间皮瘤

间皮瘤
同义词	恶性间皮瘤
	电脑断层影像显示左侧间皮瘤合并纵膈淋巴结肿大。
症状	呼吸困难、腹部肿胀、胸壁疼痛、咳嗽、感觉疲惫、体重下降
并发症	肋膜积液（英语：pleural effusion）
常见始发于	渐发性
类型	asbestos-related disease[]、cell type cancer[]、疾病
肇因	暴露于石棉之后约40年
风险因子	遗传学、感染猿猴空泡病毒40（SV40）
诊断方法	医学影像、恶性积液检验、活体组织切片
预防	减少石棉暴露
治疗	外科手术、放射线疗法、化学疗法、肋膜黏连术
预后	五年存活率：约8%（美国）
盛行率	60,800（2015年）
死亡数	32,400（2015年）
分类和外部资源
医学专科	肿瘤学
ICD-11	XH0XV0
OMIM	156240
DiseasesDB	8074
MedlinePlus	000115
eMedicine	280367
	[编辑此条目的维基数据]

间皮瘤（Mesothelioma）是一种源自于覆盖内脏表面的薄层组织（间皮细胞）的癌症^[9]。最常患病的部位是胸膜^[1]^[3]。腹膜也有，但较少见。在罕见的情下会出现在心包膜^[10]或睾丸鞘膜（英语：tunica vaginalis）^[1]^[11]。间皮瘤的症状有因肺中液体潴留（英语：pleural effusion）造成的呼吸困难、腹部肿胀、胸壁疼痛、咳嗽、疲倦，以及体重减轻^[1]。这些症状出现的速度一般而言较为缓慢^[2]。

超过80%的间皮瘤是由暴露在含石棉的环境中所导致的^[3]。暴露程度越高，风险越大^[3]。截至2013年，约有1.25亿人曾在工作环境中接触石棉^[12]。患病比例较高的族群有：石棉矿的矿工、将石棉加工制做成产品的人、工作时会接触石棉制品的人、和以上这些人同住的人，以及在含有石棉的建筑物中工作的人^[3]。从暴露石棉到癌症出现大约相隔40年^[3]。清洗石棉工作者的衣物也会增加清洗者的罹病风险^[12]。其他风险因子包含遗传以及被SV40病毒感染^[3]。间皮瘤可以用胸部X光及X射线计算机断层成像进行初步诊断，再用细胞生物学或是活体组织切片来确诊^[2]。

预防的重点为减少石棉暴露^[4]。间皮瘤的治疗通常包括手术、放射线疗法，及化学疗法^[5]。有一种称为肋膜黏连术的术式，是用滑石之类的物质使胸膜产生疤痕并沾黏在一起，可用来防止肺部积水增加^[5]。化疗一般会用顺铂及培美曲塞（英语：pemetrexed）^[2]。在美国，患者的五年存活率平均而言为8%^[6]。

在2015年，约有60800人罹患间皮瘤，其中32000人因此死亡^[7]^[8]。世界各地的间皮瘤发生率依地区而不同^[3]，在澳洲及英国的发生率较高，在日本则较低^[3]。在美国，每年约有3000个人得到此病^[13]，男性得到此病的比率比女性高^[3]。自1950年起，此病的发生率便呈现上升的趋势^[3]。被诊断出此病时病患大多年过65，且大多在七十岁左右死亡^[3]。在石棉的商业化应用问世以前，这个疾病非常罕见^[3]。

预防[编辑]

香港于2008年修订了《肺尘埃沉着病(补偿)条例》（正名为《肺尘埃沉着病及间皮瘤(补偿)条例》），给予间皮瘤患者相当于尘肺病患者的补偿待遇，理据是两者同是暴露于石棉环境的后遗症。

参考资料[编辑]

^ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 Malignant Mesothelioma Treatment–Patient Version (PDQ®). NCI. 2015-09-04 [2016-04-03]. （原始内容存档于2016-04-05）.
^ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 Kondola, S; Manners, D; Nowak, AK. Malignant pleural mesothelioma: an update on diagnosis and treatment options.. Therapeutic Advances in Respiratory Disease. 2016-02-12, 10 (3): 275–88. PMC 5933604 . PMID 26873306. doi:10.1177/1753465816628800.
^ ^3.00 ^3.01 ^3.02 ^3.03 ^3.04 ^3.05 ^3.06 ^3.07 ^3.08 ^3.09 ^3.10 ^3.11 ^3.12 ^3.13 Robinson, BM. Malignant pleural mesothelioma: an epidemiological perspective.. Annals of Cardiothoracic Surgery. November 2012, 1 (4): 491–6. PMC 3741803 . PMID 23977542. doi:10.3978/j.issn.2225-319X.2012.11.04.
^ ^4.0 ^4.1 Whittemore, Alice S. Cancer epidemiology and prevention 3rd. Oxford: Oxford University Press. 2006: 669 [2020-03-08]. ISBN 9780199747979. （原始内容存档于2021-03-07）.
^ ^5.0 ^5.1 ^5.2 Malignant Mesothelioma Treatment–Patient Version (PDQ®). NCI. 2015-09-04 [2016-04-03]. （原始内容存档于2016-04-05）.
^ ^6.0 ^6.1 Age-Adjusted SEER Incidence and U.S. Death Rates and 5-Year Relative Survival (Percent) By Primary Cancer Site, Sex and Time Period (PDF). NCI. [2016-04-03]. （原始内容存档 (PDF)于2015-09-06）.
^ ^7.0 ^7.1 GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 2016-10-08, 388 (10053): 1545–1602. PMC 5055577 . PMID 27733282. doi:10.1016/S0140-6736(16)31678-6.
^ ^8.0 ^8.1 GBD 2015 Mortality and Causes of Death, Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 2016-10-08, 388 (10053): 1459–1544. PMC 5388903 . PMID 27733281. doi:10.1016/s0140-6736(16)31012-1.
^ Malignant Mesothelioma—Patient Version. NCI. January 1980 [2016-04-03]. （原始内容存档于2016-04-06）.
^ Sardar, MR; Kuntz, C; Patel, T; Saeed, W; Gnall, E; Imaizumi, S; Lande, L. Primary pericardial mesothelioma unique case and literature review.. Texas Heart Institute Journal / From the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 2012, 39 (2): 261–4. PMC 3384041 . PMID 22740748.
^ Panou, V; Vyberg, M; Weinreich, UM; Meristoudis, C; Falkmer, UG; Røe, OD. The established and future biomarkers of malignant pleural mesothelioma.. Cancer Treatment Reviews. June 2015, 41 (6): 486–95. PMID 25979846. doi:10.1016/j.ctrv.2015.05.001.
^ ^12.0 ^12.1 Gulati, M; Redlich, CA. Asbestosis and environmental causes of usual interstitial pneumonia.. Current Opinion in Pulmonary Medicine. March 2015, 21 (2): 193–200. PMC 4472384 . PMID 25621562. doi:10.1097/MCP.0000000000000144.
^ What are the key statistics about malignant mesothelioma?. American Cancer Society. 2016-02-17 [2016-04-03]. （原始内容存档于2016-04-08）.

外部链接[编辑]

香港肺尘埃沉着病补偿基金委员会官方网页上的介绍

ATSDR — Case Studies in Environmental Medicine: Asbestos Toxicity （页面存档备份，存于互联网档案馆） U.S. Department of Health and Human Service (public domain)
Mesothelioma: Questions and Answers from the U.S. National Cancer Institute
Cancer.gov: Malignant Mesothelioma （页面存档备份，存于互联网档案馆） from the U.S. National Cancer Institute
Mesothelioma from the American Cancer Society
Malignant Mesothelioma （页面存档备份，存于互联网档案馆） review article from the American Cancer Society
Medlineplus: Mesothelioma （页面存档备份，存于互联网档案馆） from MEDLINE, part of the United States National Library of Medicine
Worksafe, Western Australia, from Western Australia's Department of Consumer and Employment Protection（英语：Department of Consumer and Employment Protection）
US Nat'l Institute for Occupational Safety and Health （页面存档备份，存于互联网档案馆）, from the Centers for Disease Control
Australian Mesothelioma Register （页面存档备份，存于互联网档案馆）
What is Mesothelioma? Research and advocacy from the Mesothelioma Applied Research Foundation（英语：Mesothelioma Applied Research Foundation）
Radiology of mesotheliomas, with additional examples （页面存档备份，存于互联网档案馆） from Radiopaedia.org
Information （页面存档备份，存于互联网档案馆） from Cancer Research UK
UK mesothelioma statistics from Cancer Research UK
Malignant Pleural Mesothelioma NCCN Patient Guidelines for Malignant Pleural Mesothelioma National Comprehensive Cancer Network（英语：National Comprehensive Cancer Network）

