Scherpereel Arnaud
INSERM Unit 774, Institut Pasteur de Lille, France.
Respir Med. 2007 Jun;101(6):1265-76. doi: 10.1016/j.rmed.2006.10.018. Epub 2006 Nov 29.
Previously considered as a rare tumor, malignant pleural mesothelioma (MPM) has become a very important public health issue. In fact, MPM is a tumor with a poor survival, and its incidence is expected to continue to increase for at least the next 10 years. Asbestos exposure is the main factor involved in MPM pathogenesis. The diagnosis of MPM may be difficult because of differential diagnosis such as pleural benign disease induced by asbestos exposure or pleural metastasis of adenocarcinoma. Management of patients with MPM also remains complicated because they are often referred for evaluation late in the evolution of the disease. Moreover, MPM exhibits a high resistance to radiotherapy and chemotherapy; only few patients are candidates for radical surgery. New therapeutic strategies such as gene or cell therapy are still on clinical trial. Therefore, an optimal treatment of MPM is not clearly defined yet, despite the introduction of recent drugs. Between April 2005 and January 2006, the French Speaking Society for Chest Medicine (SPLF), in collaboration with other French scientific societies, brought together experts on mesothelioma to draw up recommendations in order to provide clinicians with clear, concise, up-to-date guidelines on management of MPM, presented in this report.
恶性胸膜间皮瘤（MPM）曾被认为是一种罕见肿瘤，如今已成为一个非常重要的公共卫生问题。事实上，MPM是一种生存率很低的肿瘤，预计其发病率至少在未来10年还会继续上升。石棉暴露是MPM发病机制中的主要因素。由于存在鉴别诊断，如石棉暴露引起的胸膜良性疾病或腺癌的胸膜转移，MPM的诊断可能会很困难。MPM患者的治疗也依然复杂，因为他们在疾病进展后期才常被转诊进行评估。此外，MPM对放疗和化疗表现出高度抗性；只有少数患者适合进行根治性手术。基因或细胞治疗等新的治疗策略仍在临床试验阶段。因此，尽管有近期药物问世，但MPM的最佳治疗方案仍未明确界定。2005年4月至2006年1月期间，法语区胸科医学协会（SPLF）与其他法国科学协会合作，召集间皮瘤专家制定建议，以便为临床医生提供关于MPM管理的清晰、简洁、最新指南，本报告中呈现了这些指南。
