[Anatomopathological tools for screening and medical surveillance of people exposed to asbestos]

The deleterious effects of asbestos exposure include benign and malignant pleuro-pulmonary lesions leading to considerable morbidity and mortality, underlying the necessity for improvement of early detection strategies. Pathological techniques (morphology and immunohistochemistry) remain the gold standard for diagnosis of asbestos related disorders, together with mineralogic studies and for determination of associated pathological processes. There are yet no reliable pathological tools able to survey and detect asbestos exposed patients which are non invasive, acceptable for the patients and obvious in directing efficient therapy. Three main conclusions are drawn: 1) Promising approach includes EMA immunostaining in the evaluation of suspicious mesothelial lesions; 2) P53, proteases immunostaining and K-Ras mutation analysis in early detection of bronchial preneoplasia; 3) sputum screening for specific tumor markers of transformation (hRNPA2/B1), or morphometric DNA quantification for the detection of subclinical bronchopulmonary carcinomas. These recent developments are the first step of a long road to routine detection of these lesions.