Evans G R, Baldwin B J
Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston, USA.
Plast Reconstr Surg. 1997 Apr;99(5):1354-8; discussion 1359-61. doi: 10.1097/00006534-199704001-00023.
A plethora of data has been used to condemn and defend the role of silicone and its association with "adjuvant disease." In the ongoing attempt to enhance our knowledge, we have chosen to identify tissue silicon levels (n = 15) in capsules that form around chemotherapeutic port-a-catheter devices, which consist of a metal dome encapsuled by silicone. We have compared these levels with previously established silicon levels in augmented breast capsules, distant tissue sites in these same augmented women, and nonaugmented cadaveric tissues from various geographic locations in the United States. All specimens were harvested by a "no touch" technique, not formalin fixed, frozen, and shipped to an independent toxicology laboratory for analysis. Inductively coupled plasma atomic emission spectroscopy was employed to obtain the tissue silicon measurements. Results demonstrated silicon values ranging from nondetectable in 9 patients to as high as 41 micrograms/gm. These values fell in between our cadaveric (0.5 to 6.8 micrograms/gm) and augmented tissue silicon levels (18 to 8700 micrograms/gm). Although the sample size is small and the power of statistical analysis is low, there was no correlation between the patient's silicon level and age, type of cancer, type of chemotherapeutic agent, radiation therapy, or length of time the port-a-catheters were in place. Although detectable levels of silicon identified around port-a-catheter devices were higher than expected, it is impossible to make any conclusions about these levels and the role of a potential collagen-vascular disease. What we have shown, however, is that silicone breast implants may not be the only medical device that can elevate tissue silicon levels. Our data seem to suggest that there may be a progression of measurable tissue silicon levels based on the amount of environmental or device-related silicon exposure a person has had at a particular time in his or her life. It is our belief that as we identify these tissue silicon levels, they will serve as a baseline and reference for further scientific studies.
大量数据被用于谴责和捍卫硅酮的作用及其与“辅助疾病”的关联。在不断努力增进我们知识的过程中，我们选择确定围绕化疗输液港装置形成的胶囊中的组织硅水平（n = 15），该装置由硅胶包裹的金属圆顶组成。我们将这些水平与先前确定的隆胸胶囊、这些隆胸女性的远处组织部位以及来自美国不同地理位置的未隆胸尸体组织中的硅水平进行了比较。所有标本均采用“无接触”技术采集，未用福尔马林固定，而是冷冻后运至独立的毒理学实验室进行分析。采用电感耦合等离子体原子发射光谱法进行组织硅测量。结果显示，硅值范围从9名患者中检测不到到高达41微克/克。这些值介于我们的尸体组织（0.5至6.8微克/克）和隆胸组织硅水平（18至8700微克/克）之间。尽管样本量小且统计分析能力低，但患者的硅水平与年龄、癌症类型、化疗药物类型、放射治疗或输液港留置时间之间没有相关性。尽管在输液港装置周围检测到的硅水平高于预期，但无法就这些水平以及潜在的胶原血管疾病的作用得出任何结论。然而，我们所表明的是，硅胶乳房植入物可能不是唯一能提高组织硅水平的医疗器械。我们的数据似乎表明，根据一个人在其生命中特定时间所接触的环境或与器械相关的硅的量，可能存在可测量的组织硅水平的进展。我们相信，随着我们确定这些组织硅水平，它们将为进一步的科学研究提供基线和参考。
