Update on malignant mesothelioma.
Update on malignant mesothelioma.
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DOI：
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发表时间：
2005-09
期刊：
影响因子：
3.5
通讯作者：
K. Antman;R. Hassan;M. Eisner;L. Ries;B. Edwards
中科院分区：
文献类型：
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作者：
K. Antman;R. Hassan;M. Eisner;L. Ries;B. Edwards
间皮瘤在美国并不常见，每年约有3，000例新发病例（或每年每百万美国人约有11例风险）。然而，发病率和死亡率可能被低估了。大多数都与石棉有关，尽管有些是在先前的辐射港口出现的，并且与猿猴病毒（SV）40的报道仍然存在争议。大约85%的间皮瘤发生在胸膜，大约91%发生在腹膜，一小部分发生在心包或图尼卡睾丸迷走神经膜。大约一半的间皮瘤的组织学是上皮性的（管状乳头状），其余的是肉瘤性的或混合性的。多囊性间皮瘤和分化良好的乳头状间皮瘤在缺乏治疗的情况下与长期生存相关，应排除在用于疾病常见的快速致死组织学变异的临床试验之外。中位生存期不到一年，尽管在一些联合治疗的研究中报道了选定患者，特别是上皮组织学患者的中位生存期更长。最近的随机试验表明，在铂类化疗基础上添加新的抗叶酸剂可显著改善疾病进展时间和生存率。
Mesotheliomas are uncommon in the United States, with an incidence of about 3,000 new cases per year (or a risk of about 11 per million Americans per year). Incidence and mortality, however, are probably underestimated. Most are associated with asbestos, although some have arisen in ports of prior radiation, and a reported association with simian virus (SV)40 remains controversial. About 85% of mesotheliomas arise in the pleura, about 91% in the peritoneum, and a small percentage in the pericardium or tunica vaginalis testis. The histology of about half of mesotheliomas is epithelial (tubular papillary), with the remainder sarcomatous or mixed. Multicystic mesotheliomas and well-differentiated papillary mesotheliomas are associated with long survival in the absence of treatment and should be excluded from clinical trials intended for the usual rapidly lethal histologic variants of the disease. The median survival is under a year, although longer median survivals for selected patients, particularly those with epithelial histology, have been reported in some combined-modality studies. Recent randomized trials have shown significant improvement in time to progression and survival for the addition of new antifolates to platinum-based chemotherapy.