Objectives To determine cell differential counts and the number of asbestos bodies (ABs) in bronchoalveolar lavage (BAL) fluid obtained from patients with asbestosis, and to correlate the results with their survival.
Methods The BAL cell differential counts and ABs from 91 patients with asbestosis were determined. The BAL cell differential counts were analysed in relation to smoking status. BAL cell differential counts and the number of ABs were correlated with the patients’ survivals.
Results A neutrophilic cell pattern was observed independently of smoking habits with both Papanicolau (8.4%) and May-Grunwald-Giemsa (6.5%) staining. Smoking and a high number of ABs (>2 AB/mL) were associated with high total cell counts and high macrophage and low lymphocyte differential counts. The median survival of the patients was 131.8 months. Shortened survival was associated with high numbers of ABs (78 vs 165 months; p=0.042) and low lymphocyte (77 vs 179 months; p=0.005), high neutrophil (102 vs 180 months; p=0.016) and high eosinophil (104 vs170 months; p=0.007) differential counts.
Conclusion A neutrophilic cell pattern was evident in BAL from patients with asbestosis. Smoking and ABs both affected the total cell count and the macrophage and lymphocyte differential counts. Several BAL parameters associated with patient survival, suggesting that BAL cell count analyses could be used in the estimation of the prognosis of patients with asbestosis.
- cytology and histology
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Contributors EK collected the study material, analysed the data and prepared the draft of the manuscript. LV participated in the collection of the study material. RB participated in the statistical data analyses. RK managed and designed the study, planned the data collection form and interpreted the data. All authors have read and approved the final manuscript.
Funding Eerika Keskitalo has received grants for scientific work from the Research Foundation of the Pulmonary Diseases and the Foundation of the Finnish Anti-Tuberculosis Association. Riitta Kaarteenaho has received grants for the study group from the Foundation of the Finnish Anti-Tuberculosis Association, the Research Foundation of the Pulmonary Diseases, the Research Foundation of North Finland, the Jalmari and Rauha Ahokas Foundation and a state subsidy of the Oulu University Hospital.
Competing interests Riitta Kaarteenaho has received a congress travel cost from Orion Pharma; a consulting fee from GSK and lecture fees from Roche, Boehringer-Ingelheim and Ratiopharm.
Ethics approval The study protocol was approved by the Research Ethics Committee of the Northern Ostrobothnia Hospital District, and permission to use data from death certificates was given by Statistics Finland. No consents for the inclusion into this study were collected because of the retrospective design of the study in which most of the patients had already died as well as due to the register-based nature of research in accordance with Finnish legislation.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The dataset generated during this study is available on reasonable request from the corresponding author. The data are not publicly available since it contains information that could compromise research participant privacy.
Correction notice This article has been corrected since it published Online First.
Patient consent for publication Not required.
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