Rivalutazione del reale ruolo svolto dalla DLCO nella diagnosi precoce dell'asbestosi

To the end of years '70 an association was demonstrated between the intensity of the exposure to asbestos and the presence of not radiological signs of early asbestosis, such as the reduction of alveolus-capillary exchanges and the presence of a ventilatory restrictive deficit. During the last years it was demonstrated that the restrictive syndrome was due to other causes. Also for CO diffusing capacity, thanks to HRCT reports, it was begun that this test didn't represent a premature sign of interstitial damage. We evaluated the alveolus-capillary exchanges in 27 subject exposed to asbestos, all previously undergone to Chest X-ray and HRCT in order to evidence if, in presence of an early radiological interstitial damage, it could co-exist a reduction of CO diffusion. We observed that in 7.4% of cases both Chest X-ray and HRCT showed lesions, in another 29.6% HRCT showed premature lesions not otherwise visible and in the last 63% both the techniques were negative. Nobody of 27 subjects had a reduction of CO diffusion, with the exception of a case. Our experience confirms that alveolus-capillary exchanges is useful far the follow-up of asbestosis, while it places some doubts on its effectiveness in the early diagnosis.