[NCI2015Pt-1] 1.0 ^1.1 ^1.2 ^1.3 ^1.4 Malignant Mesothelioma Treatment–Patient Version (PDQ®). NCI. 2015-09-04 [2016-04-03]. （原始内容存档于2016-04-05）.

[Kon2016-2] 2.0 ^2.1 ^2.2 ^2.3 ^2.4 Kondola, S; Manners, D; Nowak, AK. Malignant pleural mesothelioma: an update on diagnosis and treatment options.. Therapeutic Advances in Respiratory Disease. 2016-02-12, 10 (3): 275–88. PMC 5933604 . PMID 26873306. doi:10.1177/1753465816628800.

[Rob2012-3] 3.00 ^3.01 ^3.02 ^3.03 ^3.04 ^3.05 ^3.06 ^3.07 ^3.08 ^3.09 ^3.10 ^3.11 ^3.12 ^3.13 Robinson, BM. Malignant pleural mesothelioma: an epidemiological perspective.. Annals of Cardiothoracic Surgery. November 2012, 1 (4): 491–6. PMC 3741803 . PMID 23977542. doi:10.3978/j.issn.2225-319X.2012.11.04.

[Whit2006-4] 4.0 ^4.1 Whittemore, Alice S. Cancer epidemiology and prevention 3rd. Oxford: Oxford University Press. 2006: 669 [2020-03-08]. ISBN 9780199747979. （原始内容存档于2021-03-07）.

[NCI2015PtTx-5] 5.0 ^5.1 ^5.2 Malignant Mesothelioma Treatment–Patient Version (PDQ®). NCI. 2015-09-04 [2016-04-03]. （原始内容存档于2016-04-05）.

[SEER2016-6] 6.0 ^6.1 Age-Adjusted SEER Incidence and U.S. Death Rates and 5-Year Relative Survival (Percent) By Primary Cancer Site, Sex and Time Period (PDF). NCI. [2016-04-03]. （原始内容存档 (PDF)于2015-09-06）.

[GBD2015Pre-7] 7.0 ^7.1 GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 2016-10-08, 388 (10053): 1545–1602. PMC 5055577 . PMID 27733282. doi:10.1016/S0140-6736(16)31678-6.

[GBD2015De-8] 8.0 ^8.1 GBD 2015 Mortality and Causes of Death, Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 2016-10-08, 388 (10053): 1459–1544. PMC 5388903 . PMID 27733281. doi:10.1016/s0140-6736(16)31012-1.

[9] Malignant Mesothelioma—Patient Version. NCI. January 1980 [2016-04-03]. （原始内容存档于2016-04-06）.

[Sar2012-10] Sardar, MR; Kuntz, C; Patel, T; Saeed, W; Gnall, E; Imaizumi, S; Lande, L. Primary pericardial mesothelioma unique case and literature review.. Texas Heart Institute Journal / From the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 2012, 39 (2): 261–4. PMC 3384041 . PMID 22740748.

[Pan2015-11] Panou, V; Vyberg, M; Weinreich, UM; Meristoudis, C; Falkmer, UG; Røe, OD. The established and future biomarkers of malignant pleural mesothelioma.. Cancer Treatment Reviews. June 2015, 41 (6): 486–95. PMID 25979846. doi:10.1016/j.ctrv.2015.05.001.

[Gul2015-12] 12.0 ^12.1 Gulati, M; Redlich, CA. Asbestosis and environmental causes of usual interstitial pneumonia.. Current Opinion in Pulmonary Medicine. March 2015, 21 (2): 193–200. PMC 4472384 . PMID 25621562. doi:10.1097/MCP.0000000000000144.

[13] What are the key statistics about malignant mesothelioma?. American Cancer Society. 2016-02-17 [2016-04-03]. （原始内容存档于2016-04-08）.

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