Biomarker assessments in asbestos-exposed workers as indicators for selective prevention of mesothelioma or bronchogenic carcinoma: rationale and practical implementations

Our plain-English summary of Biomarker assessments in asbestos-exposed workers as indicators for selective prevention of mesothelioma or bronchogenic carcinoma: rationale and practical implementations, by E. Pluygers, P. Baldewyns, P. Minette, et al (European Journal of Cancer Prevention, 1992).

The study

• Authors: E. Pluygers, P. Baldewyns, P. Minette, M. Beauduin, P. Gourdin, P. Robinet
• Journal: European Journal of Cancer Prevention
• Published: 1992;1(2):129-38
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In the first part of this study we have shown how the serum levels of four selected tumour markers, namely tissue polypeptide antigen (TPA), carcino-embryonic antigen (CEA), hyaluronic acid (HA) and ferritin, display patterns characteristic of mesothelioma (M) or bronchogenic carcinoma (BC) in asbestos-exposed workers, and we hypothesize that the differences in marker patterns correspond to differences in carcinogenesis mechanisms. In a preliminary study, we found these specific marker patterns in 5/19 exposed workers of whom only one demonstrated any radiological signs of disease. Thus these specific marker patterns may be early events, occurring long (possibly years) before the classical radiological signs of exposure to asbestos. Accordingly they afford an optimal opportunity for prevention which should be adapted to the carcinogenesis mechanism as it is revealed by the marker pattern; it is aimed at antagonizing free radical carcinogenesis in all persons with TPA levels in excess of 100 U/l or Ferritin in excess of 400 ng/ml, and at inhibiting chemical carcinogenesis in those having elevated CEA levels (over 3 ng/ml). The mechanisms involved in these inhibitory processes are described and discussed, as well as the practical implementations that proceed from them. A prevention trial is now being started among 300 active and retired workers of an asbestos-cement works in northern France; the design of the study is presented. This prevention programme should be maintained over many years and holds a strong potential for reducing the untoward effects of exposure to asbestos.

In plain English

This article described the rationale and design of a cancer prevention trial that the authors said had been started among 300 male volunteers, active and retired, from an asbestos-cement factory in northern France. Each worker was to have two controls matched for age and smoking habits, with no known asbestos exposure. Blood was tested for four tumour markers: tissue polypeptide antigen (TPA), carcino-embryonic antigen (CEA), hyaluronic acid and ferritin. Under the plan, workers with two consecutive TPA levels above 100 U/l, or one ferritin level above 400 ng/ml, would receive N-acetyl-cysteine, beta-carotene, selenium and vitamins. All other participants would receive placebo. Workers with CEA above 3 ng/ml would also receive fenretinide. In preliminary results, serum from 19 asbestos-exposed workers had been tested. Five had raised TPA, and only one of the five had X-ray evidence of asbestosis. The authors concluded that serum TPA is a very early indicator of damage from asbestos exposure. They believed targeted prevention had potential to reduce cancer. No cancer outcomes were reported. The article did not state which types of asbestos the workers were exposed to.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Description of the rationale and design of a prevention trial that had been started in an exposed cohort with matched unexposed controls, with preliminary marker results
• Who was studied: Male staff of an asbestos-cement factory in northern France, in two arms of 150 volunteers each: active workers aged 50 or less with at least 2 years of potential exposure, and retired workers. Two controls per worker, matched for age and smoking, living in the same industrial area with no known asbestos exposure. Study dates not given.
• Exposure: Work at an asbestos-cement factory. Fiber types were recorded from personnel files but are not reported in the article. The authors described the first 19 tested workers as exposed to low doses for relatively short durations.
• Main results:
  • Preliminary: of 19 asbestos-exposed workers whose serum had been tested, 5 had raised serum TPA. Only 1 of these 5 had radiological evidence of asbestosis. No results for controls were given.
• The authors' conclusion: The authors concluded that serum TPA is a very early indicator of damage from asbestos exposure, detectable before the classical signs of asbestosis. They stated a belief that targeted prevention regimens offer potential for reducing cancer incidence.
• Limitations the authors state:
  • At the time of writing, only 19 of the exposed subjects' sera had been tested.
  • The marker patterns for mesothelioma and bronchogenic carcinoma came from the authors' earlier study of advanced cases.
  • The agreement between serum marker results and gallium-67 lung uptake had not yet been confirmed.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Biomarker, Mesothelioma, Bronchogenic Carcinoma, Hyaluronic Acid, Ferritin, Carcinogenesis, Asbestos-Cement.

Related studies

• Biomarker assessments in asbestos-exposed workers as indicators for selective prevention of mesothelioma or bronchogenic carcinoma: rationale and practical implementations — E. Pluygers, P. Baldewyns, et al. (1991)
• Morphology of bronchogenic carcinoma in workers formerly exposed to crocidolite at Wittenoom Gorge in Western Australia — J.E. Baker, D.C. Reutens, et al. (1986)
• Assessment of biomarkers in asbestos-exposed workers as indicators of cancer risk — M. Amati, M. Tomasetti, et al. (2008)
• Association of asbestos and bronchogenic carcinoma in a population with low asbestos exposure — M.L. Warnock, A.M. Churg (1975)
• Asbestosis associated with bronchogenic carcinoma — R. Stoll, R. Bass, et al. (1951)
• Asbestos, an extrinsic factor in the pathogenesis of bronchogenic carcinoma and mesothelioma — W.M. O'Donnell, R.H. Mann, et al. (1966)

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