Pneumosclerotic changes in lung tissues as a sign of tumor transformation in workers of the main professions of coal mines

Introduction. The workers of coal mines are characterized by a high level of not only occupational diseases, but also oncological diseases. Modern knowledge in the field of studying pneumoconiosis contains many contradictions in the assessment of the pathogenetic mechanisms of lung damage, in particular, the morphogenesis of neoplastic changes in the respiratory system at the final stage of the disease with pronounced sclerotic changes. The study is devoted to the occurrence and development of tumor tissue in the miners working in the underground conditions. The task is to identify morphological trigger mechanisms for the development of oncological pathology in miners, relying on pathomorphological, immunohistochemical studies of the changes in the epithelial tissue of the airways, as well as various cellular communities of the bronchi, blood vessels of the lungs and lung tissue parenchyma using the example of epithelial-mesenchymal transformation under dust load.

The purpose of this study was to determine the influence of the fibroplastic process on the development of oncological pathology in miners who worked in underground conditions.

Materials and methods. Histological, immunohistochemical and morphometric studies of the respiratory system obtained during 50 autopsy works of a group of Kuzbass miners working in underground conditions was carried out. Cancer of various localization and histogenetic affiliation was previously diagnosed in 20 miners. The mucous membrane of the bronchi, respiratory tissue of the lungs, arteries and veins of the pulmonary circulation were studied. Immunohistochemical study was performed using monoclonal antibodies (marker of proliferation Ki-67, oncogene of proapoptotic activity Bcl-2, growth and neoangiogenesis factors, endothelial function factors CD-31 and CD-34, marker of epithelial tissue cytokeratin (cyt), muscle tissue markers — actin, desmin, vimentin, connective tissue markers — collagen, laminil, markers of intercellular interactions EMA, SMA).

Results. Transformed fibroblasts, myofibroblasts are a cell population of dedifferentiated epithelial tissue with different expressions of nonspecific markers (desmin, actin, vimentin), capable of tumor transformation. Sclerotic tissue changes in pneumoconiosis are the areas of tumor transdifferentiation. Fibroblasts with an altered phenotype, namely myofibroblasts, are able to give rise to the growth of undifferentiated mesenchymal cell communities (tumor tissue), including atypical epithelial cells, adipocytes, chondrocytes and endotheliocytes.

Conclusions. Epithelial-mesenchymal transformation can be a triggering mechanism for the development of tumor transformation from extensive fibrosed zones in miners with dust lung pathology. In this case, the main etiological factor of tumor progression is activated fibroplastic cells.

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