Histological types of malignant mesothelioma and asbestos exposure

Our plain-English summary of Histological types of malignant mesothelioma and asbestos exposure, by W.E. Wright, R.P. Sherwin (British Journal of Industrial Medicine, 1984).

The study

• Authors: W.E. Wright, R.P. Sherwin
• Journal: British Journal of Industrial Medicine
• Published: 1984;41(4):514-7
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000588).

Abstract

The Los Angeles County Cancer Surveillance Program abstracts hospital pathology records on almost all cases of cancer occurring in the county. Those cases of pleural and peritoneal mesothelioma that occurred between 1972 and 1978 were identified. Occupational histories were obtained from interviews, and the histopathology of the tumours was reviewed by a member of a mesothelioma reference panel who was unaware of the exposure histories. The relation of asbestos exposure to the three histological types of mesothelioma (epithelial, mesenchymal, and mixed) was studied among the 29 cases for whom occupational histories were available and who were also considered to have histopathology consistent with mesothelioma. The proportion of cases exposed to asbestos was high for both the epithelial (11/17, 65%) and mixed histological types (6/11, 55%). The single case of mesothelioma classified as a mesenchymal type was also exposed to asbestos. Cases who had worked in shipyards were represented in each of the three groups. In cases who had worked in asbestos production and manufacture an exclusively epithelial type of tumour was observed. In cases who had worked as insulators or in heating trades the histological type was predominantly (3/4) mixed. These data do not support the hypothesis that any specific histological type of mesothelioma is especially related to asbestos exposure.

In plain English

This study asked whether people with different microscopic types of malignant mesothelioma (epithelial, mesenchymal and mixed) differed in how often they had been exposed to asbestos. The authors used cases from a population-based cancer registry in Los Angeles County from 1972 to 1978, covering pleural and peritoneal mesothelioma. Work histories came from telephone interviews with the patients or their nearest living relatives. The study included the 29 cases whose tissue was judged more likely than not to be mesothelioma. Asbestos exposure was found in 11 of 17 epithelial cases (65%), 6 of 11 mixed cases (55%) and the single mesenchymal case, or 18 of 29 overall (62%). Among women, 1 of 4 epithelial cases and 0 of 2 mixed cases were exposed. Jobs in asbestos production and manufacture appeared only among epithelial cases, while shipyard work appeared in all three types. The authors concluded that their data did not support the idea that any one type is especially related to asbestos exposure. They noted that their number of cases was small.

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: Case series drawn from a population-based cancer registry (Los Angeles County Cancer Surveillance Program)
• Who was studied: 29 people with pleural or peritoneal mesothelioma first diagnosed in Los Angeles County, 1972 to 1978. They were selected from 191 registry cases: 118 of these had both tissue and interview information, and 29 of those had tissue judged more likely than not to be mesothelioma. The article does not report how many of the 29 were pleural and how many peritoneal.
• Exposure: Likely occupational asbestos exposure, judged from chronological job histories taken in telephone interviews with the cases or their nearest living relatives. Jobs were classed as likely asbestos exposure (insulation, asbestos production and manufacture, heating trades, shipyards, construction) or all other jobs. Fiber types were not assessed.
• Main results:
  • 11 of 17 epithelial cases (65%, men and women combined) had been exposed to asbestos.
  • 6 of 11 mixed-type cases (55%, men and women combined) had been exposed to asbestos.
  • The single mesenchymal case (a man) had been exposed to asbestos.
  • Overall, 18 of the 29 cases (62%) had been exposed to asbestos.
  • Among women, 1 of 4 epithelial cases (25%) and 0 of 2 mixed cases had been exposed to asbestos.
  • Jobs in asbestos production and manufacture were found only among people with epithelial mesothelioma (5 of 11 exposed epithelial cases).
  • Among the 6 exposed mixed-type cases, 2 had worked in heating trades and 1 in insulation.
  • Shipyard work appeared in all three types: 4 of 11 exposed epithelial cases, 1 of 1 exposed mesenchymal case, and 3 of 6 exposed mixed cases.
  • Asbestos exposure was more common in cases judged likely to be mesothelioma (62%) than in cases where another diagnosis was favoured (52%).
• The authors' conclusion: The authors concluded that their data do not support the hypothesis that any specific histological type of mesothelioma is especially related to asbestos exposure.
• Limitations the authors state:
  • The authors describe their number of cases as small.
  • The authors indicate that studies with more cases and a more accurate estimate of asbestos exposure would be needed to confirm whether the finding applies to other cases and to subcategories of the three types.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Asbestos Exposure, Pathology, Peritoneal Mesothelioma, Histopathology, Mesothelioma, Insulator.

Related studies

• A study of the histological cell types of lung cancer in workers suffering from asbestosis in the United Kingdom — F. Whitwell, M.L. Newhouse, et al. (1974)
• Malignant mesothelioma of the pleura: relation between histological type and clinical behaviour — M.R. Law, M.E. Hodson, et al. (1982)
• Occupational exposures and risk of stomach cancer by histological type — M. Santibañez, J. Alguacil, et al. (2012)
• Occupational exposures and risk of oesophageal cancer by histological type: a case-control study in eastern Spain — M. Santibañez, J. Vioque, et al. (2008)
• Metastases in diffuse pleural mesothelioma: influence of histological type — M. Huncharek, J. Muscat (1987)
• Incidence of lung cancer by histological type among asbestos cement workers in Denmark — E. Raffn, E. Lynge, et al. (1993)

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