7微克/克。通过对牛肝标准品（国家标准局，参考物质1577a）的多次分析计算出运行间精密度（平均值为5.1微克/克；变异系数为13.7%；n = 13）。在高硅水平的组织中观察到显著的生物学变异性（21.4%至52.5%）。由于在制备过程中组织中的硅会浸出，因此石蜡包埋、福尔马林固定的组织不适用于此方法进行硅分析。因此仅使用新鲜冷冻的组织样本。
