Abstract
Background: pleural mesothelioma is a rare cancer in the general population, but it is more common in subjects occupationally exposed to asbestos. Studies with asbestos fiber quantification in pleural tissue are scarce: for this reason, we aimed at undertaking a scoping review to summarize the evidence provided by studies in which asbestos fibers were determined by electron microscopy (SEM or TEM) in human pleural tissues, whether normal or pathologic. Materials and methods: A scoping review of articles that quantified asbestos fibers in human pleural tissue (normal or pathologic) by electron microscopy (SEM or TEM), in subjects with asbestos exposure (if any) was performed. Results: The 12 studies selected comprised 137 cases, out of which 142 samples were analyzed. Asbestos fibers were detected in 111 samples (78%) and were below the detectable limit in 31 samples (22%). The concentration of asbestos fibers detected in the positive samples was distributed from as low as 0.01 mfgdt (millions of fibers per gram of dry tissue) up to 240 mfgdt. However, the minimum concentration of fibers overlaps in the three types of tissues (normal pleura, pleural plaque, mesothelioma) in terms of magnitude; therefore, it is not possible to distinguish a definite pattern which differentiates one tissue from the other. Conclusions: The studies included were heterogeneous as to the representativeness of the samples and analytical techniques; the possibility of false negatives must be considered. It would be desirable to systematically search for asbestos fibers to fill the knowledge gap about the presence of asbestos fibers in normal or pathological pleural tissue in order to better understand the development of the different pleural diseases induced by this mineral.
Highlights
Introduction published maps and institutional affilAsbestos is a carcinogenic mineral and is the primary risk factor for malignant mesothelioma in the pleura, peritoneum, and other mesothelial tissues [1], in addition to being a risk factor for lung cancer and other diseases
Pleural mesothelioma is a rare disease in people not exposed to asbestos, with an estimated incidence of 1–2 per million per year [2]; in cohorts of subjects occupationally exposed to asbestos, up to 10% of deaths may be caused by malignant mesothelioma [3]
We aimed at undertaking a scoping review to summarize the evidence provided by studies in which asbestos fibers were determined by electron microscopy
Summary
Asbestos is a carcinogenic mineral and is the primary risk factor for malignant mesothelioma in the pleura, peritoneum, and other mesothelial tissues [1], in addition to being a risk factor for lung cancer and other diseases. Pleural mesothelioma is a rare disease in people not exposed to asbestos, with an estimated incidence of 1–2 per million per year [2]; in cohorts of subjects occupationally exposed to asbestos, up to 10% of deaths may be caused by malignant mesothelioma [3]. Especially amphiboles, have a long persistence in tissues and their presence has been studied for almost 50 years in humans [4], especially with electron microscopy (scanning-SEM or Transmission-TEM) [5]. Determination of asbestos fibers in the pleural iations
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