Assessment of Optical and Scanning Electron Microscopies for the Identification and Quantification of Asbestos Fibers and Typical Asbestos Bodies in Human Colorectal Cancer Tissues

Asbestos research, identification, and quantification have been performed over the years, and the relationship between fiber inhalation and lung disease development is well defined. The same cannot be said for the gastroenteric system: the International Agency for Research on Cancer (IARC) believes that colorectal cancer (CRC) could be associated with asbestos exposure, but research has not demonstrated a casual nexus between exposure and CRC, despite highlighting an association tendency. The combination of scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) is the most applied technique in asbestos fiber identification in tissues and intestinal mucosa. In this study, SEM/EDS was applied to evaluate the presence of asbestos fibers and bodies (ABs) inside the tissue of eleven patients affected by CRC who had undergone environmental exposure due to living in an asbestos-polluted area where an Eternit plant had been active in the past. This technique was coupled with optical microscopy (OM) to verify whether the latter could be applied to evaluate the presence of these mineral phases, with the goal of understanding its suitability for identifying fibers and ABs in colon tissues. In addition to verifying the presence of fibers, this study allowed us to identify the deposition site of said fibers within the sample and possibly detect associated tissue reactions using OM, over a shorter time and at lower costs. Despite being a preliminary and descriptive work, the obtained results allowed us to propose a method involving first-sample OM observation to identify regulated (fibers with a length ≥ 5 μm, a thickness ≤ 3 μm, and a length/thickness ratio > 3) asbestos phases and ABs in the extra-respiratory system. In fact, OM and SEM/EDS provided similar information: no asbestiform morphology or ABs were found, but phyllosilicates and other inorganic materials were identified. This research needs to be continued using higher-resolution techniques to definitively rule out the presence of these fibers inside tissues whilst also increasing the number of patients involved.