間皮瘤 - 维基百科,自由的百科全书
間皮瘤 | |
---|---|
又称 | 惡性間皮瘤 |
電腦斷層影像顯示左側間皮瘤合併縱膈淋巴結腫大。 | |
症状 | 呼吸困难、腹部腫脹、胸壁疼痛、咳嗽、感覺疲憊、體重下降[1] |
併發症 | 肋膜積液[1] |
起病年龄 | 漸發性[2] |
类型 | asbestos-related disease[*]、cell type cancer[*]、疾病 |
病因 | 暴露於石棉之後約40年[3] |
风险因素 | 遗传学、感染猿猴空泡病毒40(SV40)[3] |
診斷方法 | 醫學影像、惡性積液檢驗、活體組織切片[2] |
預防 | 減少石棉暴露[4] |
治療 | 外科手術、放射線療法、化学疗法、肋膜黏連術[5] |
预后 | 五年存活率:約8%(美國)[6] |
患病率 | 60,800(2015年)[7] |
死亡數 | 32,400(2015年)[8] |
分类和外部资源 | |
醫學專科 | 肿瘤学 |
ICD-11 | XH0XV0 |
OMIM | 156240 |
DiseasesDB | 8074 |
MedlinePlus | 000115 |
eMedicine | 280367 |
間皮瘤(Mesothelioma)是一種源自於覆蓋內臟表面的薄層組織(間皮細胞)的癌症[9]。最常患病的部位是胸膜[1][3]。腹膜也有,但較少見。在罕見的情下會出現在心包膜[10]或睪丸鞘膜[1][11]。間皮瘤的症狀有因肺中液體瀦留造成的呼吸困難、腹部腫脹、胸壁疼痛、咳嗽、疲倦,以及體重減輕[1]。這些症狀出現的速度一般而言較為緩慢[2]。
超過80%的間皮瘤是由暴露在含石棉的環境中所導致的[3]。暴露程度越高,風險越大[3]。截至2013年,約有1.25億人曾在工作環境中接觸石棉[12]。患病比例較高的族群有:石棉礦的礦工、將石棉加工製做成產品的人、工作時會接觸石棉製品的人、和以上這些人同住的人,以及在含有石棉的建築物中工作的人[3]。從暴露石棉到癌症出現大約相隔40年[3]。清洗石棉工作者的衣物也會增加清洗者的罹病風險[12]。其他風險因子包含遗传以及被SV40病毒感染[3]。間皮瘤可以用胸部X光及X射线计算机断层成像進行初步診斷,再用細胞生物學或是活體組織切片來確診[2]。
預防的重點為減少石棉暴露[4]。間皮瘤的治療通常包括手術、放射線療法,及化學療法[5]。有一種稱為肋膜黏連術的術式,是用滑石之類的物質使胸膜產生疤痕並沾黏在一起,可用來防止肺部積水增加[5]。化療一般會用順鉑及培美曲塞[2]。在美國,患者的五年存活率平均而言為8%[6]。
在2015年,約有60800人罹患間皮瘤,其中32000人因此死亡[7][8]。世界各地的間皮瘤發生率依地區而不同[3],在澳洲及英國的發生率較高,在日本則較低[3]。在美國,每年約有3000個人得到此病[13],男性得到此病的比率比女性高[3]。自1950年起,此病的發生率便呈現上昇的趨勢[3]。被診斷出此病時病患大多年過65,且大多在七十歲左右死亡[3]。在石棉的商業化應用問世以前,這個疾病非常罕見[3]。
預防
[编辑]香港於2008年修訂了《肺塵埃沉着病(補償)條例》(正名爲《肺塵埃沉着病及間皮瘤(補償)條例》),給予間皮瘤患者相當于塵肺病患者的補償待遇,理據是兩者同是暴露于石棉環境的後遺症。
參考資料
[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).
外部連結
[编辑]- 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
- 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
- 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