Mesothelioma-A plea for biologic research
Mesothelioma-A plea for biologic research
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间皮瘤-生物研究的呼吁
DOI：
10.1002/ajim.4700070302
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发表时间：
1985
影响因子：
3.5
通讯作者：
J. Craighead
中科院分区：
文献类型：
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作者：
J. Craighead
当代医学上很少有话题比独特的石棉相关肿瘤恶性间皮瘤引起更多争议。流行病学家争论不同矿物类型的石棉诱发肿瘤的能力是否不同。病理学家不同意，并致力于完善工具以明确诊断。卫生官员正在思考和辩论学校和其他公共建筑中石棉的危害，而公民则惊愕地看着。律师们以高昂的成本提起无数的人身伤害诉讼。尽管所有这些努力都具有明显的医学和社会重要性，但我们必须问科学正在为那些接触石棉并有患间皮瘤风险的人做些什么。为什么我们不能更多地了解这种疾病的发病机制？遗憾的是，在过去的十年中，相对较少的癌症生物学家将注意力集中在这种癌症上。间皮瘤现已成为一个毁灭性的临床问题，毫无疑问，这种情况在未来几十年仍将持续。我们是否动员了科学人力来解决与间皮瘤发展相关的复杂生物学问题？答案显然是否定的。到目前为止，目前我们对肿瘤过程理解的革命很大程度上没有提供关于间皮瘤如何发展以及如何在其进化的早期、可逆阶段检测和治疗这些病变的新见解。 Wagner 及其同事的探路贡献 [Wagner et al, 19601] 引导我们研究纤维变异作为致癌的关键因素。 Stanton 和 Wrench [1972] 的研究进一步深入了解了这一概念，并证明了动物模型对于探索与间皮瘤有关的科学问题的有用性。然而，今天我们还没有利用这些模型来更彻底地检验“斯坦顿假说”及其与人类疾病的真正相关性。科学家们仍然以模糊的术语讨论平滑体癌发生的概念，很难理解它在当代的含义，也不知道它是否适用于间皮瘤的发病机制。然而我们对这种疾病没有其他合理的解释。显然需要新的想法。
Few topics of contemporary medical importance provoke more controversy than the unique asbestos-associated neoplasm-malignant mesothelioma. Epidemiologists argue as to whether the various mineralogical types of asbestos differ in their capacity to induce the tumor. Pathologists disagree and work to perfect tools to establish the diagnosis definitively. Health officials ponder and debate the hazards of asbestos in schools and other public buildings, as citizens look on in dismay. And attorneys litigate, at extraordinary cost, endless numbers of personal injury suits. While all of these efforts have their obvious medical and societal importance, we must ask what science is doing for those who have been exposed to asbestos and are at risk of developing mesothelioma. Why don’t we know more about the pathogenesis of this disease?Alas, during the past decade, relatively few cancer biologists have focused their attention on this cancer. Mesothelioma is now a reality as a devastating clinical problem, and doubtless it will continue to be for decades into the future. Have we mobilized our scientific manpower to address the complex biological problems related to the development of mesothelioma? The answer quite obviously is no. Thus far, the current revolution in our understanding of the neoplastic process has largely occurred without providing new insights into how mesotheliomas develop and how it might be possible to detect and treat these lesions at an early, reversible stage in their evolution. The pathfinding contributions of Wagner and his colleagues [Wagner et al, 19601 led us to the investigation of fiber variation as a key factor in carcinogenesis. The studies of Stanton and Wrench [1972] provided further insight into this concept and demonstrated the usefulness of animal models for exploring scientific questions concerned with mesothelioma. Yet, today we have not capitalized on these models to examine more thoroughly the “Stanton hypothesis” and its true relevance to disease in man. Scientists still discuss in vague terms the concept of smooth body carcinogenesis, hardly understanding in contemporary terms what it means and not knowing whether it applies to the pathogenesis of mesothelioma. Yet we have no other reasonable explanation for the disease. New ideas clearly are needed.