Presence of asbestos in peritoneal malignant mesotheliomas in women

Our plain-English summary of Presence of asbestos in peritoneal malignant mesotheliomas in women, by D.S. Heller, R.E. Gordon, P.B. Clement, et al (International Journal of Gynecological Cancer, 1999).

The study

• Authors: D.S. Heller, R.E. Gordon, P.B. Clement, R. Turnnir, N. Katz
• Journal: International Journal of Gynecological Cancer
• Published: 1999;9(6):452-455
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Heller DS, Gordon RE, Clement PB, Turnnir R, Katz N. Presence of asbestos in peritoneal malignant mesotheliomas in women. Asbestos plays a causal role in pleural mesotheliomas. The role in peritoneal mesotheliomas is less clear, particularly in women, who are less likely to have an exposure history. Seven peritoneal malignant mesotheliomas in women with no recorded asbestos exposure were analyzed in this report. Tissue digestion was performed on paraffin blocks of tumor. Transmission electron microscopy, energy-dispersive spectroscopy, and electron diffraction were performed for tissue fiber burden and fiber identification. Asbestos fiber burdens were present in 6 cases. Two showed crocidolite, 2 showed chrysotile, one showed chrysotile and amosite, and one showed chrysotile and tremolite. Fiber burdens ranged from 56,738 to 1,963,250 fibers per gram wet weight tissue. All fibers counted were between 1 and 5 microns. This study demonstrates asbestos in peritoneal mesotheliomas in women. Asbestos may play a role in the development of these tumors.

In plain English

This laboratory study examined tumor tissue from seven women with malignant mesothelioma of the peritoneum (the lining of the abdomen) whose reviewed records showed no known asbestos exposure. Six cases came from a multi-institution study's consultation files and one from an author. The cases dated back as far as 1973. The authors dissolved tissue from stored paraffin tumor blocks and used electron microscopy to count and identify fibers. Asbestos was found in 6 of the 7 tumors: crocidolite in two, chrysotile in two, chrysotile with amosite in one, and chrysotile with tremolite in one. The seventh tumor showed fibrous silica. Asbestos levels ranged from 56,738 to 1,963,250 fibers per gram wet weight of tissue. The average across the six tumors with asbestos was 494,106 fibers per gram. In the authors' earlier study, normal ovarian tissue from women with no exposure history averaged 515,931 fibers per gram. No contamination of paraffin or solutions was detected. The authors concluded that asbestos is often present in these tumors. They stated that the study does not ascribe causality and that indirect exposure could not be entirely ruled out.

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: laboratory analysis of fibers in archived tumor tissue using analytical electron microscopy (tissue digestion, transmission electron microscopy, energy-dispersive spectroscopy, electron diffraction). Cases from the authors' previous study were used as controls.
• Who was studied: 7 women with peritoneal malignant mesothelioma and no known asbestos exposure in reviewed records. Six cases came from archival consultation material of a multi-institution study and one was contributed by an author. Cases dated back as far as 1973. Controls were women with no exposure history from the authors' previous study of ovarian tissue.
• Exposure: No recorded or known asbestos exposure. The study measured asbestos fiber burden and fiber type in tumor tissue from paraffin blocks, expressed per gram wet weight.
• Main results:
  • Asbestos fibers were detected in the tumors of 6 of the 7 women.
  • Fiber types: crocidolite in 2 cases, chrysotile in 2, chrysotile and amosite in 1, chrysotile and tremolite in 1.
  • The remaining case showed fibrous silica rather than asbestos. Its asbestos burden was below the detection limit of 10,087 fibers per gram wet weight.
  • All fibers counted were 1 to 5 microns long, with aspect ratios greater than 5.
  • Tumor fiber burdens ranged from 56,738 to 1,963,250 fibers per gram wet weight of tissue in the six asbestos-positive cases.
  • The mean fiber burden in the tumor tissue was 494,106 fibers per gram wet weight. This equals the average of the six asbestos-positive tumors listed in Table 2. The mean in normal ovarian tissue from control women with no exposure history (previous study) was 515,931 fibers per gram wet weight.
  • No asbestos contamination of paraffin or laboratory solutions was detected.
• The authors' conclusion: The authors concluded that asbestos is often present in the peritoneal mesotheliomas of women with no known exposure history. They said further studies are needed to evaluate whether relatively low intra-abdominal fiber burdens cause these tumors.
• Limitations the authors state:
  • The study does not establish that asbestos caused the tumors.
  • Most cases came from a consultation practice, so indirect asbestos exposure cannot be entirely excluded.
  • Several tissue specimens were small, which may partly explain the fairly low fiber burdens.
  • Only tumor tissue was available for retrospective analysis. Higher burdens may be present in adjacent benign tissue.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleural Mesothelioma, Peritoneal Mesothelioma, Exposure History, Asbestos Exposure, Tissue Digestion, Paraffin Block, Transmission Electron Microscopy (TEM).

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• Papillary peritoneal tumors in women — A. Foyle, M. Al-Jabi, et al. (1981)
• Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma — G.H. Eltabbakh, M.S. Piver, et al. (1999)
• Asbestos exposure and differences in occurrence of peritoneal mesothelioma between men and women across countries — A. Burdorf, B. Järvholm, et al. (2007)
• Asbestos textile production linked to malignant peritoneal and pleural mesothelioma in women: Analysis of 28 cases in Southeast China — Z. Gao, K. Hiroshima, et al. (2015)

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