ABSTRACT
Objectives To explore and compare the clinical characteristics and risk factors for mortality between patients with artificial quartz stone silicosis and those with classic silicosis. Methods A total of 48 patients with artificial quartz stone silicosis (experiment group) and 98 patients with classic silicosis (control group) were recruited as the research subjects using the convenience sampling method. Data of clinical symptoms, laboratory tests, high-resolution computed tomography (HRCT), and pulmonary pathology of the research subjects were retrospectively analyzed. The Cox proportional hazards regression model was used to analyze the influencing factors on the survival time of silicosis patients. Results Patients in the experiment group had shorter years of dust exposure, latency period and time since last exposure than those in the control group (all P<0.01). The positive rate of anti-nuclear antibodies and the expression of neuron-specific enolase in the experiment group were higher than those in the control group (39.6% vs 10.2%, median： 28.44 vs 16.25, both P<0.01). The PaO2 levels in the experiment group were lower than those in the control group (median： 66.0 vs 89.0, P<0.01). The patients in the experiment group had lower vital capacity, inspiratory reserve volume, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and carbon monoxide diffusion capacity compared to the control group (all P<0.05), but the maximal expiratory flow in 75% vital capacity was higher than the control group (P<0.05). Compared with the control group, patients in the experiment group had the presence of ground-glass opacity (GGO) in both lungs, aggregation and fusion of subpleural nodules, and gradual formation of progressive massive fibrosis (PMF), with higher potential of pneumothorax. Within 5 years after diagnosis, the mortality of patients in the experiment group was higher than that in the control group (27.1% vs 4.1%, P<0.01). The Cox regression model analysis results showed that patients with nodule aggregation on lung HRCT images had a higher risk of mortality than those without nodule aggregation, and lower lung function including vital capacity, FVC, FEV1 and maximum expiratory flow in 25% vital capacity had higher risk of reduced survival time (all P<0.05). Conclusion Compared with patients with classic silicosis, patients with artificial quartz stone silicosis have higher level of serum neuron-specific enolase, increasing the risk of autoimmune diseases. Pulmonary imaging features in patients with artificial quartz stone silicosis include GGO, PMF and susceptibility to pneumothorax, and rare calcification of mediastinal lymph nodes, leading to a higher mortality rate within 5 years after diagnosis.
ABSTRACT
Objective@#To explore the CT imaging features of artificial stone-agglomerated quartz associated silicosis.@*Methods@#A total of 37 cases confirmed with artificial stone-agglomerated quartz associated silicosis from December 2016 to August 2018 and 38 cases confirmed with traditional classical silicosis at the same period were retrospectively reviewed.The clinical characteristics (including gender, age and working age)and the imaging features (including the nodule features, ground glass opacity, merging features, consolidation, secondary changes, etc.) of the two groups were recorded. The variables including the imaging findings between the two groups were analyzed by Fisher exact test.@*Results@#Of all the cases, there were bilateral diffuse small nodules which distributed with upper-zone predominance. Small nodules can merge together and form mass shadow. The complications such as lymphadenopathy, calcification, emphysema/pneumatocele, pulmonary interstitial fibrosis could also be found. Among the various imaging features, the presence of ground glass opacity, small nodules merging together in the subpleural zones, consolidation, pulmonary interstitial fibrosis, pneumothorax were found in 28,16,18,17,5 cases, respectively in artificial stone-agglomerated quartz associated silicosis group, and 2,4,4,4,0 cases, respectively in the traditional classical silicosis group. The percentages of these above signs were higher in the artificial stone-agglomerated quartz associated silicosis group than the traditional classical silicosis group, and the differences were statistically significant (P<0.01). The artificial stone-agglomerated quartz associated silicosis group had 3 cases with mediastinal lymph node enlargement with calcification, while the traditional classical silicosis group had 12 cases. This sign showed a lower significantly incidence in the artificial stone-agglomerated quartz associated silicosis group than the traditional classical silicosis group (P<0.01).@*Conclusion@#The characteristic changes of CT imaging features in artificial stone-agglomerated quartz associated silicosis are small nodules with the background of ground glass opacity, the nodules merging together under subpleural zones, consolidation, mediastinal lymph node enlargement with less calcification and complicated with pulmonary interstitial fibrosis and pneumothorax.
ABSTRACT
Objective To explore the CT imaging features of artificial stone?agglomerated quartz associated silicosis. Methods A total of 37 cases confirmed with artificial stone?agglomerated quartz associated silicosis from December 2016 to August 2018 and 38 cases confirmed with traditional classical silicosis at the same period were retrospectively reviewed.The clinical characteristics(including gender, age and working age)and the imaging features(including the nodule features, ground glass opacity, merging features, consolidation, secondary changes, etc.)of the two groups were recorded. The variables including the imaging findings between the two groups were analyzed by Fisher exact test. Results Of all the cases, there were bilateral diffuse small nodules which distributed with upper?zone predominance. Small nodules can merge together and form mass shadow. The complications such as lymphadenopathy, calcification, emphysema/pneumatocele, pulmonary interstitial fibrosis could also be found. Among the various imaging features, the presence of ground glass opacity, small nodules merging together in the subpleural zones, consolidation, pulmonary interstitial fibrosis, pneumothorax were found in 28,16,18,17,5 cases, respectively in artificial stone?agglomerated quartz associated silicosis group, and 2, 4, 4, 4, 0 cases, respectively in the traditional classical silicosis group. The percentages of these above signs were higher in the artificial stone?agglomerated quartz associated silicosis group than the traditional classical silicosis group, and the differences were statistically significant(P<0.01). The artificial stone?agglomerated quartz associated silicosis group had 3 cases with mediastinal lymph node enlargement with calcification, while the traditional classical silicosis group had 12 cases. This sign showed a lower significantly incidence in the artificial stone?agglomerated quartz associated silicosis group than the traditional classical silicosis group(P<0.01). Conclusion The characteristic changes of CT imaging features in artificial stone?agglomerated quartz associated silicosis are small nodules with the background of ground glass opacity, the nodules merging together under subpleural zones, consolidation, mediastinal lymph node enlargement with less calcification and complicated with pulmonary interstitial fibrosis and pneumothorax.