Prognostic Implication of Exfoliative Airway Pathology in Cancer-Free Coal Workers’ Pneumoconiosis

Uiju Cho, Tae-Eun Kim, Chan Kwon Park, Hyoung-Kyu Yoon, Young Jo Sa, Hyo-Lim Kim and Tae-Jung Kim ()
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Uiju Cho: Department of Hospital Pathology, St. Vincent Hospital, The Catholic University of Korea, 93 Jungbu-daero, Suwon 16247, Korea
Tae-Eun Kim: Department of Hospital Pathology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Seoul 07345, Korea
Chan Kwon Park: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
Hyoung-Kyu Yoon: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
Young Jo Sa: Department of Thoracic Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Seoul 07345, Korea
Hyo-Lim Kim: Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Seoul 07345, Korea
Tae-Jung Kim: Department of Hospital Pathology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Seoul 07345, Korea

IJERPH, 2022, vol. 19, issue 22, 1-14

Abstract: Background: The purpose of this study is to see if exfoliative pulmonary airway pathology in cancer-free coal workers’ pneumoconiosis (CWP) can be used as a biomarker for predicting pulmonary morbidity. Methods: We investigated persistent metaplastic changes in bronchoscopic washing cytology and differential cell counts in bronchoalveolar lavages (BAL) in 97 miners with CWP and 80 miners without CWP as the control. Clinicopathological parameters were examined including pulmonary function tests and the presence of progressive massive fibrosis. Results: When compared to the control group, severe alveolitis, severe goblet cell hyperplasia (GCH), severe hyperplastic epithelial change, and severe squamous metaplasia were the distinguishing biomarkers in CWP. Multivariate analysis revealed that severe alveolitis and severe GCH, along with miner duration and current smoker, were independent predictors of pulmonary mortality. The survival analysis revealed a significantly different survival rate between the three groups: no evidence of severe alveolitis and severe GCH, presence of severe alveolitis or severe GCH but not both, and both severe alveolitis and severe GCH. Conclusions: The severities of alveolitis and goblet cell hyperplasia in the bronchoscopic study are independent prognostic factors for CWP. A pathologic grading system based on these two parameters could be used in the stratification and clinical management of CWP patients.

Keywords: pneumoconiosis; alveolitis; progressive massive fibrosis; coal worker; miner; cytology; bronchial washing; goblet cell hyperplasia; squamous metaplasia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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