Simple quantitative analysis of asbestos body using the sediment of formalin injected into surgically resected lung cancers

Our plain-English summary of Simple quantitative analysis of asbestos body using the sediment of formalin injected into surgically resected lung cancers, by Y. Sakai, C. Ohbayashi, H. Itami, et al (Pathology International, 2010).

The study

• Authors: Y. Sakai, C. Ohbayashi, H. Itami, K. Kajimoto, T. Sakuma, K. Uchino, M. Yoshimura, S. Matsumoto, Y. Idei, T. Oka
• Journal: Pathology International
• Published: 2010;60(2):78-86
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A simple screening method for quantitatively analyzing asbestos bodies that can be carried out even in community hospitals, is needed in order for laborers and neighborhoods in the vicinity of asbestos factories to apply for compensation for asbestos-related injury. Eighty-eight consecutive cases of surgically resected primary lung cancer were analyzed for asbestos bodies using two methods, and the correlation between them was statistically examined. The first was the conventional technique using lung tissue digestion and phase-contrast scanning, and the second was the authors' method using light microscopy to scan the sediment of formalin-injected lung specimens. The overall correlation coefficient of the concentration of asbestos bodies between the authors' method (C(AB/SED)) and the conventional method (C(AB/DLT)) was 0.4576, a weak statistically significant correlation; in patients with occupational asbestos exposure, however, the correlation coefficient was 0.7341. Despite the cost, it may be prudent to use the conventional method under the present law for patients with C(AB/SED)>or=3.5/mL. C(AB/DLT) >3000/g dry lung tissue when C(AB/SED) is >or=3.5/mL suggests the potential for the accumulation of asbestos absorption by lung tissue.

In plain English

This study, from Hyogo Cancer Center in Japan, compared two ways of counting asbestos bodies in lungs removed during surgery for primary lung cancer. It covered 88 consecutive patients operated on from August 2007 to March 2008. The standard method dissolves lung tissue and counts asbestos bodies per gram of dry tissue by phase-contrast microscopy. The authors' method counts them per milliliter in the formalin wrung by hand from the inflated lung, using an ordinary light microscope. Overall, the two counts showed a weak but statistically significant correlation (coefficient 0.4576). Among the 11 men with occupational asbestos exposure, the coefficient was 0.7341. Some patients showed large mismatches: one had no asbestos bodies detected in the formalin but 3637 per gram of dry lung tissue. The authors partly attributed the imperfect agreement to differences in formalin collection and lung sampling site. They concluded their method could serve as a simple, low-cost screen. They wrote that more than 3.5 bodies per milliliter may be equivalent to more than 3000 per gram of dry lung tissue and may indicate seeking the standard test for compensation.

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: Method-comparison study: two laboratory methods for counting asbestos bodies applied to the same surgically resected lung specimens, compared with Spearman's correlation
• Who was studied: 88 consecutive patients (60 men, 28 women, aged 42 to 85) who had surgery for primary lung cancer at Hyogo Cancer Center, Japan, from August 2007 to March 2008. Eleven men reported occupational asbestos exposure, and all of them were smokers or ex-smokers.
• Exposure: Asbestos bodies in lung specimens, counted two ways: (1) the authors' method, using the sediment of formalin injected into the resected lung and then wrung out (asbestos bodies per mL, read by light microscopy); (2) the conventional method, using lung tissue digestion and phase-contrast scanning (asbestos bodies per g dry lung tissue). Occupational exposure history was recorded. Fiber types were not identified in this study.
• Main results:
  • All 88 patients: the correlation between the formalin-sediment count and the lung-tissue digestion count was 0.4576, which the authors called a weak statistically significant correlation.
  • Patients with occupational asbestos exposure (11 men): the correlation coefficient between the two methods was 0.7341.
  • Large discrepancies occurred in individual patients. One subject had 0 asbestos bodies per mL of formalin (none detected by the sediment method) despite 3637 per g dry lung tissue. Another had 0 per g dry lung tissue despite 5.24 per mL of formalin.
  • Patients with 5000 or more asbestos bodies per g dry lung tissue had 4.60 plus or minus 6.42 asbestos bodies per mL of formalin. Patients below 5000 per g had 0.46 plus or minus 2.85 per mL. The difference was statistically significant (P = 0.0022).
  • Patients with 3000 or more asbestos bodies per g dry lung tissue had 3.48 plus or minus 7.36 per mL of formalin. Patients below 3000 per g had 0.29 plus or minus 1.65 per mL. The difference was statistically significant (P less than 0.0001).
  • Smokers or ex-smokers and non-smokers differed significantly in the formalin-sediment count (P = 0.0001) but not in the lung-tissue digestion count (P = 0.0838).
• The authors' conclusion: The authors concluded that their method may be difficult to correlate with the conventional technique but could serve as a simple and low-cost method for routine examinations. They wrote that more than 3.5 asbestos bodies per mL of formalin may be equivalent to more than 3000 per g dry lung tissue, and may be an indicator of applying for compensation after the conventional analysis. They suggested that, despite the cost, the conventional method may be prudent under the present law for patients at or above 3.5 per mL.
• Limitations the authors state:
  • The researchers differed in the timing and extent of formalin collection and in the site of lung tissue sampled. The authors also named asbestos fiber types and time since exposure as reasons the correlation was not stronger.
  • The distribution of asbestos bodies and fibers may differ even within the same lobe of the lung.
  • Asbestos body analysis applies mainly to amphibole, because chrysotile is less biopersistent in lung tissue.
  • The authors stated that further study is needed to clarify the discrepancies between the two methods.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Body Formation, Lung Cancer, Asbestos Bodies, Tissue Digestion, Asbestos Exposure.

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