Quantitative Assessment of Asbestos Fibers in Normal and Pathological Peritoneal Tissue-A Scoping Review

Our plain-English summary of Quantitative Assessment of Asbestos Fibers in Normal and Pathological Peritoneal Tissue-A Scoping Review, by Y. Caraballo-Arias, C. Zunarelli, P. Caffaro, et al (Life, 2022).

The study

• Authors: Y. Caraballo-Arias, C. Zunarelli, P. Caffaro, F. Roccuzzo, M.R. Nocilla, M.C. Imperiale, C. Romano, P. Boffetta, F.S. Violante
• Journal: Life
• Published: 2022;12(12)
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Peritoneal tissue is the second most affected site by malignant mesothelioma linked to asbestos exposure. This scoping review aims to summarize the findings of the studies in which asbestos fibers in the peritoneum were quantified by electron microscopy, occasionally associated with spectroscopy, both in neoplastic and non-neoplastic tissue. The 9 studies selected comprised 62 cases, out of whom 100 samples were analyzed. Asbestos fibers were detected in 58 samples (58%). In addition, 28 cases had diagnosis of peritoneal mesothelioma. For 32 cases, a lung tumor sample was available: 28/32 samples analyzed presented asbestos fibers; 18/32 reported amphiboles with a range from not detected to 14.2 million fibers per gram of dry tissue (mfgdt); 18/32 reported chrysotile, with a range of 0 to 90 mfgdt. The studies were heterogeneous for type of samples, analytical technology, and circumstances of exposure to asbestos. To evaluate asbestos fibers in the peritoneum and to better understand the association between asbestos exposure and malignant peritoneal mesothelioma, it is desirable that the search for asbestos fibers becomes a routine process every time peritoneal tissue is accessible.

In plain English

This article is a scoping review. The authors searched three databases for studies that counted asbestos fibers in human peritoneal tissue (the abdominal lining, including the omentum and mesentery) by electron microscopy. They included 9 studies, 8 published between 1989 and 2002, covering 62 cases and 100 samples. Of the 62 cases, 28 had peritoneal mesothelioma and 16 pleural mesothelioma. Asbestos fibers were detected in 58 of the 100 samples and were below the detection limit in 42. In 32 tumor samples from the 28 peritoneal mesothelioma cases, fibers were detected in 28. Amphiboles were found in 18 of 32 samples, at up to 14.2 million fibers per gram of dry tissue, and chrysotile in 18 of 32, at up to 90 million. The authors stated that the studies differed in samples, methods and exposure, were all case series, and lacked data to compare mesothelioma cases with controls. The authors concluded that fiber counting may help identify asbestos-related peritoneal mesothelioma and suggested doing it whenever peritoneal tissue is accessible.

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: Scoping review of published studies that quantified asbestos fibers in human peritoneal tissue by electron microscopy. Three databases (PubMed, Scopus, Embase) were searched on 4 February 2022. All included studies were case series.
• Who was studied: 9 included studies (8 published between 1989 and 2002, 1 after 2002) comprising 62 cases and 100 samples of peritoneal tissue, from autopsies or biopsies. 28 cases had peritoneal mesothelioma, 16 had pleural mesothelioma, and 18 had other diagnoses.
• Exposure: Asbestos fibers measured in peritoneal tissue (tumor tissue, omentum, mesentery), reported as amphiboles (including amosite, crocidolite and tremolite in individual studies) and chrysotile. The subjects in the included studies had occupational, unknown, or no known asbestos exposure.
• Main results:
  • Across all 100 samples, asbestos fibers were detected in 58 (58%) and were below the detection limit in 42 (42%).
  • Of the 62 cases, 28 (45%) were diagnosed with peritoneal mesothelioma and 16 (26%) with pleural mesothelioma.
  • In 32 tumor tissue samples from the 28 peritoneal mesothelioma cases, asbestos fibers were detected in 28/32 (87%) and were below the detection limit in 4/32 (13%).
  • In these tumor samples, amphiboles were found in 18 of 32 samples (4 of 8 studies) and chrysotile in 18 of 32 samples (4 of 8 studies).
  • In the tumor samples, amphiboles ranged from 0.000447 to 14.2 million fibers per gram of dry tissue (mfgdt). Chrysotile ranged from a lowest positive value of 0.33 to 90 mfgdt.
• The authors' conclusion: The authors concluded that quantifying asbestos fibers may be useful in identifying asbestos-related peritoneal malignant mesothelioma. They suggested quantifying fibers whenever peritoneal tissue is accessible and correlating the results with occupational and environmental exposure.
• Limitations the authors state:
  • The included studies were heterogeneous in sample type (autopsy and biopsy), analytical technology, and asbestos exposure.
  • All the reviewed articles were case series, which limits the level of evidence.
  • The studies did not provide enough data to compare mesothelioma cases, non-mesothelioma cases and controls. Many did not specify the anatomical origin of the samples.
  • Most studies are over 20 years old, and fibers may be recognized better with current technology.
  • Negative results may be true negatives due to small samples, or false negatives due to sample preparation or microscopic processing.

Topics

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Asbestos Exposure, Peritoneum, Peritoneal Mesothelioma, Amphibole Group, Fibers Per Gram, Chrysotile.

Related studies

• Quantitative assessment of asbestos fibers in some normal and pathological extra-abdominal tissues-a scoping review — F. Graziosi, P. Caffaro, et al. (2023)
• Quantitative Assessment of Asbestos Fibers in Normal and Pathological Pleural Tissue-A Scoping Review — Y. Caraballo-Arias, P. Caffaro, et al. (2022)
• Quantitative Assessment of Asbestos Fibers in Abdominal Organs: A Scoping Review — Y. Caraballo-Arias, F. Roccuzzo, et al. (2023)
• A trial on the quantitative risk assessment of man-made mineral fibers by the rat intraperitoneal administration assay using the JFM standard fibrous samples — S. Adachi, K. Kawamura, et al. (2001)
• Response to: Pleural mesothelioma, and occupational and non-occupational asbestos exposure: a case-control study with quantitative risk assessment — P. Boffetta (2016)
• Pathways affected by asbestos exposure in normal and tumour tissue of lung cancer patients — S. Ruosaari, T. Hienonen-Kempas, et al. (2008)

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